One of the most rewarding case types, for a number of reasons.
This patient had failing RCTs on #15 and 16 four years after being treated by an Endodontist. She returned to that Endodontist, who removed the crown on 15 and made a large access in the crown on 16, and still was unable to find the canals. They put in a good effort to find the missed canal in 15, but were looking in the wrong place. Fortunately the roots are fused so no perforation was created. At this point the towel was thrown in and patient was advised to extract both teeth.
She was very upset at the idea of losing these teeth, even with one of them being a third molar. So she found me for a second opinion.
I treated these cases in multiple visits to make sure it they were working prior to finishing. Sometimes just a little more effort is all the difference. These are cases where anybody’s “best hour” isn’t good enough, these require time and effort.
Slide 1: Pre-op images. Note area of deep troughing in 15, and untreated DB canals in both teeth.
Slide 2: located troughed area, filled with MTA, placed composite over MTA, located missed DB canal.
Slide 3: previous (large) access in 16, located untreated DB canal. Removed all gutta percha in both teeth, located, shaped and #endovac all canals prior to placing #calciumhydroxide
Slide 4: Visit 3. After a calcium hydroxide change at visit 2. Images were taken that confirmed healing (Images on right). The cases were obturated at this visit, only after healing was confirmed radiographically. This eliminates 🤞. Slide 5. One year recall on right shows excellent healing. This patient was extremely happy we took the time and effort to save her teeth, even her wisdom tooth.
Slide 6: a quote that Gary Carr sent me that I always think about.
#endodontics #endodontia #endodoncia #dentistry #dentalcases #rootcanal #rootcanaltreatment #rootcanalretreatment #missedcanal #nstep #endodonticrecall