hello everyone and welcome to the first episode of the new series The Diary of an endodontist if you want to see clinical cases in more details and with lots of tips and tricks this is the series for you I'm Danny manuu specialist endodontist and prostodoncia of Dentistry through clinical cases that me and my Specialist Team see in our two especially endodontic practice here in England what we want to achieve from that is that you use the tips and tricks and applying your daily routine today I'm going to show you a case that we will discuss
about j-shaped lesions stay with [Music] me it's so good to see you here this is a space for professionals like you who want to enhance enance your knowledge and improve your clinical skills one of the questions I often receive from our referring dentists is if teeth Associated to g-shaped lesions are correct or not sometimes they are and sometimes they aren't so in this case this lady was referred to us we did some tests like the sensibility test it was necrotic and the de parodontal pocket showed us that there was a pocket more than 5 mm
deep on the disto of that tooth we then discussed with a patient that could be a cracked tooth and it could be that we wouldn't be able to save and we offered to the patient that we could explore it further The Next Step was to take a cbct and what the cbct revealed was that the radiolucency was more apically and towards the mid third of that rout and not as much cervically the foration was absolutely fine so so we then discussed with the patient the possibility that this tooth could be crashed and that we could
end up losing that tooth but there was a chance that we could open the tooth and there wouldn't be a problem and that tooth could be saved the patient agreed to explore it further I access the tooth and I could see always under the rubber Dum please always under the rodum and lots of magnification so microscope if you can if you can't a good pair of Loops at least 3.5 and I could see under the amalgam that there was a disto crack the crack was not going below the CJ as far as I could tell
was not traveling down the routs so there was a chance we could save most of the time nowadays we try to save the cracked teeth and there are several ways you can do that but we'll leave that for another topic we carried on with the treatment and in cases like that we could have finished in one visit and to to be honest I prefer to finishing a single visit because then you advise the patient to go for a crown and there is less risks of fracture in the interim treatment however in this case I dressed
with calcium hydroxide and asked the patient to come back in a week and she managed to come back to us after 14 months the good thing about that is that I could check that we were going right direction and that the infection was healing the downside of leaving that long is that the crack can travel further but of course when I took the whole amalgam I took this truth out of occlusion so I protected it and that's the best thing to do because if you live in your occlusion there's more risk of fracture further I
then proceeded with the completion of the case and that's what you can see is all completed all obturated with a single cone and bioceramic but I don't know if you can see a line here and this line shows that the composite feeling is in this area so in crack teeth what you have to do is bring your core at least 2 to three millimet inside of the canal doing that bonding it properly you will be a able to protect that distal margin a little bit further the tooth had a small crack so to protect that
tooth I decided to remove the whole disto and just Bond a nice um composite feeling to go under the crown I hope you have enjoyed our first episode and have learned something from it that you could apply in your daily routine if you want me to discuss any further case just put in the comments below and also don't forget to subscribe we will be routinely putting different PES and we want you to be with us stay [Music] tuned
