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...

  In our clinical practise, we often assume a canine to have one root and one root canal. So was my assumption but my habit of critically evaluating the preoperative radiograph has helped to predict the presence of 2 root canals in the present case. On a literature search, I have realised that the occurrence of 2 canals is as high as 12% in some populations and it was about 3.2% in the Indian population. This made me realise how often we might be missing out on these extra canals which might later cause treatment failure.  On examining the preoperative radiograph 2 root canals were seen joining at the apex. It shows a typical Vertucci type II canal system. we went ahead with access opening which was made in a buccolingual direction similar to maxillary premolar. the simple logic here is that the canine roots are broader on the buccolingual direction and that facilitates extra canals. The canals were slowly negotiated with a 10 size K file and working length was determined and ...

All about bioceramics sealers Bioceramics are the class of ceramics used for repair and replacement of diseased and damaged parts of the musculoskeletal system History Calcium phosphate was first used as bioceramic restorative dental cement by LeGeros et al, 1982 .  The first documented use of bioceramic materials as a root canal sealer was by Krell and Wefel , 1984 Chohayeb et al.,1987 , evaluated the use of calcium phosphate as a root canal sealer in adult dog teeth. It made a more uniform and tighter adaptation to the dentinal walls as compared to guttapercha . Calcium phosphate cement has subsequently been used successfully in pulp capping, apical barrier formation, periapical defect repairs and bifurcation perforation repairs. Classification of bioceramic materials Mechanism of action  the following mechanisms have been suggested for calciumsilicate -based sealers : Diffusion     W.Zhang , 2009 Infiltration    R ....