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Tiago Pimentel - Endodontics

@endodonticstp

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🇬🇧 Specialist Endodontist
🎓 DDS, MSc (Endo), MClinDent (Endo), MEndo RCS (Edin)
💻 ClinFolio Co-founder

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Get together with colleagues at the upcoming Regional Meeting, the perfect chance to hear from the experts and expand your endodontic skills.

We'll be joined by Dr Massimo Giovarruscio, Dr John Rhodes, Dr Fabio Gorni, and Dr Tiago Pimentel, who will be delivering insightful lectures across the two days.

Register now! (link in bio)

#BES #RegionalMeeting #Oxford #DentalEvent #Endodontics by @endodonticstp

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a month ago

Dr Tiago Pimentel describes what attendees can expect from his session in Oxford:

“At this year’s BES Regional Meeting I’m giving a session called ‘Nothing is impossible: are we there yet?’ After thinking about what is failing us, I think the weakest link is us.

“What I hope you leave with is a bit of useful discomfort, a sharper eye for the moments when failure isn’t in our hands or on our files, it’s in our heads."

Book your place now (link in bio)

#BES #RegionalMeeting #Lecture #Endodontics #Oxford by @endodonticstp

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2 months ago

Booking is NOW OPEN for our 2026 Regional Meeting! Friday 20th & Saturday 21st November.

Rhodes House, Oxford is a historic Grade II listed venue in the heart of the city. Additionally, the Conference Dinner will be held at the historic Oxford Town Hall and will feature a sit-down meal, band and DJ ensuring you will party the night away.

We are delighted to be joined by Guest speakers Dr. Fabio Gorni, Dr. Massimo Giovarruscio, Dr. John Rhodes and Dr Tiago Pimentel. Additionally, the Friday morning Table Clinic speakers are Dr. Claudia Brown, Dr. Melanie Kidner, Dr. Howard LLoyd and Dr. Fiona McMichen.

Book now!

#BES #RegionalMeeting #Oxford #DentalMeeting #DentalSpeakers by @endodonticstp

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3 months ago

The Water Whisperer.

This is the end of the "Behold" series with the final boss of pseudo-science: The Homeopath.

While the rest of us are bound by the laws of physics and chemistry, this guy is operating on "vibes." He believes that if you take a substance and dilute it until not a single molecule remains, it somehow becomes more powerful.

By that logic, if I throw a single coffee bean into the Atlantic Ocean, the entire sea is now a triple-shot espresso.

Here is the Homeopath’s toolkit:

- The Magic Water: It "remembers" the medicine, but conveniently forgets the sewage it passed through.

- The Sugar Pill: The most expensive confectionery in the world.

- The Philosophy: "Less is More." (Except when it comes to the invoice).

SERIES FINALE: This is the last episode of our "Behold" character series! From the Bioceramic sealer dentist to the Hollistic extractor, and finally the Homeopath—we’ve covered the spectrum of chaos.

Which character was your favorite? Or which one did you relate to the most (be honest)? Let me know in the comments!

#Homeopathy #Science #EvidenceBased #PlaceboEffect #MedicalHumor #BeholdSeries #SeriesFinale #Chemistry #CriticalThinking by @endodonticstp

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8 months ago

It’s easier to scare a patient than to find an MB2...

There is a growing trend of demonizing Root Canal Treatment (RCT) under the guise of "holistic" or "biological" dentistry. But if you look closely, the solution to the "toxic tooth" is never simple disinfection—it’s almost always a surgical extraction followed by a high-ticket "biologic" implant.

Let’s translate the buzzwords:
- "It's a dead organ": Meaning, "I don't have the patience or magnification to treat it properly."
-"Root Cause of Disease": Meaning, "I can charge 5x more for an implant than I can for an Endo."

Don't let bad science dictate your healthcare. An implant is a great replacement for a missing tooth, but it is a terrible replacement for a savable one.

#SaveTheTooth #Endodontics #DentalMyths #HolisticDentistry #RootCanal #BiologicDentistry #EvidenceBased #DentistLife by @endodonticstp

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9 months ago

Unpopular Opinion: We are suffering from "Action Bias" in endo.

We often feel that doing more steps = better dentistry. But when it comes to Calcium Silicate sealers (aka "Bioceramics"), these extra moves are based more on anxiety than actual chemistry.

Here is why you can skip the drama:

The "Water Rinse" Myth: Many of us rush to rinse out Sodium Hypochlorite (NaOCl) with water or saline because we fear it will stop the set. The Reality: Inactive NaOCl essentially breaks down into salt (NaCl) and oxygen. In the world of cement chemistry, salt is actually an accelerator. You aren’t saving the bond by washing the bleach out; you’re just adding a step.

The "Wet Paper Point" Myth: We dip a paper point in water to "moisten" the canal because we know these sealers need water to set. The Reality: Dentin is already ~12% water by weight. Even when a canal is "paper point dry," the microscopic tubules are still full of moisture.

The Science-Based Protocol:
1️⃣ Final Rinse with NaOCl (Keep those tubules clean).
2️⃣ Dry with Paper Points until the last one is clean (Do NOT use alcohol).
3️⃣ Obturate.

Your sealer is smart. It will find the moisture it needs from the dentin. You don't need to babysit the hydration reaction.

Paper 1 (On Moisture):
Study: "Effect of different dentin moisture on the push-out strength of bioceramic root canal sealer" (2022).
Finding: Canals dried with standard paper points had significantly higher bond strength than those left wet or dried with ethanol.

Paper 2 (On NaOCl):
Study: "Analysis of Bond Strength of Bioceramic Sealer Following Irrigation with Chlorhexidine" (2025).
Finding: Bioceramic bond strength was higher when NaOCl was the final irrigant compared to CHX.

(it is a shame there are no papers with direct comparison between H2O and NaOCl - which to be fair wouldn't be too different).

Paper 3 (On Interaction):
Study: "Effect of Sodium Hypochlorite Concentration... on Dislodgement Resistance" (2021).
Finding: NaOCl deproteinization negatively affected Resin sealers but favored the adhesion of Calcium Silicate sealers. by @endodonticstp

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9 months ago

by @endodonticstp

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2 years ago

🦷 Clinical Case Highlights

This patient was referred by his GDP for the root canal treatment of the UR6

🔍 History of presenting complain: The patient presented to his GDP with symptoms of irreversible pulpitis. The root canal treatment was initiated by the GDP, however the GDP decided to refer the patient when he could not find the MB2.

🔍 Clinical Findings: The UR6 presented with normal mobility and no pocketing and it was mildly tender to percussion and on buccal palpation. The access cavity was restored with a temporary filling material.

🔍 Radiographic Findings: the root canal anatomy was apparently visible, however the buccal roots were curved. A CBCT scan was taken to assess the potential presence of the MB2. It showed one MB root canal orifice, and then the canal seemed to morph into either a ribbon shaped canal or 2 canals, but it then seemed to merge back into 1 canal. (Curved roots and small caliber canals are not a great combination when CBCT is needed to assess the radicular anatomy).

💡 My Approach:

- Access cavity refinement. The MB1 seemed to have a small fin towards the palatal aspect. The fin was gently brushed with a goose-neck bur to expose the orifice of the MB2.
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- Root canal preparation with Reciproc Blue R25.
- Irrigation with NaOCl and EDTA. LAI.

- Obturation - Hydraulic condensation (GP + TotalFill BC sealer). The GP after LAI wasn’t sliding as smoothly to length.

- Composite core build-up

The patient was sent back to GDP care for cuspal coverage.

#endodontia #rootcanaltreatment #saveteeth #dentaleducation #laserindentalpractice #laser #reciprocblue #endolovers #endodonticpassion #endodonticspecialty #LAI #biolase #waterlase by @endodonticstp

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2 years ago

🦷 Clinical Case Highlights

This patient was referred by her GDP for the root canal re-treatment of the UR6

🔍 History of presenting complain: The UR6 had been root filled and restored with an amalgam filling more than a decade ago. The tooth was largely asymptomatic until recently, however it has been causing some localised pain on biting.

🔍 Clinical Findings: The UR6 presented with normal mobility and no pocketing and it was mildly tender to percussion and on buccal palpation. The tooth was restored with a large amalgam filling and there were no visible cracks

🔍 Radiographic Findings: I had to adjust the radiographic technique, as the radiograph sent by the referring dentist did not show the apex of the palatal root and periapical tissues (ideally 2 to 3mm). I have used an anterior holder and the film was vertical, which is unusual for posterior teeth, but it works really well in cases where the teeth are long (Working length on the palatal root was 27mm). The periapical radiograph showed a missed DB canal, short root filling in the palatal canal and also very short root filling in the MB canal). Small periapical radiolucencies were present on each root.

💡 My Approach:

- Amalgam core removal and pre-endodontic composite build-up

- GP removal and canal preparation with Reciproc Blue R25 (single-file - no glide path). The MB canal was ledged and a size 10 C-Pilot file was used to bypass it, but the file was not taken to length.

- Irrigation with NaOCl and EDTA. PUI.

- Obturation - Hydraulic condensation (GP + TotalFill BC sealer)

- Composite core build-up

The patient was sent back to GDP care for cuspal coverage.

#endodontia #rootcanal #saveteeth #endodontology #endodontik #noglidepath #dentaleducation #maketeethgreatagain #rootcanal #reciprocblue #endolovers #endodonticpassion by @endodonticstp

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2 years ago

🧜🏻‍♀️Exciting News! We are thrilled to announce the launch of the second edition of Pitt Ford’s Problem Based Learning in Endodontology! 🎉 This comprehensive guide has been meticulously crafted by an incredible team of editors and 38 chapter authors to enhance endodontic education worldwide.🌎
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I am humbled and honored to be a part of this editorial team with @shanonpatelendo @shalinik38 and Samantha Hamer from 🇬🇧. Thank you @shanonpatelendo for your confidence and thank you to everyone who contributed to this amazing global project!🙏🏻
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#Endodontics #ProblemBasedLearning #BookLaunch #Dentistry #DentalBooks #Teamwork #globalgoals #NeverStopLearning #Book #WeDidThis 💪🏻 taken in Perry Endodontics by @endodonticstp

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2 years ago

🦷 Clinical Case Highlights

This patient was referred by his GDP for the root canal re-treatment of the UR1 and UL1.

🔍 History of presenting complain: The UL1 and UR1 had been restored with crowns many years ago, as a consequence of dental trauma when he was a teenager. The teeth were largely asymptomatic until 6 months prior his consultation with me, when he noticed occasional tenderness and localised swelling, mainly associated with the UL1. He had also noticed that the crown of the UR1 felt loose.

🔍 Clinical Findings: Deep anterior bite. There was exuberant swelling and a sinus tract on the labial aspect of the UL1. The UL1 and UR1 were grade 1 mobile, and no probing depths >3.5mm.

🔍 Diagnosis
UR1 and UL1 - Chronic apical periodontitis associated with existing root fillings.

💡 My Approach:

- Restorability assessment. Unfortunately the UR1 caries was subcrestal and due to the context it was deemed as not salvageable.

UL1 treatment:

- GP removal with hand files (hedströem)

- Irrigation with NaOCl and EDTA. PUI.

- Obturation - 7mm MTA plug

- Fibre post and composite core build-up

Due to the extension/shape of the perirradicular radiolucency, I decided to review the patient at 3 months.
More to follow on my next post.

Please share your thoughts in the comments below regarding the possible reasons for the extensive perirradicular radiolucency. Do you believe it will heal with endodontic treatment alone?

#endodontics #endodontia #retreatment #maketeethgreatagain #weloveendo #endopassion #endodontology #cementaltear
#mtaplug by @endodonticstp

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2 years ago

People often dismiss research conducted prior to 2000, yet many of these elegant papers form the absolute foundation of contemporary knowledge.

There is a reason Kakehashi 1965 is the most cited paper in Endodontics.

On social media and even within academic and research groups, the focus tends to be on fancy equipment, files, radiographic white lines, and new materials. However, this often relegates the most critical factor in endodontic treatment to the background: BUGS! Microorganisms!

This paper unequivocally demonstrates the importance of microorganisms in the pathogenesis of pulpal and periapical disease.

#endodontik #contemporaryendodontics #rootcanal #endodonticspecialty #endodonticeducators #endolovers #endodontics #kakehashi #kakehashi1965
#healing #dentalresearch #endoresident by @endodonticstp

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2 years ago