Nothing special. A few premolars i got to treat recently with access cavity designs specific to what the clinical scenario demanded. Case 1 Case 2 Case 3
3yr recall of a cracked #36 with fracture extending into the ML root. When the peri-apex looks clean i sometimes don’t hesitate considering an endo. Of course with an informed consent about the doubtful prognosis. A post was cemented in the involved root for some added re-enforcement.
Deep sub-gingival margin. Always good to see a well isolated work space, which makes our life so much easier. The usual shaping and irrigation protocol. WVC and Fiber-post cemented, i hope to get a 1.-25mm ferrule during the crown prep.
Calcified canals are never an excuse under the scope. This #15(?) was in the position of a 1st molar and almost got me in my search for the canals. The usual shaping and irrigation protocol. WVC obturation. Pre-op Clinical image On removal of restoration Calcified chamber Mesio-buccal canal DB canal
#19 with (1)# file in the MB (2) Ledged ML (3) Screw post in the distal. The file dislodged with a U-file and ultrasonics to sand away the composite and vibrate out the post. Fibre-post in the MB and distal canals. Getting that 1.5-2.5 mm ferrule in the lingual side will be crucial in this case.
#3 Er. RCT. Pulpitis probably following a recent amalgam close to the distal pulp horn. I’ve confined the access to the mesial aspect. I don’t think this one needs as post-endo but then its going to be her dentists decision.
#18 RCT With this kind of gingiva sinking the whole tooth an indirect post-endo would have been a nightmare (atleast for me) in this case. Orifice directed access done and the carious lesion prepared and restored separately along with the DO in the 19, the cuspal integrity is intact so just the direct composite post […]
Somehow i find these premolars canals that splits in the middle 3rd harder to locate and shape than the ones that split in apical. Heat treated NiTi’s come in really handy in these cases.
– In this case i opted for an access to the centre (place where the orifice projects) and restored the distal half separately – The usual shaping and cleaning protocol and also restored the mesial slot in the 47 through the space i got with a open distal margin in 46. 47 is symptomatic as […]
– Pt age 13yrs old then – IOPA revealed a taurodontic anatomy and a PA lesion in relation to the palatal root. – On access the floor was completely calcified and appeared bleached and ovoid. Managed to localize all canals which were in eccentric locations – I noticed that I had pushed GP outside the […]