Endodontics Redefined

Endodontics Redefined Endodontics Redefined is a small attempt to make sure everyone understand and deliver their best effort in terms of Endodontic treatment.

Today in the era of high end gadgets, we lack the understanding of basic principles and the science..

Curvatures, calcification, splits all in one!!One of the toughest case in recent times, tested patience to the core. Ext...
27/07/2025

Curvatures, calcification, splits all in one!!

One of the toughest case in recent times, tested patience to the core.

Extremely narrow canals with a deep seated split with distal canal scouted and filled. Multiplaner curvatures with mesial system.

Hybrid approach using Reciprocation.

Cheers, keep scouting.

Finding mb2 is always a challenge, and to negotiate the path that has a completely independent trajectory would add onto...
21/07/2025

Finding mb2 is always a challenge, and to negotiate the path that has a completely independent trajectory would add onto the complexity of the case.

An independent MB2 canal means it has its own distinct opening (or***ce) in the pulp chamber and travels to the apex as a separate entity. Although it may have an anastomosis joining mb1 somewhere in the middle, but again finding a separate path further.

This contrasts with canals that may join with the primary MB1 canal (confluent) or have a joining and separate exit (fin). Scouting such anatomies with hand instruments is a task in narrow Calcified canals.

Here is a case with independent mb2 , with multiple transverse ramifications in between and opening laterally along the inner wall.
Keep scouting, cheers

Cases that test your abilities and patience !!As the carious lesion migrates apically to the obliterated CEJ, loss of gi...
13/07/2025

Cases that test your abilities and patience !!

As the carious lesion migrates apically to the obliterated CEJ, loss of gingival tissues or signs of inflammation along its way and concomitant damage to the exposed root surface occur.

The outcome is an elongated clinical crown with a gouge in the facial aspect of the tooth or marginal inflammatory response. These scenarios are difficult as accessing the root canal system wothout addressing them prior, would tend to infect your working field and incomplete isolation would be an issue.

The disadvantage to using composite resin is its disappointing record of root-surface marginal leakage and secondary caries. Its use also requires adequate isolation and contamination control. Composite resin is a good choice for abrasion and erosion lesions. An interesting option of sealing the root defect with MTA and carrying out further endodontic intervention here.

Keep scouting ,cheers.

Cases that appear an easy negotiation from the diagnostic xrays would often pose a challenge managing the multiplaner cu...
06/07/2025

Cases that appear an easy negotiation from the diagnostic xrays would often pose a challenge managing the multiplaner curvatures in the opposite plaane.

Small stainless-steel instruments inserted into the root canal can be used to gather information about its morphology. As these instruments are withdrawn from the root canal, their shape replicates the three-dimensional curvature of the canal. Dr West stresses that the file must not be forced apically through any obstructions and suggests oscillating the file back and forth in 30° to 60° increments to simulate a “watch-winding , this would work everytime when you passing through these complex curvatures

Reciprocation is used after the canal has been negotiated to the working length by hand and with the use of a small ss K-File. Reciprocation proceeds with the first file that binds at working length. That would ensure an easy access for rotary Endodontics.

Keep scouting. Cheers.

Apical scouting has many rules!!Palatal canal is extremely common to find these variations. Another deep scouting caseMi...
29/06/2025

Apical scouting has many rules!!

Palatal canal is extremely common to find these variations. Another deep scouting case
Missed variations in close proximity to the antral floor has a higher chances of causing periapical lesion. Scouting the anatomy to seal the anatomy better!

Mumbai, looking forward to see you soon!! Our next advanced Endodontic Bootcamp in Mumbai is scheduled on 20th and 21st ...
29/06/2025

Mumbai, looking forward to see you soon!!

Our next advanced Endodontic Bootcamp in Mumbai is scheduled on 20th and 21st September ( limited to 15 participants only)

Looking forward to another extensive microendo bootcamp in Mumbai!!

Stiffer instruments and lack of control over your manual instruments, would tend to 'Ledge' the canals routinely. Its im...
23/06/2025

Stiffer instruments and lack of control over your manual instruments, would tend to 'Ledge' the canals routinely.
Its important to achieve an optimal glide path before you advance in the canal with your larger taper instruments.

Gauging the canal dimensions here and keeping my instruments centered along the tortuous path was hard.

Managed the ledges manually followed by apical preparation using step back technique, to maintain the canal trajectory. Cheers.
Keep scouting.

It is worth noting that complete obliteration of the canal radiographically may not always suggest absence of a canal sp...
15/06/2025

It is worth noting that complete obliteration of the canal radiographically may not always suggest absence of a canal space. Situations where calcified tissue deposition would block the lumen would still have a possibility of negotiating till the working length.

Certain parameters need to be taken care though,
-Pulp chamber is always located in the center of the tooth at the level of the CEJ

-Calcified pulp chamber is darker than the surrounding dentine;

-The file should be always used with a cutting tip ( modified tip k file) design and precurved manner to negotiate through narrow channel..

-Use of magnification with light;

-Repeated radiographs to assess the direction of the bur during location of canal as well as direction of file during negotiation within the root.

Extremely complex upper premolar with manual sequence followed by reciprocation files to shape the these calcified complexities.

Cheers. Keep scouting!

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