Some of Martin's cases

Click on the photo to see the result
pre-op missed MB2.JPG
pre-op missed MB2.JPG

A pre-op radiograph shows a short root filling and apical pathology

intial view missed MB2_edited.JPG
intial view missed MB2_edited.JPG

After accessing the root canal system it could be seen that 3 canals had been located and filled.

post-op missed MB2.JPG
post-op missed MB2.JPG

The post-op radiograph shows a well filled root canal system

pre-op missed MB2.JPG
pre-op missed MB2.JPG

A pre-op radiograph shows a short root filling and apical pathology

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A missed canal

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The upper left 1st molar had previously been root-filled but had persisting symptoms. Radiographic examination revealed a short and thin root filling and apical radiolcuencies. Orthograde retreatment was carried out over two visits. The existing root filling material was removed with files and solvents. A second canal in the mesio-buccal root was located using ultrasonic instruments. All four root canals were prepared with reciprocating instruments and chemo-mechanically debrided with EDTA and sodium hypochlorite. At the second visit the tooth was obturated using a warm vertical technique.

Pre-op
Pre-op

A pre-op radiograph shows short root fillings in all canals. There is also a large perforation in the apical 1/3 of the distal root with an associated area of radiolucency. A deep pocket was present in the area of the perforation, this resolved after the area was repaired.

perf 2.JPG
perf 2.JPG

The preforation was cleaned and repaired with MTA. A resorbable collagen matrix was used to prevent extrusion of the MTA into defect. The root canals were negotiated to their full length, chemo-mechanically debrided and filled.

perf 3.JPG
perf 3.JPG

At one year review there is no apical radiolucency and there has been significant reduction in the size of the radiolucency around the perforation repair.

Pre-op
Pre-op

A pre-op radiograph shows short root fillings in all canals. There is also a large perforation in the apical 1/3 of the distal root with an associated area of radiolucency. A deep pocket was present in the area of the perforation, this resolved after the area was repaired.

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A perforated molar

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The lower right 1st molar had been root treated some years prior to the patient seeing Martin. Clinically there was an isolated deep pocket buccally. Radiograophic investigation revealed a poor root filling and a perforation in the furcation region. Endodontic retreatment of the tooth was carried out over two visits and the perforation reapired with MTA. 

 

At a one year review the tooth remains asymptomatic, the pocket has resolved and there has been significant bony infill in the furcation region.

curved root 1.JPG
curved root 1.JPG

A pre-op radiograph shows a very curved mesio-buccal root

curved root 2.JPG
curved root 2.JPG

Careful negotiation of the mesio buccal root with small k files to establish a glide path

curved root 3.JPG
curved root 3.JPG

Final root filling. The canal morphology has been successfully followed

curved root 1.JPG
curved root 1.JPG

A pre-op radiograph shows a very curved mesio-buccal root

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A curved root

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This upper left 1st molar was referred due to the extreme curvature of the mesio-buccal root. After ensuring good straight-line access to the root caanls Martin established a glide path with hand files before, carefully, preparing the root canals with reciprocating files. After thorough chemo-mechanical debridement with EDTA and sodium hypochlorite the tooth was obturated with a warm vertical technique.

instrument removal 1.JPG
instrument removal 1.JPG

Pre-op periapical. What at first may seem a paste root filling was in fact a small k-file

instrument removal 2.JPG
instrument removal 2.JPG

After the instrument removal and root filling

instrument removal 3.JPG
instrument removal 3.JPG

instrument removal 1.JPG
instrument removal 1.JPG

Pre-op periapical. What at first may seem a paste root filling was in fact a small k-file

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A fractured instrument

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The lower left 2nd premolar fractured and required a post-crown to restore it. Unfortunately a previous dentist had attempted a root filling and fractured a small hand file in the root canal. Martin removed the instrument using a Masseran kit and following root treatment placed a fibre post and composite core ready for restoration with a crown