C shape with Distal Dilaceration and Mesial Anesthemosis
-Levin
Author: Fix It Crew
Perio of Endo Origin
These can be unpredictable. Teeth with deep periodontal probings on teeth with mesial and distal roots in close proximity can have those probings as a result of periodontal disease. They can also have those probings as a result of endodontic pathosis. Really, the best way to determine if its endodontic origin, is to initiate endodontics and monitor the probings over time. If the probings resolve, as they did in this case, then the cause is endodontic in nature. Unfortunately, if its periodontal in nature the prognosis is usually poor. After a few months in CaOH2, we had our answer, as the probings dropped to 3mm and then we finished the case. Managing the case in this way makes things predictable. The one year followup shows complete healing in 2D.
-Trudeau
Crown Fracture Repair
This 11 year old sustained trauma to his front maxillary incisor. It was uncomplicated (not involving the pulp). The fractured segment was re-bonded and the fracture line was camouflaged with composite for an aesthetic fix. Today we saw him for a followup at 1.5 years. The tooth still responded normally to cold and we’ve seen some root development.
-Trudeau
Discolored Canine
No history of trauma, but there was some discoloration. It was symptomatic as well. We performed some bleaching as well as the endodontic therapy.
-Trudeau
Resorption on a Lateral
37 yo. Hx of Mx advancement with ortho.
4 visits. You can see the more and more of the resorption being debrided with the CaOH radiographs.
MTA obturation with a fiber post.
-Karmali
Biodentine Cvek Pulpotomy
This was a young patient who sustained trauma which resulted in a crown fracture to his maxillary central. The tooth had been restored, but the dentist had reported a significant exposure. Weighing the options we went with vital tooth therapy due to the incomplete development of the root. We chose Biodentine for the pulpotomy repair because it isn’t supposed to stain. At one year it looks like there is a dentin bridge and without any staining. We’ll keep him on followup, but the 1 year outcome looks good.
Bypass Express
In evaluating teeth for re-treatment, I usually look at the bitewing first to evaluate the remaining peri-cervical dentin (PCD). Then I adjust my gaze apically to see what’s going on. In evaluating this tooth, it really hadn’t been violated too bad with axial reduction as it had a gold crown, the access didn’t look particularly gauged, and the root canal shaping hadn’t been excessive. So, this tooth has another life. Honestly, I didn’t notice the separated instrument in-bedded in the root. I was able to bypass the instrument in the missed canal and medicate beyond it. We discussed the need for possibility of surgery in the future. We also discussed the risks and benefits of trying to remove the instrument rather than bypass. Lots of times, in an effort to remove an instrument the dentin cost is pretty high. So, we opted to to be content with the bypass. At the 1 year mark, it looks like we’ve got full regeneration apically. One of the clinical applications for CBCT is to evaluate healing at different time intervals.
-Trudeau
Caries Leveraged Lower Molar
A pretty long molar with mesial caries.
-Levin
Unusual Maxillary Premolar
This is the first time I’ve ever seen this variant. This maxillary premolar had a distinct mesial and distal canal. I’v seen rotated premolars before that looked like this radiographically. However, the buccal cusp was in the correct orientation. This tooth would really only allow for a single fiber post.
-Trudeau
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