Endodontics Portfolio

The following cases are some of the root canal treatment cases I have performed during fourth and fifth year.

Tooth 26

The patient originally presented to the clinic complaining of pain which gradually changed from a cold sharp pain that would occur on biting to a constant dull throbbing ache which would react to hot and cold. Clinically, the 26 had intra-coronal amalgam restorations with a compromised MB and MP cusp, the 26 was tender to percussion, had a heightened lingering pain to cold water, and the compromised cusps tested positive with Frac-Finder testing.

A diagnosis of irreversible pulpitis with symptomatic apical periodontitis was made, treatment options were discussed, and root canal treatment was performed over three stages.

Fractures were found lateral to the MB and MP cusps extending to the pulp chamber. During access, four canals were located, the MB1, MB2 DB and Palatal. Mechanical instrumentation was performed with rotary instrumentation utilising the MTwo system of files. The MB1 and MB2 canals merged into one.

All instrumented canals were then chemically irrigated utilising NaOCl and EDTA utilising ultrasonic agitation.

The canals were then obturated with a combined heat and lateral condensation technique with GP points.

Tooth 41

The patient presented to the clinic for general care. The 41 was extirpated a few years earlier to the patient presenting to the clinic, and required chemo-mechanical debridement, obturation and restoration.

A labial and lingual canal were initially found, which merged into one canal. The canal was mechanically instrumented with rotary instrumentation utilising the MTwo rotary system.

The instrumented canal was chemically irrigated utilising NaOCl and EDTA utilising ultrasonic agitation.

The canal was obturated with a combined heat and lateral condensation technique with GP points.

Tooth 35

This case was interesting, the patient presented complaining of pain from the bottom left hand side. Upon clinical examination, the 34 had a DO carious lesion, which appeared to be in close proximity to the pulp radiographically.

Clinical tests however revealed that the 34 was positive to pulp sensibility testing (Co2 snow), was not tender to percussion and otherwise responded normally. The 34 was temporised with a GIC restoration.

The 35 however, was negative to pulp sensibility testing (Co2 snow and Electric Pulp Testing), was tender to percussion and had a slight periapical radiolucency superimposed onto the LHS mental foramen.

A diagnosis of 35 pulpal necrosis with infection and symptomatic apical periodontitis was made.

I suspected two canals due to the presence of a fastbreak on the apical 1/2 of the canal, however only one was found.

The canal was mechanically instrumented with rotary instrumentation utilising the MTwo rotary system.

The instrumented canal was chemically irrigated utilising NaOCl and EDTA utilising ultrasonic agitation.

The canal was obturated with a combined heat and lateral condensation technique with GP points.