retreatment

Big chronic apical periodontitis on a lower incisor

cases, dubai, Endodontics, UAE Pablo Salmeron

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.

Removal of silver points

Endodontics, cases, dubai, UAE Pablo Salmeron

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.

Dentin bridge

casos, dubai, odontología, UAE Pablo Salmeron Leave a Comment on Dentin bridge

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 kinds of formations from pulp stones. In this case the bridge was crossing the palatal canal.

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What is great in man is that he is a bridge and not a goal.

PhD. MSc. Dr. Pablo Salmeron.

File retrieval

casos, endodoncia, odontología, UAE Pablo Salmeron Leave a Comment on File retrieval

In this case, the doctor referring the patient asked me if I could retrieve the broken file.

Broken file in mesial root

File retrieval is always changeling for me because usually requires a lot of time and the collaboration of the patient trying not to move due to the high magnified field of view where I work on and a lot of patience as well; the use of the proper equipment plays a very important role.

This case has been done with ProUltra ultrasonic tips (Dentsply) under the Labomed Magna surgical microscope view.

These tips are made of titanium and can be pre-curved allowing to work in the direction you want. The bad side of these instruments is that they tend to get blunt and break very easily.

The use of the macriscope is a must, you need to see where are you activating the ultrasonic tip to preserve as much dentin as possible and to avoid perforations.

Broken file removed from mesial root

The broken file it behaves as a rigid body due its short length although the alloy what is made of should let it behave as a flexible metal. As I told before, be patient and remove dentin little by little to create more space is the only way to get the file out of the canal.

My advice for this kind of situations is try to bypass the broken file first, and if you can’t, try to retrieve it. Bypassing instruments is something that I’m not able to do 90% of the time.

Wise to resolve, and patient to perform.

Dr. Pablo Salmeron at Dr. Roze & Associates.