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Patient Centered Endodontics: The Rehabilitation of Compromised Teeth

Bypass Express

Weekly Fix

Hampton Roads Endodontics

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

Unusual Maxillary Premolar

Daily Fix

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

Mid-Mesial Joiner

Daily Fix

Hampton Roads Endodontist

This tooth had a mid mesial portal of negotiation. Looking at cbct’s of lower molars, there’s often a concavity that makes aggressive shaping of these teeth risky. Root form appopriate instrumentation of these mid mesial canals is usually pretty conservative, especially when they join (no reason to hog it out if it does).

 

“T”!

Daily Fix

This is a primary tooth (T), I treated 7 years ago. Looks like it’s still hanging in there. Primary teeth have very thin roots so large shapes are contraindicated. This is one of the teeth that helped shape my ideas about root form appropriate instrumentation.

 

A Rad First Post

Daily Fix

While still trying to figure out the intricacies of webdesign and blogging, I needed to have a first post, and of course I wanted it to be rad. Luckily today, a Radix Entamolaris came in for a complete. I love it when I get patients who are part of a referring doctors dental team. They are discerning, and I’m always honored when they choose me.