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The 4th canal in the second maxillary molar

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

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

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.

pulpotomy

These are the steps taken:

– Rubber dam isolation.

– Microscope magnification.

– Manual removal of the soft dentin with excavator.

– Pulp horn amputation.

– Disinfected and rinsed with NaOCl from “outside” to achieve haemostasis.

– Dried with sterile cotton pellets.

– Bioceramic capping.

– Direct glass ionomer as temporally filling on top.

Dentistry today is about the small details.

PhD. MSc. Dr. Pablo Salmeron.

Re root canal treatment upper second molar

This is a re-treatment of an upper second molar #27 through an Emax crown . These kinds of treatments are difficult. However, sometimes they can be easy, and other times they can be impossible. The re-treatment of the tooth depends a lot on the work carried out by the previous dentist therefore, I endeavour to be honest with my patients, as sometimes I am not able to fix everything.

In the following case I had to re-treat a tooth filled with Thermafil. Although Thermafil is a great system and works very well in the hands of some endodontist, it doesn’t work for me. I feel that I can’t control the obturation in 3D and the plastic carrier can be easily exposed without guttapercha around.

For that reason, I feel much more comfortable and secure using vertical condensation with System B, it requires maybe more training under the microscope but is worth it and works really well for me.

27reendo

– Tooth #27

– Microscope

– K-Files #10 #15 #20

– Wave One Gold

– Bioceramics + System B.

Never give up, because when you think it’s all over, is the moment where everything starts.” — Jim Morrison.

PhD. MSc. Dr. Pablo Salmeron.

Calcified Canals. Root Canal treatment

A root canal treatment is always difficult, even more when you find calcified canals.

The only secret is to be patient, hand files and a lot of irrigation.

36B.

– Tooth #36

– Microscope

– K-Files #6 #8 #10 #15 #20

– Wave One Gold

– Bioceramics + System B

PhD. MSc. Dr. Pablo Salmeron.