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Example cases

These cases have all been treated by dentists at Kingston Park Advanced Dentistry

perfect root filling and nayyar core

Root Canal Treatment  - Upper molar tooth 

This tooth had a long standing infection under the roots of the tooth which was causing the patient discomfort when biting on the tooth. The patients original dentist had tried to do a root filling in this tooth, however, the nerve spaces in the tooth were very small and it was not possible to locate them. 

Before treatment was started, all decay was taken away from the tooth and the cavity in the back of the tooth was sealed to make sure that no more bacteria could re-infect the tooth.

Using high powered magnification, it was possible to then find the nerve spaces inside the tooth. These spaces were then enlarged and cleaned thoroughly to the end of the tooth. After a period of disinfection, the infection from this tooth healed and the tooth was sealed with a root filling. A strong foundation was placed in the centre of the tooth to support a crown which the patients own dentist was able to provide.

Old root filling in upper molar tooth

Root Canal Re-treatment upper molar tooth 

This upper molar tooth became painful several years after the origional root filling had been completed. 

On the x-ray, there was evidence of infection under the roots of this tooth which had previously had a root filling. The root filling had not reached the end of the individual roots of the tooth and bacteria was remaining inside the tooth.

This remaining bacterial had been causing a long standing infection/ inflammation under the tooth.

 

To treat this tooth, the original root filling was removed and then the space inside the tooth where bacteria was remaining was disinfected allowing the tissues under the tooth to heal resulting in the long standing pain going away. The tooth was then re-sealed with a new root filling which filled the three dimensional space inside the tooth

New root filling removing bacteria and pain
Root canal retreatment over-extended GP

Root Canal Re-treatment. 

In this case, there was pain from the upper left central incisor tooth despite a historical root canal filling. The conventional x-ray of the tooth showed there was a root filling in the tooth which appeared to extend nicely to the end of the root. 

A three-dimensional x-ray (CBCT scan) was taken which shows the root filling had been pushed through the end of the tooth was was irritating the ligament around the end of the tooth - this was the cause of the chronic pain since the root filling was completed

To treat this, the old root filling was removed and the end of the tooth sealed with a material which allows the tissues around the end of the tooth to heal (Bioceramic MTA cement). The root canal space in the tooth was then sealed with a conventional root filling material and the pain the patient had been experiencing stopped.

Removal of old root filling. Sealing endo of root with MTA cement and new root canal

Root Canal Treatment upper molar tooth 

This upper right molar tooth had rather complex root anatomy with lateral (side) canals at the end of the separate roots. Using a thorough cleaning protocol, the space inside the tooth was cleaned and then completely sealed using state of the art techniques to ensure the space inside the tooth was three-dimensionally sealed.

Failure to disinfect the entire space inside a tooth can leave behind bacteria which can cause root filled teeth to become painful again.

UR6 Primary.jpg
pain from tooth after root filling

Root Canal Re-treatment lower left premolar. 

Despite having an old root filling, this lower premolar tooth was causing the patient pain when biting on the tooth and there was some pain in the gum next to the tooth. 

There was bacteria inside the tooth under the old root filling. To treat this tooth, the old root filling was removed and the space under the old root filling located and cleaned. 

After a period of disinfection which resolved all the pain the patient was experiencing from the tooth, the tooth was re-sealed with a new root filling which extended to the very end of the root of the tooth. 

Root Canal after full mouth rehabilitation / cosmetic crowns. 

This patient had recently completed a full mouth rehabilitation and had cosmetic all ceramic crowns on his anterior teeth which had been done to a very high standard. Unfortunately, the upper left lateral incisor tooth became symptomatic and the patient was referred for management of this. 

In cases where there are crowns on teeth, it is really important to keep the access hole which gains access to the space inside the tooth as small as possible retaining the integrity of the crown and also keeping as much underlying tooth structure as possible. 

minimal access through ceramic crown
Endo through cosmetic crowns
root canal cosmetic dentistry
Repeat root filling.JPG
unfilled canal in tooth.JPG

Re-treatment of molar tooth where there was an extra canal in the tooth

This tooth had previously been root filled, but the tooth had become painful to bite on. The historical root filling was sub-optimal and there was also an unfilled nerve space in one of the roots of the tooth (MB2). Microbes remaining in the pulp system were resulting in the symptoms of periapical periodontitis. 

The old root filling was removed and the extra nerve space located. After disinfecting the pulp system, the tooth was symptom free. The tooth was then sealed with a new root filling and an amalgam Nayyar core placed to form the foundations for a crown which the patients regular dentist was planning.

obturated MB2.JPG
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