علی مرسلی - متخصص درمان ریشه

علی مرسلی - متخصص درمان ریشه دکتر علی مرسلی

جراح – دندانپزشک، متخصص درمان ریشه
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Conventional radiographs are nothing more than black and white points — and it is we clinicians who interpret those shad...
07/12/2025

Conventional radiographs are nothing more than black and white points — and it is we clinicians who interpret those shades and turn them into diagnosis and treatment.
In this case, an opaque mass can be seen adjacent to the apex of the maxillary molar, closely resembling extruded sealer beyond the apex.
A parulis (fistula) is also visible clinically between the first molar and premolar, and tracing reveals its origin to be the MB root of the maxillary first molar.
The treatment plan is nonsurgical retreatment of the molar.
But the question remains: what is that opaque mass?
The patient has a history of trauma and surgery involving the maxilla and zygomatic bone — a detail that may help explain the radiographic finding.
#اندو

Root canal treatment of four anterior teeth.Teeth with periapical lesions are treated endodontically and then followed u...
07/12/2025

Root canal treatment of four anterior teeth.
Teeth with periapical lesions are treated endodontically and then followed up. The likelihood of lesion healing after orthograde root canal therapy is high, but never guaranteed.
In cases like this, I mentally prepare the patient for the possibility of an apical surgery in the future.
There is no limitation to performing single-visit treatment on these teeth, as long as isolation and treatment principles are followed meticulously.
In this case, I completed the root canal treatment of all four teeth in a single session.

We can’t always talk about ideal treatments — sometimes we need to talk about failures too.Ten years ago, I was a young ...
07/12/2025

We can’t always talk about ideal treatments — sometimes we need to talk about failures too.
Ten years ago, I was a young endodontist (well… I still consider myself young!) working without a microscope and already taking on cases that were more challenging than many I treat today.
I started treatment on this mandibular second molar, and during the procedure I realized I could not bypass a separated instrument — and on top of that, I fractured another file at the distal root apex myself.
My recommendation to the patient was extraction.
However, the adjacent tooth had been extracted just a short time earlier, and the patient said they were not mentally prepared to lose another tooth. They insisted on keeping this one, even if only for a year.
I completed the endodontic treatment and placed a temporary restoration to provide coronal sealing until follow-up.
But the next follow-up took ten years to happen!
Cases like this can neither be labeled a success nor a failure. Healing has certainly occurred, yet the treatment itself cannot be considered reliable.
Still, if we evaluate endodontics by its ultimate goal — preserving teeth for as long as possible — then from the patient’s perspective, that goal has been achieved for now.

Keeping a tooth with a limited prognosis at any cost is not considered a virtue in modern dentistry. However, preserving...
03/12/2025

Keeping a tooth with a limited prognosis at any cost is not considered a virtue in modern dentistry. However, preserving a tooth as an option when no better alternative exists, and doing so under conditions that approach the standards of care, is highly valuable.
This maxillary second molar is one of those cases in which I would, under normal circumstances, unhesitatingly recommend extraction as the first treatment choice. But this does not apply to an elderly patient who is taking bisphosphonate medications.
Isolation in this case is a major challenge. It is important to note that a definitive diagnosis of furcation involvement should not be based solely on radiographs. The difference in height between the buccal and palatal bone plates can sometimes mislead us into incorrect interpretation.
Of course, the main challenge with this tooth is the treatment plan for its coronal reconstruction. After removing the crown and observing the tooth directly, our general dentist colleague—following the consultation—has accepted the challenge.

How can we increase our speed in endodontics?The answer comes in just two words: flawless isolation!Isolation is the key...
02/12/2025

How can we increase our speed in endodontics?
The answer comes in just two words: flawless isolation!
Isolation is the key to improving a clinician’s efficiency in root canal treatment.
With proper isolation, the retreatment of these three teeth can be completed in a single 90-minute session while maintaining all clinical standards.
For the mandibular central incisor, an MTA plug of approximately 3 mm was placed.
The other two teeth were obturated using the warm vertical technique.
Working length was determined exclusively with the apex locator, and sodium hypochlorite was used at the highest possible concentration.
morendo moreendo drmorsaliendo rootcanalspecialist iranianendodontist endo
#اندودنتیست

Premolars can be some of the most intimidating teeth to treat endodontically.Their complex and unpredictable morphology ...
30/11/2025

Premolars can be some of the most intimidating teeth to treat endodontically.
Their complex and unpredictable morphology makes it difficult to accurately determine the level of difficulty during the initial assessment.
Once you know you’re dealing with a premolar, you must be prepared for anything—ranging from the simplest cases to the most intricate canal anatomies.

Coincidence can happen in anything — including dentistry:This patient had undergone an implant procedure in the maxillar...
30/11/2025

Coincidence can happen in anything — including dentistry:

This patient had undergone an implant procedure in the maxillary first premolar region. Two weeks later, they returned to their dentist with a parulis (fistula) in the same area.
At first glance, it seemed related to the implant, but on closer examination, the dentist suspected another tooth as the true source of the problem.
The most challenging part of this case was convincing the patient that the fistula was not caused by the recent implant, simply because the two events happened close together.
To reassure the patient, I took a final radiograph with tracing to clearly demonstrate the origin of the lesion.
To avoid such misunderstandings, it’s important not to limit our evaluation to the teeth adjacent to an implant. A comprehensive assessment of the patient’s overall dental health is essential.

Coincidence can happen in anything — including dentistry: This patient had undergone an implant procedure in the maxilla...
30/11/2025

Coincidence can happen in anything — including dentistry:
This patient had undergone an implant procedure in the maxillary first premolar region. Two weeks later, they returned to their dentist with a parulis (fistula) in the same area.
At first glance, it seemed related to the implant, but on closer examination, the dentist suspected another tooth as the true source of the problem.
The most challenging part of this case was convincing the patient that the fistula was not caused by the recent implant, simply because the two events happened close together.
To reassure the patient, I took a final radiograph with tracing to clearly demonstrate the origin of the lesion.
To avoid such misunderstandings, it’s important not to limit our evaluation to the teeth adjacent to an implant. A comprehensive assessment of the patient’s overall dental health is essential.
# parulis

Retrograde surgery of the maxillary central and lateral incisors:Extensive endodontic lesions do not always resolve with...
30/11/2025

Retrograde surgery of the maxillary central and lateral incisors:
Extensive endodontic lesions do not always resolve with orthograde root canal treatment.
In this case, the primary treatment had already been completed, and a high-quality retreatment was also performed by another endodontic specialist. However, the lesion continued to progress, and the patient’s symptoms — including pain and swelling — did not improve.
The only tooth-preserving option was apical surgery, which involved lesion resection, root-end resection, and placement of a retrograde filling material.
Due to the size of the lesion, bone grafting and a membrane were also used to support regeneration.

Follow-up after 8 years — Management of traumatic anterior teethThese anterior teeth were injured in a car accident.The ...
29/11/2025

Follow-up after 8 years — Management of traumatic anterior teeth
These anterior teeth were injured in a car accident.
The central incisor had both a crown fracture and mild intrusion.
The lateral incisor had a crown fracture with pulp exposure.
By the time the patient presented for dental treatment, both teeth had developed pulp necrosis (the patient had been hospitalized for one week for medical care).
A calcium-silicate–based plug (CEM cement) was placed in both teeth.
Following root canal therapy, the restorative treatment was completed by a prosthodontic colleague.
After 8 years, both teeth remain in normal and healthy condition.


#اندو #اندودنتیست #اندودانتیکس #تروما

Would you sign up for a three-day Formula One driving course and then jump straight into the world championship afterwar...
26/11/2025

Would you sign up for a three-day Formula One driving course and then jump straight into the world championship afterwards? Most likely your answer is no — because you value your life. Learning endodontics is similar. Endo is challenging. It is a skill-based discipline that takes time, repetition, training and real experience, and just like every Formula One driver, we all have to start somewhere. These two cases are true Formula One moments in endodontics: in the first case, the initial radiograph makes the second molar look like a single- or two-canal tooth with a tapered root, but it isn’t. It has a buccal canal with a Vertucci type V configuration and is in fact a three-canal molar. The second case involves two traumatized upper central incisors. Over the years, both severe calcification and external resorption have occurred, likely at different time intervals. No canal is visible, yet in children and adolescents we must do everything possible to preserve the teeth and avoid the consequences of early extraction. Endodontics is deceptively complex, and mistakes in endo — just like in Formula One — can be catastrophic, and the price is the life of the tooth.

With the right tools—magnification, bioceramic sealers, and the confidence that comes from skill and experience—even mul...
26/11/2025

With the right tools—magnification, bioceramic sealers, and the confidence that comes from skill and experience—even multi-canal premolars with complex anatomy no longer need to feel stressful or overwhelming. They can become smooth, predictable, and enjoyable treatments. Still, endodontics is never truly “routine” for any clinician… it always requires focus, precision, and full presence at the chair.

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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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