This gentleman was referred to Peter Raftery for the management of his upper left central incisor. It had been traumatised many years earlier and had become discoloured. Whilst this did not particularly concern the patient he decided to improve its appearance in time for his son’s wedding because he had noticed he was not prone to smiling in photographs.
After root canal re-treatment the tooth was bleached over the course of three visits. The patient was happy with the result achieved well in time for the Big Day!
In this case multiple anterior teeth had been prepared for cosmetic castings which had led to pulpal complications. Close scrutiny the pre-operative radiograph suggested a second root on this lower canine. Judicious removal of lingual dentine via the operating microscope proved useful in identifying the location of the extra orifice.
Every effort is made to conserve existing cast restorations where possible. In this case the post at UR4 was removed though the well-fitting crown paving the way for non-surgical root canal re-treatment (including a previously undiscovered palatal canal). It was expected that primary treatment of UR5 would be more straightforward since approximately 90% have a single canal. In this case an additional apical foramen was suspected when the diagnostic file was seen to curve mesially; away from the distal apical radiolucent area. The second portal of exit was identified, instrumented, cleaned and filled.
Root canal treatment in this instance prolongs the useful service of a crown and a three unit conventional bridge.
A final case – reviewed eighteen months after apicectomy shows complete healing of the apical area associated with UL2. The pre-operative radiograph was exposed with a gutta-percha point inserted into the swelling (In suppurating cases, when a radiograph is exposed in this way the precise source of the infection can be confirmed). In this case the adjacent UL1 was also noted to be non-vital. Peter liaised with the referring Practitioner who provided the root canal treatment UL1. Peter then proceeded with microsurgical apicectomy of UL2 with MTA retro-filling.
The full range of surgical and non-surgical Specialist endodontic treatments is available from Peter at the Elms Lea endodontic service. Please do not hesitate to call if we can be of assistance to you.
Referrals can be by post, fax, E-mail (firstname.lastname@example.org) or directly through our website. In emergencies we can take telephone referrals. Referral forms and reply-paid envelopes can be sent to you on request, or forms downloaded from our website, www.elmslea.com.
Naturally all patients referred for specialist treatment are strictly embargoed from general practice at Elms Lea.
This patient, who required Periodontal treatment, was treated by Elisa Agudo. A gingival veneer was made to regain the pre-condition look. The result is a natural and lovely looking smile.