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Clinical Cases

                                    #9 Anterior RCT/Calcified

• Diagnosis:  Symptomatic Pulpal Necrosis with Normal Periapical Tissues.
• History of trauma, which led to extensive canal calcification.

• History of acute trauma to teeth #8 & #9 with partial extrusion of both teeth. Normal Pulp Vitality of adjacent teeth.
• Teeth repositioned, splinted and RCTs completed.

• Diagnosis:  Irreversible Pulpitis with Normal Periapical Tissues.
• RCT completed under Oral Sedation.

 

• Diagnosis:  Previously opened with seperated file. Normal Periapical Tissues.
• Retrieval of seperated file under the surgical microscope and completion of RCT.

• Diagnosis:  Irreversible Pulpitis with Acute Apical Periodontitis.
• Complicated two-canal RCT successfully performed under the surgical microscope.

• Diagnosis:  Irreversible Pulpitis with Normal Periapical Tissues.
• Four-canal RCT completed.

• Diagnosis:  Irreversible Pulpitits with Normal Periapical Tissues.
• Extremely long and curved canals.
• Crown Lengthening, build-up and crown to follow.

 

• Diagnosis:  Irreversible Pulpitis both teeth, #s 2 & 3, due to recurrent decay.
• Completed RCTs depicting extensive canal curvatures for tooth #3.

 

                                                                    #30 Molar RCT

• Irreversible Pulpitis with Acute Apical Periodontitis.
• Four-canal RCT.  NOTE: Abrupt apical mesial canal curvature.

 

• Diagnosis:  Pulpal Necrosis with Chronic Apical Periodontitis Tooth #18.  Three years later Tooth #19 developed the same condition.
• NOTE: Excellent osseous healing for both cases, especially furcal and D apical bone loss tooth #18.

 

                                                           #30 Molar RCT

• Diagnosis:  Irreversible Pulpitits with Normal Periapical Tissues.
• Completed 5-canal RCT.
• NOTE:  Periapical Enostosis on both roots.

• Diagnosis:  Previous RCT with Acute Apical Periodontitis.
• Retreatment completed using Light Speed for Apical enlargement.

 

• Diagnosis:  Previous RCT (Silver Point) with Acute Apical Periodontitis due to microleakage.
• Calcium Hydroxide used as intracanal medicament for two weeks.
• Final Obturation completed under the surgical microscope using MTA in conjunction with a Collagen Apical Plug.

 

• Diagnosis at time of consult:  Previous RCT with Acute Apical Abscess with blown-out MB lesion.  Questionable prognosis due to suspected fracture.
• One-month re-evaluation revealed WNL soft tissues and normal probing depths.
• Completed Retreatment with previously missed MB2 successfully treated. No fractures detected under magnification. Excellent expected prognosis.

 

• Diagnosis:  Previous RCT with Chronic Apical Periodontitis.
• NOTE: Favorable osseous healing at recall.  This case is now ready for the final restoration.

 

• Diagnosis:  Previous RCT with extensive Chronic Apical Periodontitis.
• Endodontic Microsurgery with MTA retrofill performed under Oral Sedation. NOTE: Signs of apical scar formation.

 

                                                        #20 Premolar Apicoectomy

• Diagnosis:  Previous RCT with Chronic Apical Periodontitis.
• Favorable osseous healing at Recall.

 

                                                         #14 Molar Apicoectomy

• Diagnosis:  Previous RCT with Chronic Apical Periodontitis.
• Endodontic Microsurgery performed on the MB Root.  MB and MB2 canals were interconnected via an Isthmus.  Retroprep included all these spaces and retrofilled with MTA.

 

                                                     #14 Retreatment & Apicoectomy

• Diagnosis:  Previous RCT with Chronic Apical Periodontitis due to microleakage.
• Extensive Post Build-Up removed.
• NOTE:  Excellent healing on all three roots.

 

• Diagnosis:  Previous RCT with Chronic Apical Periodontitis.
• Endodontic Microsurgery performed on both roots with treatment of interconnecting
  Isthmus.

 

• Diagnosis:  Previous RCT with Refractory Chronic Apical Periodontitis.
• Intentional Replantation completed after atraumatic extraction, apical resection and MTA retrofill.
• NOTE:  Excellent periradicular and osseous healing with lack of clinical replacement resorption.

 

• Diagnosis:  Normal Pulp with external Root Resorption MB area.
• Surgical repair with Geristore.
• 7-month recall revealed excellent healing with Normal Vital Pulpal status.

 

• Diagnosis:  Previously opened by referring dentist due to trauma - complicated crown fracture.
• Seven-month course of Calcium Hydroxide induced an Apical Calcific barrier ressembling Apexogenesis.

 

• Diagnosis:  Pulpal Necrosis with Chronic Apical Periodontitis due to bacterial invasion via Dens Evaginatus.
• Completion of treatment was done under the surgical microscope.
• Obturation was done with MTA over an Apical Collagen Plug.

 

• Diagnosis:  Irreversible Pulpitis with Incomplete Apical Development.
• Eight-month course of Calcium Hydroxide led to excellent apical closure.
• Final Obturation completed with MTA and Gutta Percha/sealer.
• Initial and final procedures were performed under IV Sedation.