retreatment Archives | PhD. MSc. DMD. Pablo Salmeron, Consultant Endodontist DHA/ DOH in Dubai

Removal of silver points

cases, dubai, Endodontics, 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

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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.

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

PhD. MSc. Dr. Pablo Salmeron.

Focus

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This is just a footage with some clips of my treatments. 720p50 for HD.

It is during our darkest moments that we must focus to see the light.

PhD. MSc. Dr. Pablo Salmeron.

File retrieval

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

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

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.

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.

Re root canal treatment upper second molar

dubai, endodoncia, odontología, UAE Pablo Salmeron

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.