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Big chronic apical periodontitis on a lower incisor

This case was referred to me for the retreatment of a lower incisor (#41). The tooth presented with a big chronic apical periodontitis, which seemed to be affecting the teeth next to it as well. 

In this kind of situation, it is very important to do a meticulous diagnosis to identify the source of the problem so that we do not treat the other teeth mistakenly without reason.

The large size of the lesion is not a synonym for tooth extraction, which unfortunately we see quite often in the decision-making processes. In the absence of bacteria, the bone heals, and we can save the tooth. 

The retreatment was carried out over two sessions with a three-week calcium hydroxide dressing between them.

The use of advanced technologies, materials, and techniques is crucial for improving treatment success rates. With the right experience, planning, and tools, complex cases are usually successful. I always recommend seeking out a specialist with experience to address these kinds of situations and prevent further damage. While results may vary from patient to patient, they are highly predictable in the vast majority of cases.

Let me save your tooth.

PhD. MSc. Dr. Pablo Salmeron at Dr. Roze & Associates.

Lateral chronic periodontitis

This case was referred to me for a re-root canal treatment of an upper left second premolar (25).

The tooth was presenting a lateral periodontitis which can indicate either a tooth fracture or an untreated lateral canal. 

For these kind of cases I always take a CBCT (3D x-ray) to ensure proper treatment planing and to obtain more information about the possible cause of the problem. I like to be very honest with all my patients and I always explain them the challenges of every case and the possible outcomes. 

The treatment was successful and, although a lateral canal wasn’t visible on the x-ray, it was likely the cause of the problem. A proper disinfection protocol and the use of advanced technologies and techniques are crucial for improving treatment success rates.

With the right experience, planning and tools complex cases are usually successful. I always recommend seeking out a specialist with experience to fix this kind of situations and to prevent further damage. The result may vary from patient to patient but it’s very predictable in the vast majority of cases. Let me save your tooth. 

Success is not final; failure is not fatal: It is the courage to continue that counts.

PhD. MSc. Dr. Pablo Salmeron at Dr. Roze & Associates.

Broken file retrieval on an upper second molar

This patient was referred to me for a re-root canal treatment of an upper left second molar (27). This tooth presented a broken instrument in the palatal canal. Due to the location of the tooth (the last one) and the location of the broken file at the apex, the treatment became an important challenge. For these types of cases, I always take a CBCT to properly plan the treatment.

value honesty with all my patients, and I always explain the challenges of each case and the possible outcomes to them. With the right experience, planning, and tools, complex cases are typically successful. My advice is always to seek out an experienced specialist to address these situations and prevent further damage.

While results may vary from patient to patient, they are highly predictable in the vast majority of cases.

Keep challenging yourself to think better, do better, and be better.

PhD. MSc. Dr. Pablo Salmeron at Dr. Roze & Associates.

Removal of silver points

This patient was referred to me for a re-root canal treatment of an upper left second premolar (15). The tooth was presenting a couple of metal post and a silver point obturation. Within the always difficulty of  re-root canal treatments, removal of metal posts and silver points are quite predictable with the proper skills. This tooth was already treated 2 times in the past so preserve as much natural tooth structure was very important. Every time that the tooth is root canal treated or re-treated adds another layer of difficulty for the next treatment making very challenging sometimes to fix what it was done 20 or 30 years ago. My advice is always to find the right specialist with experience to fix this kind of situations to avoid further damage. 

The obturation was done using bioceramic sealer and the treatment was completed in one session. The result may vary from patient to patient but it’s very predictable in the vast majority of cases. Let me save your tooth

Patience and perseverance have a magical effect before which difficulties disappear and obstacles vanish.

PhD. MSc. Dr. Pablo Salmeron at Dr. Roze & Associates.

Upper first molar with 5 canals, MB3

This is why the use of the microscope is so IMPORTANT in Endodontics. This is an upper first molar with 5 canals. I like to clean and shape first the main canals to work after on the accessories. In this case I found a MB2 and MB3 canal. It’s IMPOSSIBLE to do this with the limitations of our naked eye, even with loupes. Mind as well the “conservative” access done in this case.

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Love looks through a telescope; envy, through a microscope.

PhD. MSc. Dr. Pablo Salmeron at Dr. Roze & Associates.