Endodontic treatment of Geminated Canine

 An unusual presentation of a Canine (13) with periapical pathology showing an extra tooth structure on the mesial side.

On closer inspection, the pulp chambers seem connected. Since there is no missing tooth in the area, it looks like a case of Gemination.

After access opening, length determination of primary root is carried out.

Attempt is made to negotiate the additional root canal but the double curvature does not yield. The tooth  is unlikely to heal unless the additional root is endontically treated or resected.

Surgical intervention is planned. A flap is raised and the additional root resected. The resulting perforation is sealed off with GIC.

 Master cone placed.

Post Obturation radiograph. 

The bony defect is expected to fill up in time. 

To be reviewed in 3 & 6 months.....

On the MB2 trail

A carious exposed 16 requiring Endodontic treatment.

Initial working length determination using hand files.

Closer inspection of pulpal floor reveals another Mesiobuccal orifice. A faint canal can also be seen on radiograph.

The incidence of MB2 canal in Maxillary Ist & 2nd Molars is quite high and time should be devoted to to its location and treatment. 

Both MB canals have been located. It exibits a Type III  canal anatomy.

Post obturation radiograph .Protaper rotary files were used for canal preparation. 

Post obturation radiograph taken from another angle to see better separation of canals. 

Wrong turn !

A patient reports with symptoms of  pulpitis and apical periodontitis in 47. The tooth has a # filling.

 An obstruction is encountered in  the apical third of distal canal.

A precurved file and tactile feeling help negotiate a sharp distal bend in the apical third.

The distal canal is prepared by hand filing in the  apical third and Protaper rotary in coronal and middle third.

Mesial root has a Type II canal anatomy and is prepared with Protaper rotary files.

                                               

After final Obturation using 6% G.P.as master cone and lateral condensation technique.

Pegged for Crown

 A 26 yr. old girl is  unhappy with the dark shadows in between her front teeth. She wants crowns on  her peg laterals to fill up the gaps.

Minor preps are done on her laterals and impressions are sent for fabrication of 3M Lava crowns. 

3M Lava crowns on dental cast.

Crown after cementation with resin cement.

Final appearance after crown cementation.

Midline diastema closure is planned for Composite build-up.