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Archive for Unusual anatomy

3+1 (by Ilya Mer)

All clinical cases Cases by Ilya Mer Endodontics Retreatment Three canal premolars Unusual anatomyPublished September 21, 2015 at 4:33 am Comments Off on 3+1 (by Ilya Mer)

How many canals in first upper premolar could be? One – sometimes, two – usually, three – rare. Four? Are you serious?

Missed canal as a second opinion (by Ilya Mer)

All clinical cases Cases by Ilya Mer Endodontics Follow up PAL Retreatment Unusual anatomyPublished October 7, 2014 at 5:47 am Comments Off on Missed canal as a second opinion (by Ilya Mer)

Русская версия  Patient came to get a second opinion  about treatment plan of first mandibular molar. He had consulted with 2 dental surgeons (!)  and was suggested apicoectomy or GUESS?  Right – extraction and implant!

С-shaped second lower molar (by Ilya Mer)

All clinical cases C-shaped molar Cases by Ilya Mer Endodontics SAF Unusual anatomy Vital casesPublished November 18, 2013 at 5:34 pm Comments Off on С-shaped second lower molar (by Ilya Mer)

Sometimes during a routine work you suddenly face a challenging  anatomy like this tooth C-shaped second mandibular molar with irreversible pulpitis          

C-shape second molar retreatment (by Ilya Mer)

All clinical cases C-shaped molar Cases by Ilya Mer Endodontics Retreatment Unusual anatomyPublished July 7, 2013 at 11:17 am Comments Off on C-shape second molar retreatment (by Ilya Mer)

I have no idea why this tooth was endodontically treated, patient didn’t  remember why when and where it was done. Patient had no complains but fracture of composite restoration. RD has planned to get a new restoration for this tooth and sent patient for my evaluation whether endo should be redone      

Lateral lesion (by Ilya Mer)

All clinical cases Cases by Ilya Mer Endodontics Lateral canal Unusual anatomyPublished March 30, 2013 at 7:32 am Comments Off on Lateral lesion (by Ilya Mer)

Sinus tract  appeared two years after the crown placement. Tracing with GP cone leaded to middle third area, that could get a clue of big lateral canal. It was found and cleaned with ultrasonic agitation of NaOCl. After initial shaping and Ca(OH)2 placement the sinus tract healed.      

Irreversible pulpitis #36 (19) (by Ilya Mer)

Cases by Ilya Mer Endodontics Middle mesial one step endodontics Unusual anatomy Vital casesPublished March 7, 2013 at 10:42 am Comments Off on Irreversible pulpitis #36 (19) (by Ilya Mer)

There is a typical clinical situation: bad spontaneous pain, pain provoked by cold agent, deep distal caries    

Lateral lesion (by Ilya Mer)

All clinical cases Cases by Ilya Mer Endodontics Follow up Lateral canal PAL Unusual anatomyPublished October 18, 2012 at 9:36 am 1 Comment

Русская версия This patient was referred to our clinic for evaluation of RCT #37 (18) The initial therapy was carried out 5 years before that moment.  A year before symptoms appeared: swelling, pain, sinus tract. The NSTCT was attempted (patient said that  several dressing were changed during number of weeks) Symptoms gone but came ot
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Lateral canal and apical hook (by Ilya Mer)

All clinical cases Cases by Ilya Mer Endodontics Follow up Lateral canal RetreatmentPublished September 19, 2012 at 2:34 pm 1 Comment

Русская версия Patient was referred for apical surgery of #12 due to acute apical periodontitis and sinus tract. Elective endo treatment was done 3 years before just before PFM placement. After consult we made a decision of orthograde revision first then surgery if need. I had no illusions I could negotiate the apical curve but
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Missed anatomy via falsa and apical perforation (by Ilya Mer)

All clinical cases Cases by Ilya Mer Endodontics Middle mesial Perforation repair Retreatment Unusual anatomyPublished May 20, 2012 at 8:02 am 1 Comment

Русская версия Patient have had a toothache and after he was examinated by his dentist got recommendation to make RCT of tooth #36. By some reason he had held the decision making over until the severe pain come and that time extirpation has been made by another dentist. Nonetheless the treatment the patient was still
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Radix entomolaris (by Ilya Mer)

All clinical cases Cases by Ilya Mer Endodontics Radix Entomolaris Unusual anatomyPublished November 17, 2011 at 9:58 am 1 Comment

Русская версия An additional root in lower molar, so called “radix entomolaris”. There were two point made the treatment more difficult – distal access and 25mm of the working length.

С-shape anatomy (by Ilya Mer)

All clinical cases C-shaped molar Cases by Ilya Mer Endodontics Unusual anatomyPublished October 12, 2011 at 3:05 pm 1 Comment

Русская версия This patient has been referred after RD opened “hot” tooth and was confused by its anatomy. I was told the only distal canal has been identified but pulp chamber all the time filled out by blood come from hidden orifices. Dentist put some iofodorm contenting paste in the pulp chamber and sent the
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Possible perforation in furcation (by Ilya Mer)

All clinical cases Cases by Ilya Mer Endodontics Lateral canal Unusual anatomyPublished July 22, 2011 at 7:32 am 1 Comment

Русская версия Patient suffering from pain and  swelling  sent to RCT of 36 (19) with a suspicion of  perforation in coronal third of one of the mesials. No periodontal pockets but tooth had a high mobility

Trident (by Maxim Belograd)

All clinical cases Cases by Maxim Belograd Endodontics Three canal premolars Unusual anatomyPublished July 15, 2011 at 5:47 pm Comments Off on Trident (by Maxim Belograd)

Русская версия I’ve got a rather rare lower left first premolar with three autonomic root canals. The orifices were located unusual: lingual was on a common place but buccals were asymmetrical. Single visit, ProFiles, NaOCl, ethanol were used. Obturation was provided via vertical warm technique. I was especially pleased by “endodontic net” appeared aftef obturation.

С-shape configuration (Maxim Belograd)

All clinical cases C-shaped molar Cases by Maxim Belograd Endodontics Micro-access Unusual anatomyPublished June 17, 2011 at 12:56 pm Comments Off on С-shape configuration (Maxim Belograd)

Russian version The right lower second molar caused after full crown preparation. This situation was very favorable for microendo approach. Microaccess and orifices configuration view: Mesial buccal and distal joined on upper third. Such anatomy is very difficult for cleaning procedures so we had to work via irrigants longer and activate them more often. Obturation (squirt):

Dens invaginatus (by Ilya Mer)

All clinical cases Endodontics Oral pathology Unusual anatomyPublished May 28, 2011 at 11:27 am Comments Off on Dens invaginatus (by Ilya Mer)

Here is the today’s consult #12 with  sinus  truct, non vital, mobile, PAL. DS is dens invaginatus  

Distal hook (by Maxim Belograd)

All clinical cases Cases by Maxim Belograd Endodontics Red Russian Retreatment Unusual anatomyPublished May 8, 2011 at 12:45 pm Comments Off on Distal hook (by Maxim Belograd)

Русская версия The lower left first molar was ruther difficult to retreat. One side problem was due to hard resorcinol obturation, other one due to complex distal anatomy and obliteration on mesials. Pre-op X-ray and “tasty” resorcinol It took me a plenty of time to achieve patency on both roots. I used bended hand files
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Pulp stone and resorcionol pulpotomy re-endo (by Ilya Mer)

All clinical cases Cases by Ilya Mer Endodontics Red Russian Retreatment Unusual anatomyPublished April 24, 2011 at 8:43 am Comments Off on Pulp stone and resorcionol pulpotomy re-endo (by Ilya Mer)

Русская версия A huge pulp stone prevented from the correct access and canals exposure so previous dentist applied resorcinol formaldehyde mix and in fact pulpotomy was done.  

I’m Lovin’ it (by Maxim Belograd)

All clinical cases Cases by Maxim Belograd Direct restorations Endodontics Micro-access Post-endo restorative Unusual anatomyPublished April 10, 2011 at 8:33 pm Comments Off on I’m Lovin’ it (by Maxim Belograd)

MicroEndodontics and direct resins, what can be better? 🙂 This work I’d done couple days ago pleased me especially. One side it was a great opportunity to do microaccess on upper first left premolar, other side to restore the tooth via direct resin technique. And of cause deltas and laterals made me to be crazy
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Separated middle mesial (by Ilya Mer)

All clinical cases Cases by Ilya Mer Endodontics Middle mesial Red Russian Retreatment Unusual anatomyPublished March 24, 2011 at 1:52 pm Comments Off on Separated middle mesial (by Ilya Mer)

Русская версия Just a regular re-endo of first lower molar – there were 3 mesial orifices and 3 separated root canals into mesial root

C-shaped molar (by Ilya Mer)

All clinical cases C-shaped molar Cases by Ilya Mer Endodontics Retreatment Unusual anatomyPublished March 24, 2011 at 1:09 pm 1 Comment

Русская версия Even on preoperative X-ray it was clear that C-saped form was very expected

Bypass and full retreatment set (by Maxim Belograd)

All clinical cases Cases by Maxim Belograd Endodontics Fragment removal Red Russian Retreatment Unusual anatomyPublished March 4, 2011 at 4:39 pm Comments Off on Bypass and full retreatment set (by Maxim Belograd)

The title of this case means that we face almost all of retreatment components in one tooth. They are old bridge, resorcinol, broken file, ledge, obliteration and short obturation. Only cast post is missed to make this clinical situation one of most complex in endodontics. The treatment was done at two visits. During the first
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Middle Mesial (Maxim Belograd)

All clinical cases Cases by Maxim Belograd Endodontics one step endodontics Retreatment Unusual anatomyPublished February 3, 2011 at 9:04 pm Comments Off on Middle Mesial (Maxim Belograd)

Русская версия Here is a case of the first left lower molar retreatment where middle mesial root canal was found. PreOp and view of pulp chamber before retreatment. Minimal invasive access was performed by previous operator so we can see full unroofing over mesial system due to 🙂 . Preendo buil-up was done and access
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Crafty MB3 (Maxim Belograd)

All clinical cases Cases by Maxim Belograd Endodontics Unusual anatomyPublished January 29, 2011 at 2:42 pm Comments Off on Crafty MB3 (Maxim Belograd)

Russian version Or it was MB2… Upper left first molar made me to work hard to complete endo treatment. It took me 4 hours and became a record for a primary endodontics in my practice (frankly speaking I had no opportunity for second appt due to patient leaving to other country). The reason of such
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Il Mostro (Maxim Belograd)

All clinical cases Cases by Maxim Belograd Endodontics Unusual anatomy Video Vital casesPublished January 19, 2011 at 12:39 pm 1 Comment

Русская версия Interesting tooth was caught last week. Second upper left molar had unique anatomy: there was seprate palatal root canal and MB2 (wich was very-very difficult to negotiate), but DB and MB1 appeared to be one system orifices and joined on apical third. I faced concrement except unusual anatomy but it was easy to
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New Year’s crop (Maxim Belograd)

All clinical cases Cases by Maxim Belograd Endodontics Micro-access one step endodontics Unusual anatomy Video Vital casesPublished January 2, 2011 at 3:12 pm Comments Off on New Year’s crop (Maxim Belograd)

The end of 2010 turned out to be particularly fruitful to root canals quantity. I got an upper left first molar with five canals. Let’s see. I tried to make access conservative as much as possible but due to initial curvatures of distal and mesial systems(DB, DB2, MB and MB2)  I had to enlarge my
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3 canal premolar retreatment (by Ilya Mer)

All clinical cases Cases by Ilya Mer Endodontics Follow up one step endodontics Retreatment Three canal premolars Unusual anatomyPublished December 12, 2010 at 9:31 am 1 Comment

Russian version Non surgical retreatment of #24. The missed buccal root is seen on X-ray (arrow)

С-shaped molar

All clinical cases C-shaped molar Cases by Ilya Mer Endodontics Unusual anatomyPublished December 7, 2010 at 11:43 am 1 Comment

Russian version This patient came with pain in his right side of the jaw that radiated to the ear. 46 looked completely shattered, but the cause of pain was the second molar. Pulp tissue in the coronal third was necrotic. You can see the strings of blood vessels inside the yellow necrotic pulp tissue. From the
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Funky premolar (by Ilya Mer)

All clinical cases Cases by Ilya Mer Endodontics Follow up Retreatment Three canal premolars Unusual anatomyPublished December 7, 2010 at 8:09 am 1 Comment

Русская версия There are two buccal and one lingual canals, one like an upper molar, isn’t it?  But in fact it is a lower premolar. For my pleasure the referral took out an old cast post. I did only endo. I enjoyed, didn’t you?

1 years recall of deep split case (by Ilya Mer)

All clinical cases Cases by Ilya Mer Follow up Retreatment Unusual anatomyPublished November 30, 2010 at 12:05 pm 1 Comment

Русская версия #№36 (19) was treated with resorcinol technique long time ago. The last crown served  for more than 5 years. Percussion +. There wasn’t  any problem to negotiate the canals and I have got a patency in the both mesials. I found MM started down the middle third and went to the isthmus direction. 
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Unusual anatomy (by Maxim Belograd)

All clinical cases Cases by Maxim Belograd CT analysis Endodontics Fragment removal Retreatment Unusual anatomy VideoPublished November 28, 2010 at 11:32 pm Comments Off on Unusual anatomy (by Maxim Belograd)

The case of saving CBCT Patient was referred with broken file on palatal canal of the upper left second molar. We also faced blocked distal canal.  Last tooth on the side so we had to do all our best to save it. First appointment. Removed previous seal and obturation, localized fragment but couldn’t lift it
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Missed root (by Ilya Mer)

All clinical cases Cases by Ilya Mer Retreatment Unusual anatomyPublished November 27, 2010 at 4:33 pm Comments Off on Missed root (by Ilya Mer)

Русская версия I’ve never seen a such PIECE of necrotic pulp in the canal.. That was funny but tooth survived 4-5 years under the bridge. There were no symptoms, patient felt nothing. I shaped two canals and found something that caught my eye during cone fitting. It was a deep split of buccal canals.

Is it a lateral canal or internal resorption? (by Ilya Mer)

All clinical cases Cases by Ilya Mer Endodontics Follow up Internal resorption Unusual anatomyPublished November 27, 2010 at 4:22 pm 1 Comment

Русская версия AP appeared 8 years after crown placement. I went through the crown. Buccal canal was absolutely necrotic but palatal one had some vital tissues.  After calcium hydroxide I noticed the paste come out in the coronal third of root. Is it lateral canal or perforated root as a consequence of internal resorption or
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Apical ramifications (by Ilya Mer)

All clinical cases Cases by Ilya Mer Unusual anatomy Vital casesPublished November 26, 2010 at 9:54 pm Comments Off on Apical ramifications (by Ilya Mer)

#16 with apical ramification in the palatal canal. Two apical ports were found and patented. The third one was filed by luck with injection of guttapercha with Obtura gun.

Lower incisor with 3 canals (case by Maxim Belograd)

All clinical cases Cases by Maxim Belograd Post-endo restorative Retreatment Unusual anatomyPublished November 25, 2010 at 1:01 am Comments Off on Lower incisor with 3 canals (case by Maxim Belograd)

Interesting case I’d got at the period without optics. It’s not a secret that lover incisors have one or two canals but #26 surprised me via additional anatomy and third RC. Job was done via profiles and continuous wave. The main problem was to decide how to make a build-up. I knew that implantation would
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Tasty delta (case by Maxim Belograd)

All clinical cases Cases by Maxim Belograd Post-endo restorative Shaping algorithm Unusual anatomy Vital casesPublished November 25, 2010 at 12:46 am Comments Off on Tasty delta (case by Maxim Belograd)

Lower right second molar ache under temporary bridge. Well, ok 😉 Won via profiles and protapers D2-26.06-S2-25.04-30.04, hypo, US, cont. wave and squirt. MM joined ML. I was very pleaced with apical delta on distal. Isn’t tasty? 😀 Here is enlarged fragment of image for better visualization

Informative puffs (case by Maxim Belograd)

Cases by Maxim Belograd Unusual anatomy Vital casesPublished November 25, 2010 at 12:17 am Comments Off on Informative puffs (case by Maxim Belograd)

Here is a case shows us all of active irrigation and squirt power. Tooth # 4.8, irreversible pulpitis. Access to that wisdom tooth was great; I was able to see and to operate easily. And anatomy was challengeable – like “try me” or “come and get me” I had not enough time so was going
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Jamaica is everywhere! (by Ilya Mer)

All clinical cases Cases by Ilya Mer Retreatment Unusual anatomyPublished November 21, 2010 at 2:58 pm 1 Comment

Русская версия #45 with symptoms of apical periodontitis has been sent to my clinic to retreatment. On preop X-ray except central canal two additional white lines dropped a hint at complicated root canal system anatomy. In fact three separated canals were found and obturated

C-shape retreatment (by Ilya Mer)

All clinical cases Cases by Ilya Mer Red Russian Retreatment Unusual anatomyPublished November 21, 2010 at 2:00 am Comments Off on C-shape retreatment (by Ilya Mer)

The case of c-shaped retreatment of the second molar. Referral built the walls of GIC. After complete cleaning and shaping I left it for 4 weeks with calcium hydroxide then obturated. 6 month recall shows good healing. Hallelua!