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.
Love looks through a telescope; envy, through a microscope.
On this kind of cases we just need to take extra care and patience to do it. It’s very important to enlarge the canal little by little, irrigating all the time to remove the smear layer and avoid ledges when we perform root canal treatments.
The two most powerful warriors are patience and time.
This video is about a dentin bridge I found during a root canal re-treatment of an upper seven molar. Every time I found them I like to preserve these structures to avoid tooth weakening. Only with the help of the microscope we can distinguish these kind of formations from pulp stones. In this case the bridge was crossing the palatal canal.
What is great in man is that he is a bridge and not a goal.
Extreme case of root resorption. 13 years old patient on holidays suffering pain on central incisor. The whole canal was filled with Bioceramic (FKG), sealer and putty consistency. Last picture has been sent from his happy dad after 5 months. The tooth is symtomless and healing!!
The case I’m showing you today was referred to me for a re-treatment, as you can observe in the picture, there was a broken file on the distal canal with a big apical periodontitis. The treatment was planned to be done in two appointments. In the first one I removed the broken file, and placed calcium hydroxide for 25 days; In the second appointment the tooth was symptomless and I completed the treatment.
After 4 months the patient came for a review and the PA showed new bone formation, so the infection was healing.
I usually like to finish the treatments in a single appointment but is not a rule, time management has to be consider as another variable in root canals treatments and sometimes, is better to do it in two appointments and some others we need even three appointments.
Our greatest weakness lies in giving up. The most certain way to succeed is always to try just one more time.