PhD. MSc. DMD. Pablo Salmeron, Endodontist in Dubai

How to bypass a ledge

casos, endodoncia, UAE Pablo Salmeron

As you can see on the video, please watch it on 720p50 HD, the case I want to show today is a re-treatment of a lower left six first molar #36. The tooth presented a ledge and missed canal on the mesial root and another ledge and a broken instrument on the distal.

Although ledges sometimes can look easy to bypass, is not always possible to do mainly because of the location of the ledge and the patient’s opening mouth range.

Our instruments are flexible but tend to work in a straight line because their memory effect. To bypass and fix this kind of problems, we need to approach the canal in the proper angulation and as I said, sometimes is really tricky because of the limited opening range of the patient. We need to pre-bend our instrument with the proper angulation and remove dentin, as less as possible, from inside of the canal with small ultrasonic tips in order to straighten the access. A CBCT will allows us to visualize the anatomy of the root and identify the real angulation of the canal which is something we have to keep in mind when we try to bypass the ledge.

Patient, knowledge of the anatomy and the use of high magnification as the surgical microscope are the keys to success in this kind of treatments.

“Remove know from knowledge and you are standing on the ledge”.

PhD. MSc. Dr. Pablo Salmeron.

Pulp stone

casos, dubai, endodoncia, UAE Pablo Salmeron Leave a Comment

In this case, I found a pulp stone inside of a mandibular second molar. Dental pulp tissue can form dentin or osteodentin in the reaction to the homeostasis induced either by surgical or chemical stimulation, and the activity of pulp cells regulates the calcification of pulp tissue.

Pulp stones are calcified bodies in the dental pulps of the teeth, which can be seen in the pulps of healthy, diseased, and even un-erupted teeth in the primary and permanent dentition. Dental pulp stones may be free, attached, or embedded in the coronal or radicular pulp. They are considerably more common in the pulp chamber than in the root canal and may occur in a single tooth or several teeth.

Although pulp stones have no clinical significance, they lead to complications when endodontic therapy is needed.

As you can see in the video, their large size in pulp chamber may block access to canal orifices and alter the internal anatomy, and attached stones may deflect or engage the tip of exploring instruments, preventing their easy passage down the canal. In this kind of situation the use of the surgical microscope is mandatory.

This video has been done with a Labomed Magna microscope and Canon EOS camera.

“You can only treat what you can see”.

PhD. MSc. Dr. Pablo Salmeron.

The 4th canal in the second maxillary molar

casos, dubai, endodoncia, odontología, UAE, Uncategorized Pablo Salmeron 1 Comment

One of the most important things in Endodontics is planification, for that, we need to have an excellent knowledge of the pulp chamber anatomy as well as the different variants in configurations of the root canal system anatomy. Nowadays, and according to the American Association of Endodontists, the use of the CBCT is a standard in our field. This tool, allow us to see the tooth in a 3D model, and check the anatomy from every angle.

On the next case, I completed a root canal treatment in a second maxillary molar, almost the last tooth! the complexity of the case was the minimal mouth aperture of the patient and the tricky root canal anatomy with these 4 canals. Planning the cases before, allow me to do the treatments in a shorter and safer way.

PhD. MSc. Dr. Pablo Salmeron.

Double curvature retreatment

casos, endodoncia, odontología, UAE Pablo Salmeron

Today’s case is a retreatment through a metal ceramic crown of a first maxillary mollar, tooth #36, with double curvature.

This case took me 3 hours and the use of the whole armamentarium to be completed.

Never give up, just be patient and everything is possible.

PhD. MSc. Dr. Pablo Salmeron.

Pulp Horn Amputation

casos, endodoncia, odontología, UAE Pablo Salmeron

Today’s case is a 11 year old patient with a big caries on the second maxillary molar referred to me to save the tooth. My duty as endodontist is not only providing root canal treatments but also preserving teeth from them too.

In this particularly case I performed a pulp horn amputation.