A 45-year-old Asian male came in with pain in the lower left side of his mouth. I was able to isolate the pain coming from tooth No. 18. It had cracked tooth syndrome. Also, he had a mesially impacted wisdom tooth (Figure 1). So, I performed endodontic treatment with heat-treated NiTi files and obturated bioceramic sealer. The heat-treated files allowed me to pre-curve due to limited access, and they let me safely get around the curves (Figure 2).
|Figure 2: The heat-treated files allowed me to pre-curve due to limited access, and they let me safely get around the curves||Figure 3: The mesiobuccal, mesiolingual, and distobuccal canals all joined in the apical third, with the distobuccal canal exiting alone|
Some of the heat-treated files I’ve had great success with include Dentsply Sirona Endodontics’ Vortex Blue, Edge Endo’s EdgeFile X7, Brasseler USA’s EndoSequence SF, and SS White’s V-Taper 2H. I used bioceramic sealer—in this case, the liquid version of MTA that does not stain—because it would have been difficult to get the heat within 5 mm due to the curved and complex anatomy. Also, there was a microcrack into the pulp horn.
The mesiobuccal, mesiolingual, and distobuccal canals all joined in the apical third, with the distobuccal canal exiting alone (Figure 3). Some studies show that bioceramic sealer can strengthen the roots Companies that make and sell bioceramic sealer include Brasseler USA, EdgeEndo, SS White, and Ultradent Products.
Also, I will be speaking at CDA Presents 2019 this week in Anaheim. On Friday, I’ll be presenting “Current Trends in Endo: Fact vs. Fiction” and “Trauma—An Endodontic Perspective.” On Saturday, I’ll present “Endodontic Care: Nuts to Bolts” and “Apexogenesis, Apexification, Regeneration—Managing the Immature Apex.” Hope to see you there!
Dr. Short attended the Medical College of Georgia (MCG) School of Dentistry to attain a DMD degree in 1999. In 2002, he earned his postdoctorate degree in endodontics from Nova Southeastern University and then became a Diplomate of the American Board of Endodontics in 2009. Dr. Short is an expert consultant in endodontics to the Georgia Board of Dentistry and assistant clinical professor at the Dental College of Georgia in Augusta. His private practice, Apex Endodontics PC, is located in Smryna, Ga. He can be reached at firstname.lastname@example.org.