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Naeem Vally

@drnaeemvally

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Case studies page💡 🌍
Endodontics referrals 🔬🦷
Midrand, South Africa

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Premolar Week💛

Three premolars. Three different challenges. One goal: preserving natural teeth.

Case 1 - Single-visit ReRCT | UL5
 Crown sectioned, overhanging amalgam removed, pre-endo composite build-up, gp retrieved, wvc obt, composite core, followed by an emax onlay

Case 2 – Single-visit RCT | UL5
 Complete removal of the existing restoration, pre endo composite build-up, bc sealer obt, and composite core

Case 3 – Single-visit RCT | UR5
 Deeep Margin Elevation (DME) to achieve isolation and restorability, followed by endo as per usual. Everything under the rubber dam & microscope ofc😊

#saveteeth #endodontics

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Single visit RCT LR6 Radix🤍 #endodontics #saveteeth #rootcanaltreatment

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1. Fun referral case
2.First scouted distal canal then
3. Mesial scouted separately due to limited space.
After the 2 canals were located I saw a suspicious little “catch” Sure enough a hand file went in and it was indeed...
4. the 3rd canal
5. Happy with final result after all those hours of patient persistent struggles.

Follow @drnaeemvally
#endodontics #savingteeth #endodontia

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While reported success in the literature for endodontic therapy is comfortably above 96%, the outcomes in clinical practice often do not correlate to the published success. Similarly, surgical endodontics has ignorantly and unofficially been termed “pre-implant surgery” by many surgeons, yet once again the success published are also into the 90% ranges.

However the literature variability ranges from as low as 37% - upto 91% (Friedman 2005)

This large variability should make clinicians take some time to introspect treatment protocols and their alignment to modern day equipment and materials – Bioceramic Sealer, Bioceramic putty, use of operatory microscopes (higher outcomes than with loupes) etc.

Tooth number 31 and 41 were both endodontically treated by previous clinician, failed and subsequent apical surgery was attempted by referral surgeon which also failed.

Reason for referral? “A second surgery being unfavourable for lower anterior teeth”

Diagnosis ? Missed canals in both 31 and 41 which resulted in primary, secondary and surgical endodontic therapy.

Many questions are raised in this case which should have been “obvious”

Use of CBCT for primary diagnostics?
Use of magnification for endodontic therapy?
Use of CBCT at secondary diagnostics after initial failed therapy?

@matrixdentalspecialists
@zumax_southafrica_equitydental
@accessdentalsouthafrica

#dental #rootcanaltreatment #surgicalendodontics #endodontictherapy #endodontist #endodontics

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