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Molars have been observed to have a variety of morphological forms. The least understood and most treatable tooth in the posterior region is the upper first molar. The maxillary first molar has a complex anatomy with a wide variation in the number, size, and shape of the root canals. The case documentation highlights the endodontic treatment of the upper first molar with an anomalous position of the mesiobuccal 2 (MB2) canal. Endodontic therapy success is contingent upon the awareness of the dentist about the differences i.e. morphology and outline of the root and its canal.
RESUMO
Aesthetics has been an important aspect of dentistry along with functionality for decades but its significance is at an all-time high. Hence among techniques that contribute toward this goal, strip crown has shown convincing results. However, its acceptance did not reach its potential, especially among general dentists which could be attributed to its technique-sensitive nature. This case report sheds light on the practicality and reliability of this technique along with various modifications made by authors while striving to improve the quality of treatment provided by the clinician.
RESUMO
The maxillary second premolar has long been regarded as a tooth with a straight root canal anatomy, typically featuring a single root with two canals. However, emerging evidence suggests this tooth may harbor a more intricate internal morphology, challenging conventional perceptions, and treatment approaches. One such variation is three root canals within the upper second premolar, which has been gaining increasing attention in endodontic literature. Root canal treatment of maxillary second premolars with three canals demands meticulous debridement, shaping, and disinfection. A combination of magnification, illumination, and appropriate instrumentation aids in locating, negotiating, and cleaning the accessory canals effectively. Thorough cleaning of accessory canals can be achieved through effective irrigation solutions such as sodium hypochlorite, ethylenediaminetetraacetic (EDTA), and chlorhexidine, which help dissolve organic tissues and remove debris. Techniques like ultrasonic and sonic activation, as well as negative pressure irrigation systems, enhance the penetration and effectiveness of these irrigants. Additionally, the use of modern nickel-titanium rotary files, ultrasonic irrigation, and supplementary chelating agents enhances the management of complex canal configurations.
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In modern dentistry, restorations that are more aesthetically pleasing have now replaced the amalgam restorations. The "stamp technique" is one of the more recently developed techniques for combining aesthetics and functionality. When caries are visible on radiographs or clinical examinations of teeth with complete marginal ridges and an ideal tooth structure, this method can be used. This novel stamp technique involves creating an index beforehand, which is essentially a miniature impression or negative copy of the occlusal topography. The advantage of the stamp technique is that it replicates the actual occlusion and its anatomy, reducing the need for additional corrections. The amount of time required for the restoration's polishing and finishing is also decreased. In comparison to manual methods, for the posterior teeth, the occlusal stamp is approachable as it is a biomimetic direct composite restoration that helps to restore hidden caries with the impaired occlusal surface. It produces better outcomes as it takes less post-restoration filling adjustments.
RESUMO
Radix entomolaris (RE) is an anatomical variation that involves the existence of an extra root in lower molars, particularly the first molar. This variant, although less common, has significant clinical implications in endodontic treatment and dental surgeries. Appropriate detection of radix entomolaris is crucial for treatment planning and prognosis. Various diagnostic aids like radiography, cone-beam computed tomography, and intraoperative exploration aid in identifying this anatomical variant.
RESUMO
Dental anatomy exhibits considerable variation with the presence of additional canals being a common occurrence. The upper second molar typically presents with three canals and three roots; however, variations such as the existence of an extra canal or a root can pose challenges during endodontic treatment. Maxillary molar is characterized by an additional canal located within the palatal root, often exhibiting complex configurations and variations in morphology. Access refinement is critical to gaining adequate visibility and facilitating instrumentation. Meticulous exploration of the pulp chamber floor and careful examination of radiographs from different angles are essential for accurate diagnosis. Careful negotiation and cleaning of the extra canal with appropriate files and irrigants are essential to remove pulp tissue and debris effectively. Furthermore, obturation of the canal space with biocompatible materials is crucial to ensure a three-dimensional seal and prevent bacterial ingress. Clinically, the inability to detect and treat the extra palatal canal can lead to persistent infection, incomplete debridement, and compromised treatment outcomes. This case report delves into the significance of this anatomical variation, diagnostic modalities, and effective management strategies.
RESUMO
Endodontic therapy focuses on the root canal system to treat infected or damaged pulp tissue within the tooth, ultimately preserving the tooth and restoring its function. The root canal space should be cleaned with the use of proper instruments and chemical disinfectants to eradicate infected pulpal tissue and its remnants. The failure of endodontic therapy is attributed to a lack of understanding of the differences in anatomy among teeth, as evidenced by research. Canals are identified, and endodontic treatment is facilitated by the use of dental operating microscopes. Therefore, to achieve a favorable endodontic result, it is imperative to use all available methods to identify additional aberrant root canals. Failure to detect and adequately treat the midmesial canal (MMC) can lead to persistent infection, treatment failure, and the need for retreatment. This case underscores the importance of meticulous assessment and advanced techniques in treating complex canal configurations, ultimately leading to favorable outcomes in endodontic therapy. The MMC, a challenging anatomical feature, was located through careful clinical and radiographic examination. Advanced techniques, including ultrasonic activation and meticulous instrumentation, were employed to navigate and clean the canal effectively. Sodium hypochlorite irrigation and passive ultrasonic activation were utilized for thorough disinfection. The MMC was sealed with biocompatible materials, ensuring comprehensive obturation of the root canal system.
RESUMO
Splitting a molar means removing or separating the root and the accompanying crown portion. Hemisection of a damaged tooth aids in preserving the tooth structure and the existing alveolar bone surrounding the preserved root while also enabling the installation of a fixed prosthesis. This case report defines hemisection as an effective modality for preserving carious mandibular first molars with periodontal and periapical pathology.
RESUMO
The stamping technique, a pivotal process, has undergone significant advancements with the integration of composites. Traditionally, direct or indirect restorative cements, e.g., amalgam or composite resin, have been used to restore teeth, often presenting challenges in achieving optimal fit, esthetics, and durability. This process begins with creating an accurate impression of the prepared tooth, which serves as a blueprint for crafting the restoration. In contrast, the stamp technique, also known as the indirect restoration technique, offers several distinct advantages. The stamping technique enables the use of advanced materials that offer superior esthetics and durability. Composite resins used in stamp restorations can be shade-matched to the patient's natural teeth, resulting in seamless integration with the smile. These materials also exhibit excellent strength and wear resistance, ensuring restorations that last longer and are capable of withstanding stresses without fracture.
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Root canal treatment of vital, non-infected teeth can often be completed in a single visit, negating the necessity for dressing and provisionalization. Conversely, cases involving infected canals typically demand multiple visits, during which antibacterial medicaments are applied, making effective provisionalization crucial for varying durations. The key components of a successful root canal treatment include adequate canal shape to promote efficient obturation, thorough chemical and mechanical debridement, and complete removal of pulp tissue remnants and bacteria. The primary cause of pain following the initiation of endodontic treatments is often attributed to inadequate debridement or incomplete removal of the pulp tissue, closely followed by insufficient temporary restorations. This review aims to comprehensively overview provisionalization materials used during and immediately after endodontic procedures.