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Dental Tribune United Kingdom Edition

17Endo TribuneFebruary 2014United Kingdom Edition Dr Anoop Maini BDS(Lond) DGDP(UK) Dates: 21st March, 11th April, 16th May, 20th June, 26th September with BACD BILDHndOn150114RG Course Sponsor Call now to book on 01227 780009 and for further details visit us on facebook: ‘British Institute of Laser Dentistry’ Run by Dentists - For Dentists Gain valuable experience in Laser dentistry with advanced techniques in clinical and cosmetic procedures. Use and try Britains best soft tissue lasers, demonstrated by the renowned Dr. Anoop Maini and see why you can no longer ignore lasers to help you and your patients. In order to achieve a sat- isfactory result, I needed to remove GP using DMZ-IV and Pro-Taper re-treatment files. This was my first ex- perience of removing GP and I was careful to ensure complete removal of the GP, before re-preparing the canals chemo-mechanically. As I had evidently failed to sufficiently prepare the canals for GP the first time round, I spent some time enlarging the orifice using hand files and using EDTA to ensure that I could use the ProTaper files to length prior to obturation. I then obturated using Ther- mafil, and have subsequently restored the tooth using a por- celain onlay. An S-shaped curvature or double curvature can make a canal very challenging to negotiate. I learned that us- ing hand files initially can help prepare the canal suf- ficiently prior to using rotary files. I now know to approach curved canals like these with more caution, and to take time preparing the canals ensuring adequate mechani- cal preparation. I had never used re-treatment files before and I learnt to use a pecking motion and ensure visualisa- tion of GP on the files. I now feel more confident in doing this and therefore more able to attempt re-root treatment in the future. I chose a porcelain on- lay to restore the tooth as it provided excellent aesthet- ics, cuspal coverage and also helped to preserve more of the buccal and lingual tooth present, which would have been destroyed had I chosen to perform a crown prepara- tion. The tooth was in the pa- tient’s smile line and she was very pleased with the aes- thetic result. Overall, I was pleased with the end result of this root canal treatment and hope that the patient is able to retain this tooth for many years as a result. I feel that this case helped me to develop my endodontic skills overall as it involved improving upon a myriad of skills. Firstly, my assess- ment of a case; I had not pre- viously spent a long time an- alysing the curvature of the roots and the effect this would have on my method of root fill- ing the tooth. Since this case I have become acutely aware of the need to tailor your technique to the type of roots present, including ensuring adequate access, the need for anticurvature filing, and the advantages and disad- vantages of using rotary in- strumentation in these cas- es. Secondly, it made me realise the importance of establishing the aetiology of any problems encoun- tered. I realised that as my GP had not seated to length that I had evidently not prepared the canals adequately and by establishing this aetiology I could therefore improve the outcome by rectifying this problem. I have also real- ised that acknowledging your own limitations and compe- tency is key in endodontics; I was aware that the initial treatment I provided was poor, but that rectifying it may be difficult. I therefore en- sured I informed the patient that I would try my best to im- prove on the root treatment, but that should it be beyond my competency we would have to consider alternative pathways. This case helped me im- prove upon my endodontic planning and also, the tech- niques involved in S- shaped root canals. It has encour- aged me to realise that if an ideal result is not achieved in- itially, things can be improved upon and should not just be accepted. DT Textbook of Endodontology, Gunnar Bergenholtz, Preben Horsted-Bindslev, Claes Reit Second Edition Harty’s Endondontics in Clinical Prac- tive, Bun San Chong, Sixth Edition About the author At the time of this case, Lydia was working in a Bristol dental practice as a foundation dentist, in her second year of vocational training.