Читать книгу Clinical Atlas of Retreatment in Endodontics - Группа авторов - Страница 3

1 Chapter 1Figure 1.1 Preoperative radiograph showing radiolucency in the furcation are...Figure 1.2 Clinical picture showing the pulpal floor perforation.Figure 1.3 Radiograph showing MTA placed on the pulpal floor.Figure 1.4 Radiograph showing master cone verification after biomechanical p...Figure 1.5 Radiograph showing obturation along with intact MTA.Figure 1.6 Follow‐up radiograph showing healing in the furcation area.

2 Chapter 2Figure 2.1 Preoperative intraoral periapical radiograph with separated instr...Figure 2.2 Intraoral periapical radiograph showing instrument bypass.Figure 2.3 Intraoral periapical radiograph showing periapically extruded sep...Figure 2.4 Intraoral periapical radiograph showing obturation.Figure 2.5 Incision and flap reflection.Figure 2.6 Trephination at the site.Figure 2.7 Intraoral periapical radiograph showing the location of the extru...Figure 2.8 Curettage of the operating site.Figure 2.9 Retrieved instrument.Figure 2.10 Intraoral periapical radiograph showing instrument retrieval.Figure 2.11 Immediate postoperative intraoral periapical radiograph.Figure 2.12 Flap approximation and suturing of the operated site.Figure 2.13 Postoperative intraoral periapical radiograph after 1 month.Figure 2.14 Postoperative intraoral periapical radiograph after 1 year.

3 Chapter 3Figure 3.1 Preoperative clinical picture.Figure 3.2 Preoperative radiograph showing inadequate obturation and fractur...Figure 3.3 Gutta‐percha cones removed from the root canals.Figure 3.4 Bypassing the fractured instrument with a no. 10 manual K‐file an...Figure 3.5 Verifying the fit of master cones up to the full working length o...Figure 3.6 Final obturation radiograph with bypassing of the ledge as well a...Figure 3.7 One‐year follow‐up radiograph with postendodontic full coverage r...

4 Chapter 4Figure 4.1 Intraoral periapical x‐ray: #34 – inadequately endodontically tre...Figure 4.2 Coronal access through the metal ceramic crown showing a single c...Figure 4.3 Unfilled lateral spaces around the single cone gutta‐percha.Figure 4.4 Gutta‐percha removed to the middle third of the root.Figure 4.5 Gutta‐percha removed to the the apical third of the root.Figure 4.6 After complete removal of gutta‐percha, visualization of the sepa...Figure 4.7 Intraoperative radiograph showing removal of the gutta‐percha and...Figure 4.8 Retrieval of the separated fragment after creating a staging plat...Figure 4.9 Magnified view of the retrieved segment of the rotary file.Figure 4.10 Intraoperative x‐ray confirming complete retrieval of the separa...Figure 4.11 Working length x‐ray confirming the length gained with Tooth 34....Figure 4.12 A second working length radiograph demonstrating the complexity ...Figure 4.13 Postoperative radiograph demonstrating root canal filling materi...Figure 4.14 Follow‐up radiograph at 13 months showing periapical healing.

5 Chapter 5Figure 5.1 Preoperative radiograph showing furcal perforation, inadequate ob...Figure 5.2 Clinical picture showing removal of the crown, removal of the cot...Figure 5.3 Radiograph showing location of the canals, working length determi...Figure 5.4 Radiograph showing repair of the perforation and obturation of th...Figure 5.5 Four‐month follow‐up radiograph showing healing in the furcation ...Figure 5.6 Clinical picture showing full‐coverage permanent restoration and ...

6 Chapter 6Figure 6.1 Preoperative radiograph showing suspected strip perforation, inad...Figure 6.2 Clinical picture showing the perforation site after removal of th...Figure 6.3 Clinical picture showing location of the fractured instrument und...Figure 6.4 A loop retractor is used to catch and extract the instrument afte...Figure 6.5 Removal of the fractured instrument.Figure 6.6 Preparation of GP as an apical plug to obturate the part of the r...Figure 6.7 Obturation of the apical part of the canal with GP. This segment ...Figure 6.8 Closure of the strip perforation site with MTA. Obturation of the...Figure 6.9 Immediate postoperative radiograph showing removal of the fractur...Figure 6.10 Two‐year follow‐up radiograph showing complete healing of the pe...

7 Chapter 7Figure 7.1 Periapical radiograph showing the previously treated tooth with o...Figure 7.2 (a,b) CBCT examination revealed an apical radiolucency as well as...Figure 7.3 Specially designed microexcavator instruments used for removal of...Figure 7.4 (a,b) Use of precurved file to evaluate the lateral anatomy of th...Figure 7.5 (a,b) Attempt to negotiate the lateral anatomy of the root canal....Figure 7.6 (a,b) Obturation of the root canal. Sealer can be seen flowing th...Figure 7.7 (a–e) CBCT images for 3‐year follow‐up confirming the flow of sea...

8 Chapter 8Figure 8.1 (a–d) Radiographs showing faulty cast post with a gap between the...Figure 8.2 A lateral opening drilled in the coronal one‐third of the crown....Figure 8.3 Exposed cast post after lifting of the crown.Figure 8.4 (a,b) Demonstrating the use of WAM X forceps for decementing the ...Figure 8.5 Disinfection procedure being carried out and the removal of gutta...Figure 8.6 Sectional obturation of the apical part is complete and the prepa...Figure 8.7 Radiograph confirming the sectional obturation along with post sp...Figure 8.8 Recall radiograph confirming healing of the lateral lesion follow...

9 Chapter 9Figure 9.1 (a,b) Clinical pictures showing tracking of the sinus tract with ...Figure 9.2 Preoperative radiograph revealing previously treated mandibular c...Figure 9.3 Periapical radiograph revealing obturation of the anterior teeth....Figure 9.4 (a,b) Clinical pictures showing healing of the buccal sinus tract...Figure 9.5 Periapical radiograph showing healing of the interdental radioluc...

10 Chapter 10Figure 10.1 Preoperative radiograph showing silver cone obturation and fract...Figure 10.2 Periapical radiograph showing removal of silver cone and cement ...Figure 10.3 Precurving the endodontic file with an endo‐bender.Figure 10.4 ET 25 ultrasonic tips used to loosen and remove the fractured in...Figure 10.5 Periapical radiograph showing obturation and post space preparat...Figure 10.6 Periapical radiograph showing healing of the periapical lesion 2...Figure 10.7 CBCT showing healing of the periapical lesion 2 years after the ...

11 Chapter 11Figure 11.1 (a) Clinical picture showing Tooth 16. (b) Periapical radiograph...Figure 11.2 CBCT imaging reveals presence of periapical radiolucency along t...Figure 11.3 (a) CBCT used for measurements on the occlusal surface. (b) Meas...Figure 11.4 Based on CBCT measurements on the occlusal surface, the estimate...Figure 11.5 Drilling depth marked with a stopper on the bur. Rubber dam remo...Figure 11.6 Guided access prepared without rubber dam. Previously obturated ...Figure 11.7 Missed MB2 discovered. 10 K file used to check canal patency. Le...Figure 11.8 (a) MB1 and MB2 shaped and cleaned with rotary endodontic files ...Figure 11.9 (a) Verification of master GP on the radiograph. (b) Immediate p...Figure 11.10 Follow‐up after 1 year showing complete healing of the periradi...

12 Chapter 12Figure 12.1 Various endodontic mishaps that can occur with freehand access p...Figure 12.2 How calcification can create a challenge during endodontic treat...Figure 12.3 Different ways of improving the accuracy of endodontic access pr...Figure 12.4 The steps of working with a 3D printed tooth replica.Figure 12.5 Comparison of the accuracy of guided implant placement with guid...Figure 12.6 Common lack of interocclusal distance to accommodate the additio...Figure 12.7 Demonstrating orifice directed access preparation.Figure 12.8 Demonstrating the marked pericervical dentine that can be preser...Figure 12.9 Different types of long shank small‐headed burs recommended to b...Figure 12.10 Periapical radiograph showing inadequate obturation in Tooth 11...Figure 12.11 DICOM files from CBCT and STL files from scanning were extracte...Figure 12.12 Searching and marking of identical points.Figure 12.13 After segmentation and alignment of the information (DICOM and ...Figure 12.14 Placement of virtual burs and sleeve for final template designi...Figure 12.15 Placement of virtual bur a bit palatally since orifice projecti...Figure 12.16 The placement and stabilization of the guide in vivo.Figure 12.17 Marking of the access entry point with a narrow bur on the rest...Figure 12.18 Once the marking was done, the hole was drilled freehand.Figure 12.19 After replacing the guide, the stability of the guide bur was c...Figure 12.20 After replacing the guide, the stability of the guide bur was c...Figure 12.21 Access created with the guide bur, used with the sleeve. Root c...Figure 12.22 Estimation of working length with an electronic apex locator.Figure 12.23 Negative pressure irrigation performed throughout the procedure...Figure 12.24 Obturation done with tricalcium silicate sealer and gutta‐perch...Figure 12.25 Reinforcement with glass fiber post.Figure 12.26 Core build‐up with resin composite.Figure 12.27 (a–f) Periapical radiographs showing verification of the steps ...

13 Chapter 13Figure 13.1 Preoperative radiograph showing Tooth 36 with suspected furcatio...Figure 13.2 Perforation site after removal of the crown and previous amalgam...Figure 13.3 Cleaning of the endodontic access cavity in progress for better ...Figure 13.4 The perforation after being cleaned and disinfected.Figure 13.5 Access to the canals gained, cleaning and shaping of the root ca...Figure 13.6 Perforation along with cleaned and shaped root canals. Irrigant ...Figure 13.7 Cleaned and shaped canals. Dry and prepared perforation for rece...Figure 13.8 Blockage of canal orifices with Teflon so that MTA does not ente...Figure 13.9 Placement of MTA over the perforation and removal of Teflon from...Figure 13.10 Obturation of the root canals along with placement of MTA over ...Figure 13.11 Immediate postoperative radiograph showing complete root canal ...Figure 13.12 One‐year recall showing healing of the furcation area and the m...

14 Chapter 14Figure 14.1 Periapical radiograph showing a previously treated tooth with an...Figure 14.2 Isolation and removal of secondary caries and location of older ...Figure 14.3 Pre‐endodontic wall build‐up done before starting the retreatmen...Figure 14.4 Location of suspected extra canals traced and the need for exten...Figure 14.5 The missed mesiobuccal canal located by minimally extending the ...Figure 14.6 Disinfection process with the irrigant in action in the missed m...Figure 14.7 The final enlarged missed mesiobuccal canal up to 40/04.Figure 14.8 Immediate postoperative radiograph verifying the obturation of t...Figure 14.9 Six‐month recall and 1‐year recall radiographs showing complete ...

15 Chapter 15Figure 15.1 Periapical radiograph showing the previously treated tooth with ...Figure 15.2 Isolation and removal of the temporary restoration done to gain ...Figure 15.3 Presence of the fractured instrument seen under the dental opera...Figure 15.4 Removal of the loose fractured instrument from the distal canal ...Figure 15.5 Clinical picture showing use of 08 K‐file to check canal patency...Figure 15.6 Periapical radiograph to confirm canal patency as well as workin...Figure 15.7 Disinfection process with the irrigant in action and exploration...Figure 15.8 The final obturation verified on the radiograph.

16 Chapter 16Figure 16.1 Periapical radiograph showing an instrument fracture in Tooth 47...Figure 16.2 Removal of temporary restoration and first look at the access ca...Figure 16.3 Checking the canal patency in MB and distal canals and also taki...Figure 16.4 Verification of working length. The patient had closed her mouth...Figure 16.5 Clinical picture showing the fractured instrument in the mesioli...Figure 16.6 Enlargement of the coronal part of the canal to gain clear acces...Figure 16.7 Engagement of the fractured instrument head with the loop from t...Figure 16.8 Final cleaning and shaping of the three canals. Exploration of t...Figure 16.9 Placement of gutta‐perchas inside the canal to check the master ...Figure 16.10 Radiographic verification of the master cones up to the working...Figure 16.11 Final obturation with gutta‐perchas.Figure 16.12 Radiographic verification of obturation.Figure 16.13 Six‐month recall.

17 Chapter 17Figure 17.1 Preoperative clinical picture showing cracked temporary restorat...Figure 17.2 Preoperative radiograph showing MO temporary restoration and the...Figure 17.3 Removal of temporary restoration, access to previous endodontic ...Figure 17.4 The head of the fractured instrument is clearly visible after co...Figure 17.5 Removal of the fractured instrument in progress along with conti...Figure 17.6 Removal of the fractured instrument with a BTR loop.Figure 17.7 Radiographic verification of the removal of the fractured instru...Figure 17.8 Final obturation of the mandibular molar after removal of the fr...

18 Chapter 18Figure 18.1 Periapical radiograph inadequate root canal treatment in Tooth 1...Figure 18.2 Tooth 15 with all‐ceramic crown before starting the retreatment ...Figure 18.3 Endodontic access cavity made through the ceramic crown. Older g...Figure 18.4 Removal of gutta‐perchas with XP‐endo Shaper files from FKG.Figure 18.5 Periapical radiograph verifying the working length.Figure 18.6 Periapical radiograph verifying the master cones for obturation....Figure 18.7 Obturation of both the canals and the pulp chamber free of any g...Figure 18.8 Periapical radiograph to verify the obturation.Figure 18.8 Six‐month recall radiograph showing intact crown, obturation and...

19 Chapter 19Figure 19.1 Periapical radiograph showing inadequate root canal treatment in...Figure 19.2 First look at the endodontic access cavity in Tooth 16. Intracan...Figure 19.3 Mesiobuccal, distobuccal and palatal canals successfully located...Figure 19.4 MB2 canal located with the help of endodontic ultrasonic tips.Figure 19.5 Periapical radiograph verifying the working length.Figure 19.6 All the canals prepared up to 25/04 size with HyFlex files.Figure 19.7 Periapical radiograph verifying location of master cones in all ...Figure 19.8 All the canals obturated with gutta‐percha and sealer. The pulp ...Figure 19.9 Immediate postoperative radiograph showing obturation of all the...

20 Chapter 20Figure 20.1 Periapical radiograph showing previously treated Tooth 46 with a...Figure 20.2 Rubber dam isolation of the tooth.Figure 20.3 Previous gutta‐percha located and endodontic access cavity asses...Figure 20.4 Removal of previous obturating material with endodontic retreatm...Figure 20.5 Clinical picture showing the distal canals and the pulpal floor ...Figure 20.6 Extra canal orifice suspected next to previous distal canal orif...Figure 20.7 Suspected extra canal orifice negotiated and an extra canal loca...Figure 20.8 The periapical radiograph verifying the complete removal of gutt...Figure 20.9 The immediate postoperative periapical radiograph verifying the ...Figure 20.10 The 6‐month recall periapical radiograph verifying the intact o...

21 Chapter 21Figure 21.1 Periapical radiograph showing inadequate root canal treatment in...Figure 21.2 Rubber dam isolation of Tooth 46. Occlusal surface with resin co...Figure 21.3 (a,b) Removal of the resin composite restoration to expose the h...Figure 21.4 Post removal with the help of endodontic ultrasonic tips.Figure 21.5 (a) The distal canal after removal of the metallic post. (b) Met...Figure 21.6 (a) Gutta‐percha removed from the pulp chamber. (b) Gutta‐percha...Figure 21.7 Periapical radiograph showing working length determination after...Figure 21.8 Clinical picture showing irrigant inside the canals and pulp cha...Figure 21.9 Periapical radiograph to verify the fit of the master cones at t...Figure 21.10 Immediate clinical picture showing obturation of all the canals...Figure 21.11 Immediate postobturation periapical radiograph confirming the o...

22 Chapter 22Figure 22.1 Periapical radiograph showing inadequate root canal treatment in...Figure 22.2 Rubber dam isolation of Tooth 16. Occlusal surface with resin co...Figure 22.3 (a) Initiation of endodontic access cavity. (b) First sight of p...Figure 22.4 Signs of bleeding (perforation of the pulpal floor) can be seen ...Figure 22.5 Removal of gutta‐perchas from inside the canals, taking care not...Figure 22.6 Periapical radiograph to confirm the complete removal of gutta‐p...Figure 22.7 Intracanal medicament placed in the canals. Perforation clearly ...Figure 22.8 MTA placed over the perforation site.Figure 22.9 Clinical picture showing dry palatal perforation, after sealing ...Figure 22.10 Clinical picture showing sealing of both the perforation sites ...Figure 22.11 Clinical picture showing set MTA on the central perforation whe...Figure 22.12 Clinical picture showing use of a microbrush to condense the MT...Figure 22.13 Working length radiograph.Figure 22.14 Radiograph to verify the fit of the master cones.Figure 22.15 Clinical picture showing blocking of canals with gutta‐percha a...Figure 22.16 Clinical picture showing sealer inside the mesiobuccal canal.Figure 22.17 Clinical picture showing placement of gutta‐perchas inside the ...Figure 22.18 Clinical picture showing obturation of the canals.Figure 22.19 Immediate postoperative radiograph showing obturation and MTA i...Figure 22.20 Six‐month recall radiograph showing adequate healing of the per...

23 Chapter 23Figure 23.1 Periapical radiograph showing inadequate root canal treatment in...Figure 23.2 (a) Removal of PFM crown and rubber dam isolation of Tooth 36. (...Figure 23.3 The access cavity design and the previous gutta‐perchas.Figure 23.4 Removal of previous gutta‐percha from the canals.Figure 23.5 Periapical radiograph to confirm removal of gutta‐perchas from i...Figure 23.6 Middle mesial canal found after exploration of the access cavity...Figure 23.7 Previous gutta‐perchas stuck in the mesial canals.Figure 23.8 Stuck gutta‐perchas removed from the mesial canals with the XP‐e...Figure 23.9 Placement of MTA in the distal canal and master cone fit in the ...Figure 23.10 Radiograph verifying obturation of Tooth 36 up to the calculate...Figure 23.11 Radiograph verifying the fit of the prefabricated stainless ste...Figure 23.12 A 6‐month recall radiograph showing healing of the periapical l...

24 Chapter 24Figure 24.1 Palatal view.Figure 24.2 Buccal view.Figure 24.3 Preoperative assessment.Figure 24.4 Endodontic access cavity and location of previous gutta‐percha....Figure 24.5 Endodontic irrigant inaction.Figure 24.6 MTA plug.Figure 24.7 Cotton pellet placement.Figure 24.8 Placement of thermoplasticized gutta‐percha.Figure 24.9 Immediate postoperative radiograph.Figure 24.10 One‐year follow‐up radiograph.

25 Chapter 25Figure 25.1 Preoperative and postoperative x‐rays.Figure 25.2 Coronal, sagittal and axial views of the CBCT images of the mesi...Figure 25.3 Preoperative measurements: length of the root from a reproducibl...Figure 25.4 Location of the mental foramen from the alveolar crest. Note the...Figure 25.5 Preoperative radiographs and bitewing x‐rays: sinus tract tracin...Figure 25.6 CBCT imaging of mesial and distal roots: missed lingual canals o...Figure 25.7 Location of orifices of ML, MM, MB, DB and DL canals.Figure 25.8 Postoperative x‐rays.Figure 25.9 Preoperative x‐ray and bitewing showing a sound clinical crown a...Figure 25.10 CBCT images show no missed anatomy with lesion only on the mesi...Figure 25.11 Preoperative soft tissue with sinus tract over the MB root.Figure 25.12 After flap reflection, dehiscence of the cortical plate over th...Figure 25.13 Resected root surface with methylene blue staining showing leak...Figure 25.14 Root‐end preparation.Figure 25.15 Preoperative, postoperative and 6‐month follow‐up x‐rays.