Performance Enhancing Endodontics

It’s cases like this among others that really allow the efficacy of the Gentlewave Procedure to shine through. It allows me to delivery optimal care in a single appointment.

This 68 yr old lady presented with pain in the upper right quadrant. She reported that she’d been dealing with the pain for years. The pain had worsened lately provoking a trip to her dentist, an excellent clinician who had completed the initial root canal treatment some years back.

The prior treatment had been carried out to a very high standard but in spite of this symptoms had developed. Healing had not been forthcoming. Complex anatomy allowing microbes to remain in the canal system was a suspected etiology.

Fortunately, complex anatomy provides no safe harbor for microbes against the cleaning power of the Gentlewave Procedure and treatment was undertaken.

I feel with modern tools like 3-D imaging, multi-sonic cleaning and heat treated nickel titanium files we are cheating. I’ve always been a good cheat though and accordingly made no effort to mechanically instrument the apical bifurcation in the mesio-buccal root visible in the pre-treatment 3-D images.

Top L-R Preop radiograph, CBCT axial view P and DB roots, CBCT axial view MB root Bottom: Post op radiograph, CBCT Axial view MB root, CBCT transverse view showing obturations in apical 1/3

To better illustrating the post op appearance and with curiosity getting the better of me. I elected to take a post-op 3-D CBCT.

A pretty image is just that though. Fingers crossed this RCT will go the distance. Thanks in no small part to my cheating.

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