علی مرسلی - متخصص درمان ریشه

علی مرسلی - متخصص درمان ریشه دکتر علی مرسلی

جراح – دندانپزشک، متخصص درمان ریشه
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Retrograde surgery (apicoectomy) remains a valid treatment option—even in the era of advanced implant therapy.A single-v...
17/09/2025

Retrograde surgery (apicoectomy) remains a valid treatment option—even in the era of advanced implant therapy.
A single-visit apicoectomy can, in selected cases, provide a predictable outcome with minimal time investment and without compromising the future potential for implant placement.

In this case, the patient presented with an abscess in the region of the maxillary first premolar. Because there was no time for extraction and a comprehensive prosthetic plan for splinted crowns, the patient chose to preserve the tooth with surgical root-end management.
Given that the lesion was external, the resection and retrograde filling were performed without conventional canal preparation, yet a favorable prognosis is expected—while keeping the door open for a future implant if ever needed.
Successful apical surgery demands the right armamentarium: angled ultrasonic tips, surgical handpieces, and high-quality calcium-silicate retrograde materials greatly improve access and long-term results.


#اپیکو #آپیکو #اپیکواِکتومی #آپیکواکتومی #رتروگرید

The prevalence of three root canals in mandibular premolars is relatively low, estimated at 0.5–1.5 %. Among these teeth...
17/09/2025

The prevalence of three root canals in mandibular premolars is relatively low, estimated at 0.5–1.5 %. Among these teeth, a three-canal configuration is more frequently encountered in the first mandibular premolar than in the second.
In this particular case of a mandibular premolar, the root length was approximately 23 mm, which made canal negotiation, cleaning and shaping, and obturation challenging at every stage. The procedure required careful concentration, ample time, and precise technique, yet was successfully completed in a single visit.
Because of the canal curvature ( need severe pre curve for hand instruments), the complex canal morphology, and the location of canal tri ifurcation, instrument fatigue and wear were considerable. When such teeth are referred after treatment has already been initiated by a colleague, or when the pulp is necrotic, predicting treatment outcomes becomes even more difficult.


#اندو #اندودانتیکس #اندودنتیست #دکترمرسلی

If you ask me what truly defines endodontic skill, I’d say:precision, standardization, and minimal chair time—especially...
16/09/2025

If you ask me what truly defines endodontic skill, I’d say:
precision, standardization, and minimal chair time—especially on molars.
For me, the gold standard of endodontic mastery is treating a second molar with a distal access and locating the MB2 canal.
Any clinician who can achieve perfect isolation, find that elusive second canal, and deliver a high-quality root-canal therapy has reached the peak of endodontics.

Yes, there are many other skills in endo, but none as symbolic—or as routine—as a flawless distal access on a second molar.
That’s the everyday art of an endodontist.


#اندو #اندودنتیست

Can we perform root canal treatment on two molars in the same session?There’s really no reason to split appointments if ...
15/09/2025

Can we perform root canal treatment on two molars in the same session?

There’s really no reason to split appointments if you can achieve proper isolation and have enough time for thorough cleaning, shaping, and irrigation of all canals. A single visit is perfectly acceptable in those conditions.
However, treating two maxillary molars in one appointment comes with special considerations:
Isolation must be flawless—no compromises.
If your patient becomes fatigued, the quality of your work will drop.
Your obturation method and technique must be efficient and quick.
You need to be fully confident and always watch for those MB2 canals.
Overall, I prefer to treat molars one at a time. I rarely accept doing two molars simultaneously—unless it’s a situation like this case in September, when the patient, a student, had to leave the country soon to start university.


#اندودنتیست #اندو #دکترمرسلی

The second mesiobuccal canal (MB2) of maxillary molars is a classic challenge for endodontists: if it’s missed during pr...
15/09/2025

The second mesiobuccal canal (MB2) of maxillary molars is a classic challenge for endodontists: if it’s missed during primary root canal therapy, the prognosis can be compromised.
But in retreatment, MB2 can sometimes be the savior!
In this upper first molar case, a ledge in the MB1 canal prevented us from reaching full working length.
Discovering the MB2—showing a Vertucci type II morphology—allowed us to achieve complete working length and dramatically improved the tooth’s long-term prognosis.
Interestingly, studies show that ledges occur most frequently in the MB canals of maxillary molars.


#اندو #اندودنتیست #اندودانتیکس

Root canal treatment of a mandibular lateral incisor :In mandibular anteriors and premolars, the main challenge is alway...
28/08/2025

Root canal treatment of a mandibular lateral incisor :

In mandibular anteriors and premolars, the main challenge is always the possibility of a second canal. Especially in necrotic cases like this one, missing the lingual canal can easily lead to treatment failure.

Typically, the first canal you find is the labial canal, while the lingual canal is the one that’s easily missed. In many two-canal cases, the file tip must enter at a lingual angle, and the natural inclination of the tooth makes finding the correct path of insertion more difficult at the start. A sharp pre-curve on the file often makes this task much easier.

Prevalence:
Most mandibular lateral incisors have a single root and canal.
However, studies show that 2–15% may present with two canals, depending on the population and method (Vertucci, Cleghorn, CBCT studies).
Clinical view: Always keep the possibility of a lingual canal in mind—missing it is one of the most common causes of failure in mandibular anteriors.

#اندو #اندودنتیست

Swipe through these three retreatment cases—each with a different prognosis, presented in descending order of treatment ...
27/08/2025

Swipe through these three retreatment cases—each with a different prognosis, presented in descending order of treatment outlook.

🔹 Case 1: Maxillary molar retreatment. The previous therapy had missed the MB2 canal and failed to reach full working length. After addressing these issues, the prognosis is favorable.

🔹 Case 2: Mandibular first molar with lesions on both roots. The MB canal may show slight transportation. Prognosis is fair to good, depending on lesion healing over time.

🔹 Case 3: Mandibular molar with all five canals, including the mid-mesial, fully prepared to working length. However, due to furcation involvement, the prognosis is fair to poor. The furcation area was separately sealed with a calcium silicate putty. This was explained during the consultation, and extraction was actually the first and second option proposed. Still, the patient preferred to give the tooth a chance—no matter how small.
As endodontists, we love these risk-taking patients and commit to giving their teeth every possible chance of survival!

#اندو #اندودنتیست #اندودانتیکس

One of the main challenges in endodontic retreatment is negotiating a ledge.Diagnosing a ledge before starting treatment...
25/08/2025

One of the main challenges in endodontic retreatment is negotiating a ledge.
Diagnosing a ledge before starting treatment is—if not impossible—extremely difficult. Whenever I hear a clinician claim they can identify a ledge solely from a conventional radiograph or even a CBCT, I can’t help but smile.
In cases where I suspect the presence of a ledge, I make every effort to maximize my diagnostic capabilities with preoperative radiographs. Ledges often lead to further complications, including perforations. Negotiating a ledge is highly unpredictable, whereas managing previous treatment issues—such as removing a separated instrument—is generally far more predictable.
In this particular case of a mandibular molar, passing the ledge was not overly challenging, especially since it was possible to reach full working length in a Vertucci type II configuration through the second mesial canal.
# drmorsali
#اندو #اندودنتیست

Decision-making process in treating a 16-year-old’s second molarIn this case, both vital pulp therapy and root canal tre...
24/08/2025

Decision-making process in treating a 16-year-old’s second molar
In this case, both vital pulp therapy and root canal treatment were possible options.
However, I decided to proceed with root canal treatment.
Main reasons:
1️⃣ Apical stop could be achieved and routine endodontic treatment was feasible.
2️⃣ Caries undermined two cusps, making cusp reduction necessary. In a 16-year-old, cusp reduction raises concerns for future prosthetic/restorative needs. A reliable root canal now provides a stronger foundation and allows for future restorative options if needed.
Challenges in treating second molars:
Patient cooperation and clamp placement can be tricky, but with patience and focus it’s manageable.
Profound anesthesia is often difficult to achieve. Contrary to some endo textbooks, I usually obtain excellent anesthesia by increasing the volume and varying the injection sites (e.g., Gow-Gates technique).
Sealer used: Avalon Bioceramic Neo (USA).
Root canal treatment in teenagers is always about balancing present needs with long-term restorative potential.
#اندو #اندودانتیکس

Swipe through to see two upper molar root canal cases.The first one involves a tooth with a curved root canal, and the s...
20/08/2025

Swipe through to see two upper molar root canal cases.
The first one involves a tooth with a curved root canal, and the second features a separate MB2 canal.
In molars—especially upper molars—finding, negotiating, and obturating extra canals is one of the constant challenges in endodontics.
Overcoming these challenges and delivering standard treatment requires complete focus. That’s why during root canal therapy I don’t listen to podcasts, don’t talk, keep my phone on silent, and even when I play music, I prefer instrumental only.
Our knowledge and skills can only show their true results when combined with full concentration.

#اندو #اندودنتیست

Healing of periapical lesions has two sides: simple & complex The simple side: Perform root canal treatment on a tooth ...
20/08/2025

Healing of periapical lesions has two sides: simple & complex
The simple side: Perform root canal treatment on a tooth with an endodontic lesion and then wait for healing.
The complex side: Healing doesn’t always happen the way you expect!
Most periapical healing (or at least the greatest radiographic changes) occurs during the first year after treatment.
But—don’t lose patience! Complete healing may take several years.

Ørstavik et al. (1996) showed that while most healing occurs within the first year, it can take up to 4 years or more for full resolution. That’s why regular follow-ups (1–4 years) are crucial before calling a case a failure.

Treating teeth with lesions often leaves the dentist in a delicate balance between success and failure. Remember: it’s often too early to judge, and never too late to follow up!

#اندودنتیست
#اندو

This tooth’s root canal was treated 10 years ago through the crown, with access created through crown.Now, a decade late...
18/08/2025

This tooth’s root canal was treated 10 years ago through the crown, with access created through crown.
Now, a decade later, due to recurrent decay under the bridge posterior tooth and its extraction, the treatment plan has shifted to implants in the posterior region.
But the canine tooth, with the very same endo treatment from 10 years ago, is still fully functional and serving the patient.

Address

تهران جلال آل احمد، زیر پل گیشا (نصر)، پلاک ۷۱ طبقه چهارم مقابل ساختمان بانک کشاورزی/تلفن ۰۲۱۸۸۲۸۳۰۰۶ و ۰۲۱۸۸۲۸۳۰۰۷
Tehran

Opening Hours

Monday 10:00 - 18:00
Tuesday 10:00 - 17:00
Wednesday 10:00 - 18:00
Thursday 10:00 - 17:00
Saturday 10:00 - 17:00
Sunday 10:00 - 17:00

Telephone

+989023232902

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