Endodontic education, according to our customers, is often about sharing our successes and challenges with our colleagues. This section will offer interesting endodontic cases for your review using the latest technology as well as time-tested, classic methods. We will offer new cases to look at periodically, and will archive them for future reference.

If you have an interesting case to share, or if you have comments or questions about the current case, please forward it to endoguy@obtura.com

Sometimes, the most routine case may present more than initially appears. Root canal systems are just that, systems. They are not one or two or three canals, but rather are intricate systems with multiple branches which merely present to the practitioner a few portals of entry into the system.

Take this case for instance. The patient presented with a chief complaint of pain, which we quickly found emanated from a cariously exposed necrotic upper bicuspid with apical periodontitis. At the first visit, under rubber dam of course, caries were removed, a fairly routine buccal and lingual canal were quickly identified and grossly instrumented with hand instrumentation to a #20 apical size, calcium hydroxide placed and temporized, tooth taken out of occlusion, and the patient reappointed for 2 weeks hence.

At the second visit, instrumentation on the now asymptomatic tooth was completed under rubber dam using hand instrumentation and rotary files to an apical size of #40 .04. Irrigation protocol consisted of 5% sodium hypochlorite throughout instrumentation, followed by final irrigation with EDTA and Chlorhexidene. Obturation was accomplished using the Obtura system with Resilon/Epiphany in a microstructural replication (commonly referred to as ?squirting?) technique. Coronal buildup using bonded composite resin was completed at the same visit.

Note that despite the application of hydraulic force to but 2 points of entry into the system, multiple secondary anatomy is readily evident. More sobering is the fact that there is much more that is not obturated and thus is not visible.