What types of rotaries do you use in your clinical practice?

I prepare canal lengths in thirds… remaining cognizant of which third I am clearing and irrigating dentin and associated pulpal remnants. Considering the root preparation in three stages, I have recently been practicing with the V-Tapers for the “Apex-Up” portion of...

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Patient Management 101

I am working into my fourth decade of full time clinical endodontics. The impressive technology that we have in our offices for diagnostic purposes makes my clinical practice of endodontics much more satisfactory, as it provides images of pathology previously unseen...

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What Etiology Presents in This Case?

How Would You Treat This Case? A 52-year-old male presented with a tooth had been bothering him with sub acute subjective symptomatology for about 3 to 4 months. The referral from a local clinician requested an endodontic evaluation. The following image...

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What is the working length of this central incisor?

All to often I hear students and young dentists immediately try to determine a working length once the canal has been identified. There is a proper procedural sequence with specific chamber conditions that will allow for the most accurate working length...

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What is the source of this defect?

Patient presents for evaluation of a large asymptomatic dentinal defect… Signs and Symptoms The tooth tests vital and this radiographic view was the foundation for the referral generated from an annual hygiene appointment. Beyond the obvious...

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Why is the patient experiencing maxillary discomfort?

A healthy 57 year old female presents with sudden discomfort of the last few days presenting in the area of #14. She had some trouble sleeping the previous evening due to the discomfort. Signs and Symptoms Teeth #14 was distinctly percussion...

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Why is there soreness above her tooth?

The patient chief complaint is best described as “soreness when she touches above her tooth.” Here is the intake periapical radiograph. The patient chief complaint is best described as “soreness when she touches above her tooth.” Her DDS had been watching the area for...

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Where is the odontogenic swelling stemming from?

A 52-year- old man presented with moderate discomfort and definitive fluctuant swelling on the buccal aspect of his maxillary left quadrant.   As one can visualize from this intake periapical film not information could be evaluated from the image. We went ahead and...

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Cortical Cloaking Case #5

So often the patient will present with a previous radiograph that was imaged at another. Here presents that intake radiograph that was electronically attached to the patient’s file. Not a poor image yet it lacked the clarity I would prefer to visualize for...

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Cortical Cloaking Case #4

Film radiograph sent with patient upon referral. Slight swelling in the unattached gingiva at the junction of the attached and unattached mucosa. Limited subjective symptomatology. A CBCT scan was acquired and an anatomic slice presents: The...

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Cortical Cloaking Case #3

Fracture patterns can also be visualized in certain cases. Here the foreshortened periapical radiograph was noncontributory, and the decision was made to acquire a low volume CBCT scan of the anterior maxilla. Here this sagittal view slice...

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Cortical Cloaking Case #2

Here another case was referred, due to generalized discomfort, with a possible suspicious maxillary osseous lesion between the roots of teeth #1 and #2. The decision was made to acquire a CBCT scan. The coronal view clearly describes the width...

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