Memoir~clinical cases

 The objective of apical surgery is to surgically maintain a tooth that has an endodontic lesion which cannot be resolved by conventional endodontic (re-)treatment (von Arx 2005). The evaluation of a case referred for apical surgery must always include a careful weighing of the advantages and disadvantages of surgical and non-surgical intervention, i.e., the possibility of a conventional root-canal (re-) treatment should be considered as a therapeutic option In the present case surgery was done on lower anterior teeth.  Tissue reflection should begin from the vertical releasing incision at the junction of the submucosa and the attached gingiva. After the tissue is reflected, it must be retracted to provide adequate access for bone removal and root-end procedures. Removal of cortical bone to expose the root apex. currettage os done to remove cyst and lining.   The root has a darker, yellowish color and is hard, whereas the bone is white, soft, and bleeds when scrapped...

  Trauma and pulpal infections are part of the routine of the dental practice. Common consequences in these cases are alterations in dental color, compromising patient’s esthetics and his interaction in social environment. Bleaching aids to preserve dental structure as compared to full coverage crowns and also show immediate esthetic results. This clinical case shows a bleaching technique in devitalized teeth using bleaching agent with 35% hydrogen peroxide activated by LED light. The technique is simple to perform and also shows satisfactory results.             Informed consent was taken before treatment. On the onset of treatment, the shade of the discoloured tooth was assessed under normal daylight with a Vita porcelain shade guide (Vita classic) and also, a pre-bleaching photograph was taken for the record. On the first appointment 2mm of gutta-percha is removed from the canal orifice with a heated instrument and restored with GIC up to the c...

  Man dibular first molars are the first posterior teeth to erupt in permanent dentition and are those that most often suffer from caries. They are also the teeth that exhibit considerable anatomical variation and abnormalities regarding the number of roots and root canals. Therefore the clinician should know the various morphologic aberrations occurring in this tooth before starting the treatment. This case presents with mandibular first molars with 3 distal root canals and one root. The tooth was treated endodontically with the help of dental operating microscope. CASE 1: Local anaesthesia was induced using 1.8 ml of 2% Lignocaine and Adrenaline (Xylocaine; AstraZeneca Pharma Ind Ltd, Bangalore, India). The tooth was isolated using rubber dam and an endodontic access opening was established. The orifices of mesiobuccal, mesiolingual, distobuccal and distolingual were apparent and were initially located. The floor of the pulp chamber was viewed under dental operating microscope (...

  Composite resin is a very tricky restoration that needs a lot of practice and expertise. It's a continuous learning process. Today I'll share a few procedures I have learnt while restoring anterior teeth. Yes, it a small drop of a huge ocean and there's a lot more learning and practice for me to do..... let this be the first milestone of a really long way to go!! STEP 1: Preoperative evaluation. We often undermine the importance of working models and preoperative record. An impromptu treatment is often a recipe for disaster. Understanding the tooth angulation, emergence profile and tooth shade often help us to determine the type of restoration required and the armamentarium needed. STEP 2: Isolation longevity of any restoration depends mainly on how well we maintain the isolation. Rubber dam isolation might be frustrating. But, it's a lot better than your patient returning back with a failed restoration.                      ...

       When a tooth smiles at you that signals danger!! A C-shaped root canal often formed because of f ailure of the Hertwig’s epithelial root sheath to fuse on the lingual or buccal root surface or it  may also be formed by coalescence because of deposition of the cementum with time. ( Melton DC, 1991, JOE). There are multiple fins and connections in a C shaped root canal making it difficult to completely disinfect. I will describe my experience dealing with such canals. IDENTIFICATION??? We can identify a C shaped canal with a pre-operative radiograph by careful observation. some features observed are:  The pulp chamber is large in the occluso-apical dimension and with a low bifurcation. The semicolon-type C-shaped root canals often present with  (i) fusion or close proximity of two roots,  (ii) a large distal root canal,  (iii) a narrow mesial root canal and  (iv) a blurred image of a third canal in-between. ACCESS OPENING:...