hello everyone and welcome to the 12th episode of the Diary of an endodontist today we'll be talking about internal [Music] resorption this patient was referred to me with a sign of an internal root resorption the dentist was a bit unsure whether it was an internal or external resorption if we could save this truth or not the periapical X Radio graph shows a possible um I think it's probably a malgam based on that the configuration of that the shape of it it's possible that there is something over here as well the canal is a bit short
and defective and also the disto you can see a possible radiolucency we know from the our textbooks that the internal resorption can be inflammatory or a replacement and the way we know is if it's quite circumferential defined is inflammatory or if it's a bit uneven it may be replacement uh but as long as we cannot see the line of the canal it was always explained to us that this is a case of internal resorption whether if we see the that round shape but we can see the Canal the walls of the canal inside then is
probably a case of an external resorption I I don't fully agree with that because yes I agree if it's a true internal or a true and only external but if it's an internal that has already externalized or an external that has already internalized so it's a bit difficult for you to understand the best best thing to do is to take a cbct to confirm whether this radiolucency here is just located inside of the root and has not externalized because it depends on how uh how it has externalized already it will be depending on that for
you to say yes we can save it or not so again radiolucency here that we need to focus on and another one over there the cbct shows the the same image the one and two and the possible Amal uh look at how interesting the Ral lucency is over there on the fation if it's just unilateral and it's not extending towards the other side I would say is not a crack or at at least it could be a crack in the early stage but based on that the size of that I would say is probably a
lateral Canal instead the reny apically on the G route as we expected as well but more in interestingly is the radiolucency inside of the canal so is an internal root resorption only can we go through that yeah yes it's a bit tricky um if you are not too experienced with that but as long as you prevent your file and you are careful not to ledge that Canal that is already compromised with the resorption you can see that is just on the apico thirds is just one exit so the two the misio pako and the Mis
lingo they join and that's where the the circumference of the Regency the internal root resorption is and then it it splits into it splits no and it fuses into one Canal as long as you understand that Anatomy then it's not too difficult for you to go and do your root canal treatment you can see in more detail there is a blockage here and that's why the dentist couldn't negotiate it could be a separated file it could be a malum uh but something is blocking the way ideally you should negotiate both canals but sometimes if the
canal join if both canals they join in and there is the radiolucency here if you can manage to disinfect the whole area and block with bioceramic sealer that's not much of a problem if you leave that untreated I don't normally like to leave anything untreated I like to find all the canals and unblock and get to the end of the route but you are not sending it to extraction just because you you could not negotiate that Canal I think if you are in doubt dress the tooth monitor see if you are going the right direction
and if you are then you can plan on obturating that tooth in this case I didn't have to do inry stages I could negotiate both canals uh I was sure that this was a latro canal instead of a crack um and everything went really well and in three month time after the obturation I took an x-ray and you can now see that the area is healing really well I left the amalgam here I don't normally like to leave the amalgam I like to change the restoration but it was quite a complex tooth when I accessed
the tooth I didn't have time um to to spend on the the the feeling and the feeling was fine it was adapted was not dislodging so I said no okay I will just repair and try to see if I can save the tooth first and then it will go for a crown anyway so I was happy to leave as it as it was and patient was absolutely fine understood all the steps that we went through and the truth is now back into function and it's time for a crown thank you very much for staying with
us and I'll see you next [Music] time
