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Case

Clinical Photos

Illustrations / Diagrams

Apexification for Root-End Closure

Root Canal Apexification Case 2 -

Root Canal Apexification Case 2 - Contributed by David E. Witherspoon, BDS, MS on 2/14/2012

Figure 1 - Preoperative radiographs of tooth #9(21) diagnosed with pulpal necrosis and acute periradicular periodontitis.

Root Canal Apexification Case 2<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Working length radiograph of a maxillary central incisor.</span>

Figure 2 - Working length radiograph of a maxillary central incisor.

Root Canal Apexification Case 2<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Six-month postoperative radiograph of the left maxillary central incisor with a bonded composite core material placed in the canal system.</span>

Figure 3 - Six-month postoperative radiograph of the left maxillary central incisor with a bonded composite core material placed in the...

Figure 3 - Six-month postoperative radiograph of the left maxillary central incisor with a bonded composite core material placed in the canal system.

Root Apexification Case 3 -

Root Apexification Case 3 - Contributed by David E. Witherspoon, BDS, MS on 2/14/2012

Figure 1 - Preoperative radiograph of tooth #20(35) diagnosed with pulpal necrosis and acute periradicular preiodontitis.

Root Apexification Case 3<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Immediate postoperative radiograph of the left mandibular second premolar treated with placement of MTA in the apical third.</span>

Figure 2 - Immediate postoperative radiograph of the left mandibular second premolar treated with placement of MTA in the apical third....

Figure 2 - Immediate postoperative radiograph of the left mandibular second premolar treated with placement of MTA in the apical third.

Root Apexification Case 3<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Six-month postoperative radiograph of the left mandibular second premolar with a bonded composite core material placed in the canal system. Note periradicular healing.</span>

Figure 3 - Six-month postoperative radiograph of the left mandibular second premolar with a bonded composite core material placed in th...

Figure 3 - Six-month postoperative radiograph of the left mandibular second premolar with a bonded composite core material placed in the canal system. Note periradicular healing.

Aesthetic Restoration of Nonvital Teeth

Aesthetic restoration of maxillary left central incisor - Aesthetic restoration of maxillary left central incisor

Aesthetic restoration of maxillary left central incisor - Aesthetic restoration of maxillary left central incisor Contributed by Christof Schirra, DMD on 3/12/2012

Aesthetic restoration of maxillary left central incisor<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative facial view of unaesthetic maxillary incisors. Note the eneodonditcally treated and discolored maxillary left central incisor.</span>

Figure 1 - Preoperative facial view of unaesthetic maxillary incisors. Note the eneodonditcally treated and discolored maxillary left c...

Figure 1 - Preoperative facial view of unaesthetic maxillary incisors. Note the eneodonditcally treated and discolored maxillary left central incisor.

Aesthetic restoration of maxillary left central incisor<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Postoperative facial view of the definitive all-ceramic crown restoration. Note the significant aesthetic improvement, particularly in the light-conducting maxillary left central incisor.</span>

Figure 2 - Postoperative facial view of the definitive all-ceramic crown restoration. Note the significant aesthetic improvement, parti...

Figure 2 - Postoperative facial view of the definitive all-ceramic crown restoration. Note the significant aesthetic improvement, particularly in the light-conducting maxillary left central incisor.

Aesthetic restoration of maxillary left central incisor<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Image depicts zinc phosphate cement (left), composite resin cement (center), and glass-ionomer cement (right).</span>

Figure 3 - Image depicts zinc phosphate cement (left), composite resin cement (center), and glass-ionomer cement (right).

Aesthetic restoration of maxillary left central incisor<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Appearance of an aluminum oxide ceramic core viewed under transillumination.</span>

Figure 4 - Appearance of an aluminum oxide ceramic core viewed under transillumination.

Aesthetic restoration of maxillary left central incisor<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Transilluminated section of a natural tooth demonstrates the placement of the definitive aesthetic post. Note the brightened appearance of the tooth.</span>

Figure 5 - Transilluminated section of a natural tooth demonstrates the placement of the definitive aesthetic post. Note the brightened...

Figure 5 - Transilluminated section of a natural tooth demonstrates the placement of the definitive aesthetic post. Note the brightened appearance of the tooth.

Harmonious restoration of maxillary left central incisor with light-conducting post - Harmonious restoration of maxillary left central incisor wi...

Harmonious restoration of maxillary left central incisor with light-conducting post - Harmonious restoration of maxillary left central incisor with light-conducting post Contributed by Christof Schirra, DMD on 3/12/2012

Harmonious restoration of maxillary left central incisor with light-conducting post<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative facial view of a 19-year-old male patient with a nonvital discolored maxillary left central incisor.</span>

Figure 1 - Preoperative facial view of a 19-year-old male patient with a nonvital discolored maxillary left central incisor.

Harmonious restoration of maxillary left central incisor with light-conducting post<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> A drill was utilized to shape the root canal of the tooth.</span>

Figure 2 - A drill was utilized to shape the root canal of the tooth.

Harmonious restoration of maxillary left central incisor with light-conducting post<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> The light-conducting post is tried in to verify fit in the prepared root canal.</span>

Figure 3 - The light-conducting post is tried in to verify fit in the prepared root canal.

Harmonious restoration of maxillary left central incisor with light-conducting post<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> 4A. Phosphoric acid was applied for 15 seconds, and the canal was rinsed and dried. Following the application of a dentin bonding agent, the post was cemented, and a blocking gel was used. 4B. The core buildup is completed and prepared with 90 degree shoulder margins.</span>

Figure 4 - 4A. Phosphoric acid was applied for 15 seconds, and the canal was rinsed and dried. Following the application of a dentin bo...

Figure 4 - 4A. Phosphoric acid was applied for 15 seconds, and the canal was rinsed and dried. Following the application of a dentin bonding agent, the post was cemented, and a blocking gel was used. 4B. The core buildup is completed and prepared with 90 degree shoulder margins.

Harmonious restoration of maxillary left central incisor with light-conducting post<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Occlusal view demonstrates the placement of the retraction cord, which was placed circumferentially around the preparation.</span>

Figure 5 - Occlusal view demonstrates the placement of the retraction cord, which was placed circumferentially around the preparation.

Harmonious restoration of maxillary left central incisor with light-conducting post<br/> Figure 6. <span style='font-size: 16px; font-weight: normal'> 6A. The enamel was etched with 33% phosphoric acid according to the total-etch procedure. 6B. Facial view exhibits the milky appearance of the etched enamel surfaces.</span>

Figure 6 - 6A. The enamel was etched with 33% phosphoric acid according to the "total-etch" procedure. 6B. Facial view exhibits the mil...

Figure 6 - 6A. The enamel was etched with 33% phosphoric acid according to the "total-etch" procedure. 6B. Facial view exhibits the milky appearance of the etched enamel surfaces.

Harmonious restoration of maxillary left central incisor with light-conducting post<br/> Figure 7. <span style='font-size: 16px; font-weight: normal'> Facial view demonstrates the application of the enamel and dentin bonding agent.</span>

Figure 7 - Facial view demonstrates the application of the enamel and dentin bonding agent.

Harmonious restoration of maxillary left central incisor with light-conducting post<br/> Figure 8. <span style='font-size: 16px; font-weight: normal'> Following the removal of an oxygen-blocking gel, the retraction cord was removed with a probe.</span>

Figure 8 - Following the removal of an oxygen-blocking gel, the retraction cord was removed with a probe.

Harmonious restoration of maxillary left central incisor with light-conducting post<br/> Figure 9. <span style='font-size: 16px; font-weight: normal'> Facial view of the restoration following cementation. The inflamed gingival margin is clearly evident.</span>

Figure 9 - Facial view of the restoration following cementation. The inflamed gingival margin is clearly evident.

Harmonious restoration of maxillary left central incisor with light-conducting post<br/> Figure 10. <span style='font-size: 16px; font-weight: normal'> Facial view of the definitve all-ceramic crown restoration 3 weeks postcementation. Note the significant aesthetic improvement that has been achieved.</span>

Figure 10 - Facial view of the definitve all-ceramic crown restoration 3 weeks postcementation. Note the significant aesthetic improvem...

Figure 10 - Facial view of the definitve all-ceramic crown restoration 3 weeks postcementation. Note the significant aesthetic improvement that has been achieved.

Ceramic Post and Core Restorations for Teeth #7 and #13 - Ceramic Post and Core Restorations for Teeth #7 and #13

Ceramic Post and Core Restorations for Teeth #7 and #13 - Ceramic Post and Core Restorations for Teeth #7 and #13 Contributed by Bernard Touati, DDS on 4/27/2012

Ceramic Post and Core Restorations for Teeth #7 and #13<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative facial view of a 30 year old female patient who presented for restoration of defective ceramic laminate veneers.</span>

Figure 1 - Preoperative facial view of a 30 year old female patient who presented for restoration of defective ceramic laminate veneers...

Figure 1 - Preoperative facial view of a 30 year old female patient who presented for restoration of defective ceramic laminate veneers.

Ceramic Post and Core Restorations for Teeth #7 and #13<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> The teeth were prepared on the model for all-ceramic crowns. Ceramic post and core restorations were selected for teeth #7(12) and #13(25).</span>

Figure 2 - The teeth were prepared on the model for all-ceramic crowns. Ceramic post and core restorations were selected for teeth #7(1...

Figure 2 - The teeth were prepared on the model for all-ceramic crowns. Ceramic post and core restorations were selected for teeth #7(12) and #13(25).

Ceramic Post and Core Restorations for Teeth #7 and #13<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> The bisque bake restorations were tried-in to verify fit, proximal contacts, occlusion, length, and form.</span>

Figure 3 - The bisque bake restorations were tried-in to verify fit, proximal contacts, occlusion, length, and form.

Ceramic Post and Core Restorations for Teeth #7 and #13<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> A pickup-type impression material was utilized to verify the emergence profile. The crowns were stabilized with a fast-setting, light-bodied polyvinylsiloxane material.</span>

Figure 4 - A pickup-type impression material was utilized to verify the emergence profile. The crowns were stabilized with a fast-setti...

Figure 4 - A pickup-type impression material was utilized to verify the emergence profile. The crowns were stabilized with a fast-setting, light-bodied polyvinylsiloxane material.

Ceramic Post and Core Restorations for Teeth #7 and #13<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Once the maxillary crown restorations were seated and cemented with a resin modified glass-ionomer cement, the mandibular laminate veneers were secured with a resin cement.</span>

Figure 5 - Once the maxillary crown restorations were seated and cemented with a resin modified glass-ionomer cement, the mandibular la...

Figure 5 - Once the maxillary crown restorations were seated and cemented with a resin modified glass-ionomer cement, the mandibular laminate veneers were secured with a resin cement.

Ceramic Post and Core Restorations for Teeth #7 and #13<br/> Figure 6. <span style='font-size: 16px; font-weight: normal'> Lingual view following cementation of the mandibular laminate veneers.</span>

Figure 6 - Lingual view following cementation of the mandibular laminate veneers.

Ceramic Post and Core Restorations for Teeth #7 and #13<br/> Figure 7. <span style='font-size: 16px; font-weight: normal'> The use of CAD-CAM technology during the fabrication sequence enabled development of reliable internal relief for the definitive restorations.</span>

Figure 7 - The use of CAD-CAM technology during the fabrication sequence enabled development of reliable internal relief for the defini...

Figure 7 - The use of CAD-CAM technology during the fabrication sequence enabled development of reliable internal relief for the definitive restorations.

Ceramic Post and Core Restorations for Teeth #7 and #13<br/> Figure 8. <span style='font-size: 16px; font-weight: normal'> Postoperative facial view of the definitive all-ceramic restorations.</span>

Figure 8 - Postoperative facial view of the definitive all-ceramic restorations.

Ceramic Post and Core Restorations for Teeth #7 and #13<br/> Figure 9. <span style='font-size: 16px; font-weight: normal'> Buccal view following cementation demonstrates aesthetic tissue integration and natural light reflection.</span>

Figure 9 - Buccal view following cementation demonstrates aesthetic tissue integration and natural light reflection.

Managing a Coronal Fracture of the Endodontically Treated Central Incisor - Post-and-core placed with an all-ceramic crown in a 47-year-old male...

Managing a Coronal Fracture of the Endodontically Treated Central Incisor - Post-and-core placed with an all-ceramic crown in a 47-year-old male patient with a coronal fracture Contributed by Nathan Blitz, BSc, DDS on 11/29/2012

$Managing a Coronal Fracture of the Endodontically Treated Central Incisor Figure 1. A porcelain-fused-to-metal crown exhibits mobility due to coronal fracture of the endodontically treated incisor.$ Figure 1 - A porcelain-fused-to-metal crown exhibits mobility due to coronal fracture of the endodontically treated incisor.

Figure 1 - A porcelain-fused-to-metal crown exhibits mobility due to coronal fracture of the endodontically treated incisor.

Managing a Coronal Fracture of the Endodontically Treated Central Incisor<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> In cases of extreme coronal debilitation a post and core restoration is required. A minimum of 1.5 mm to 2.0 mm of supragingival tooth structure must remain.</span>

Figure 2 - In cases of extreme coronal debilitation a post and core restoration is required. A minimum of 1.5 mm to 2.0 mm of supraging...

Figure 2 - In cases of extreme coronal debilitation a post and core restoration is required. A minimum of 1.5 mm to 2.0 mm of supragingival tooth structure must remain.

Managing a Coronal Fracture of the Endodontically Treated Central Incisor<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> An all-ceramic crown was placed and affixed with resin cement.</span>

Figure 3 - An all-ceramic crown was placed and affixed with resin cement.

Managing a Coronal Fracture of the Endodontically Treated Central Incisor<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> The resin cement is polished at the interface of the tooth and crown utilizing rubber cups.</span>

Figure 4 - The resin cement is polished at the interface of the tooth and crown utilizing rubber cups.

Managing a Coronal Fracture of the Endodontically Treated Central Incisor<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Two-week postoperative view of the completed crown restoration.</span>

Figure 5 - Two-week postoperative view of the completed crown restoration.

Restoration of Fractured Maxillary Right Central Incisor - Endodontic post and all-ceramic crown for restoration of fractured tooth #8

Restoration of Fractured Maxillary Right Central Incisor - Endodontic post and all-ceramic crown for restoration of fractured tooth #8 Contributed by Paul R. Chalifoux, DDS on 12/10/2012

$Restoration of Fractured Maxillary Right Central Incisor Figure 1. Preoperative view of a Class 1P fractured incisor with high forces.$ Figure 1 - Preoperative view of a Class 1P fractured incisor with high forces.

Figure 1 - Preoperative view of a Class 1P fractured incisor with high forces.

Restoration of Fractured Maxillary Right Central Incisor<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Postoperative clinical facial view of the seated all-porcelain crown restoration.</span>

Figure 3 - Postoperative clinical facial view of the seated all-porcelain crown restoration.

Restoration of Fractured Maxillary Right Central Incisor<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Postoperative radiograph of the completed restoration.</span>

Figure 4 - Postoperative radiograph of the completed restoration.

Carbon Fiber Posts for Restoring Endodontically Treated Teeth

Use of Carbon Fiber Post for Treatment of Maxillary Lateral Incisor - Use of Carbon Fiber Post for Treatment of Maxillary Lateral Incisor

Use of Carbon Fiber Post for Treatment of Maxillary Lateral Incisor - Use of Carbon Fiber Post for Treatment of Maxillary Lateral Incisor Contributed by Adriana Ferreira Quintas, DDS, MS on 3/14/2012

Use of Carbon Fiber Post for Treatment of Maxillary Lateral Incisor<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative view of tooth #10(22) demonstrates compromised aesthetics.</span>

Figure 1 - Preoperative view of tooth #10(22) demonstrates compromised aesthetics.

Use of Carbon Fiber Post for Treatment of Maxillary Lateral Incisor<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> 2A. Preoperative radiograph indicates need for endodontic retreatment. 2B. Postoperative radiograph following endodontic retreatment.</span>

Figure 2 - 2A. Preoperative radiograph indicates need for endodontic retreatment. 2B. Postoperative radiograph following endodontic ret...

Figure 2 - 2A. Preoperative radiograph indicates need for endodontic retreatment. 2B. Postoperative radiograph following endodontic retreatment.

Use of Carbon Fiber Post for Treatment of Maxillary Lateral Incisor<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Carbon-fiber post prior to cementation. Lack of coronal structure indicates placement of a post and core and an all-ceramic crown.</span>

Figure 3 - Carbon-fiber post prior to cementation. Lack of coronal structure indicates placement of a post and core and an all-ceramic...

Figure 3 - Carbon-fiber post prior to cementation. Lack of coronal structure indicates placement of a post and core and an all-ceramic crown.

Use of Carbon Fiber Post for Treatment of Maxillary Lateral Incisor<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> The final preparation demonstrates adequate biologic width and gingival architecture.</span>

Figure 4 - The final preparation demonstrates adequate biologic width and gingival architecture.

Use of Carbon Fiber Post for Treatment of Maxillary Lateral Incisor<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Periapical radiograph demonstrates the radiopacity of the luting cement.</span>

Figure 5 - Periapical radiograph demonstrates the radiopacity of the luting cement.

Use of Carbon Fiber Post for Treatment of Maxillary Lateral Incisor<br/> Figure 6. <span style='font-size: 16px; font-weight: normal'> Postoperative view of the all-ceramic restoration demonstrates enhanced shape, contour, texture, and translucency.</span>

Figure 6 - Postoperative view of the all-ceramic restoration demonstrates enhanced shape, contour, texture, and translucency.

Glass-fiber Posts for the Restoration of Endodontically Treated Teeth

Use of a glass-fiber post for treatment of maxillary lateral incisor - Use of a glass-fiber post for treatment of maxillary lateral incisor

Use of a glass-fiber post for treatment of maxillary lateral incisor - Use of a glass-fiber post for treatment of maxillary lateral incisor Contributed by Adriana Ferreira Quintas, DDS, MS on 3/14/2012

Use of a glass-fiber post for treatment of maxillary lateral incisor<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative lateral view demonstrates compromised aesthetics, gingival regression, and indicates endodontic treatment.</span>

Figure 1 - Preoperative lateral view demonstrates compromised aesthetics, gingival regression, and indicates endodontic treatment.

Use of a glass-fiber post for treatment of maxillary lateral incisor<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> The glass-fiber post is tried in on the tooth structure.</span>

Figure 2 - The glass-fiber post is tried in on the tooth structure.

Use of a glass-fiber post for treatment of maxillary lateral incisor<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Following post cementation, a rounded shoulder preparation is achieved. Tooth structure is preserved for the maxillary left lateral incisor.</span>

Figure 3 - Following post cementation, a rounded shoulder preparation is achieved. Tooth structure is preserved for the maxillary left...

Figure 3 - Following post cementation, a rounded shoulder preparation is achieved. Tooth structure is preserved for the maxillary left lateral incisor.

Use of a glass-fiber post for treatment of maxillary lateral incisor<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Radiographic aspect of glass-fiber posts similar to carbon posts.</span>

Figure 4 - Radiographic aspect of glass-fiber posts similar to carbon posts.

Use of a glass-fiber post for treatment of maxillary lateral incisor<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Postoperative view of the final restoration.</span>

Figure 5 - Postoperative view of the final restoration.

Management of Nonvital Tooth #5 with a Fractured Cusp - Management of Nonvital Tooth #5 with a Fractured Cusp

Management of Nonvital Tooth #5 with a Fractured Cusp - Management of Nonvital Tooth #5 with a Fractured Cusp Contributed by Adriana F. Quintas, DDS, MS, PhD on 6/18/2012

$Management of Nonvital Tooth #5 with a Fractured Cusp Figure 1. Preoperative appearance of the nonvital, discolored tooth #5(14), with a fractured palatal cusp that requires restoration.$ Figure 1 - Preoperative appearance of the nonvital, discolored tooth #5(14), with a fractured palatal cusp that requires restoration.

Figure 1 - Preoperative appearance of the nonvital, discolored tooth #5(14), with a fractured palatal cusp that requires restoration.

Management of Nonvital Tooth #5 with a Fractured Cusp<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> An aesthetic post-and-core system was more adequate to preserve coronal tooth structure.</span>

Figure 2 - An aesthetic post-and-core system was more adequate to preserve coronal tooth structure.

Management of Nonvital Tooth #5 with a Fractured Cusp<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> The dentin discoloration required an opaque coping to achieve the correct final shade. Both the buccal and palatal dentin heights were preserved for a proper ferrule effect.</span>

Figure 3 - The dentin discoloration required an opaque coping to achieve the correct final shade. Both the buccal and palatal dentin he...

Figure 3 - The dentin discoloration required an opaque coping to achieve the correct final shade. Both the buccal and palatal dentin heights were preserved for a proper ferrule effect.

Management of Nonvital Tooth #5 with a Fractured Cusp<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> The substrate was highly discolored, to the point that no shade could be properly matched. Because the final crown shade was not bright, however, a metal free restoration to be used without cause for aesthetic concern.</span>

Figure 4 - The substrate was highly discolored, to the point that no shade could be properly matched. Because the final crown shade was...

Figure 4 - The substrate was highly discolored, to the point that no shade could be properly matched. Because the final crown shade was not bright, however, a metal free restoration to be used without cause for aesthetic concern.

Management of Nonvital Tooth #5 with a Fractured Cusp<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Despite its limited opacity, the masking effect of the ceramic crown was sufficient to achieve a correct definitive crown shade, even with a darker substrate.</span>

Figure 5 - Despite its limited opacity, the masking effect of the ceramic crown was sufficient to achieve a correct definitive crown sh...

Figure 5 - Despite its limited opacity, the masking effect of the ceramic crown was sufficient to achieve a correct definitive crown shade, even with a darker substrate.

Restoration of an Endodontically Treated Maxillary Central Incisor - Rationale and application of glass-fiber posts for the restoration of pulple...

Restoration of an Endodontically Treated Maxillary Central Incisor - Rationale and application of glass-fiber posts for the restoration of pulpless teeth Contributed by Roberto Martelli, MD, DDS on 8/2/2012

Restoration of an Endodontically Treated Maxillary Central Incisor<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative facial view of female patient following whitening demonstrates unaesthetic composite resin restorations on maxillary central incisors. Tooth #9(21) is nonvital.</span>

Figure 1 - Preoperative facial view of female patient following whitening demonstrates unaesthetic composite resin restorations on maxi...

Figure 1 - Preoperative facial view of female patient following whitening demonstrates unaesthetic composite resin restorations on maxillary central incisors. Tooth #9(21) is nonvital.

Restoration of an Endodontically Treated Maxillary Central Incisor<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> 2A. Tooth #9 was isolated with a rubber dam. 2B. Gutta-percha was removed to maintain a 4 mm to 5 mm apical seal and the canal was accessed.</span>

Figure 2 - 2A. Tooth #9 was isolated with a rubber dam. 2B. Gutta-percha was removed to maintain a 4 mm to 5 mm apical seal and the can...

Figure 2 - 2A. Tooth #9 was isolated with a rubber dam. 2B. Gutta-percha was removed to maintain a 4 mm to 5 mm apical seal and the canal was accessed.

Restoration of an Endodontically Treated Maxillary Central Incisor<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> 3A. The length of the post was determined in the canal and marked with the red sleeve. 3B. The trimmed post is replaced in the canal to confirm its length.</span>

Figure 3 - 3A. The length of the post was determined in the canal and marked with the red sleeve. 3B. The trimmed post is replaced in t...

Figure 3 - 3A. The length of the post was determined in the canal and marked with the red sleeve. 3B. The trimmed post is replaced in the canal to confirm its length.

Restoration of an Endodontically Treated Maxillary Central Incisor<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> 4A. The prepared canal was etched with 37% phosphoric acid. 4B. After 15 seconds, the etchant was gently rinsed with water and dried with paper points.</span>

Figure 4 - 4A. The prepared canal was etched with 37% phosphoric acid. 4B. After 15 seconds, the etchant was gently rinsed with water a...

Figure 4 - 4A. The prepared canal was etched with 37% phosphoric acid. 4B. After 15 seconds, the etchant was gently rinsed with water and dried with paper points.

Restoration of an Endodontically Treated Maxillary Central Incisor<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> 5A. An adhesive primer and bonding agent were applied to the canal. 5B. A flowable composite resin was dispensed into the canal.</span>

Figure 5 - 5A. An adhesive primer and bonding agent were applied to the canal. 5B. A flowable composite resin was dispensed into the ca...

Figure 5 - 5A. An adhesive primer and bonding agent were applied to the canal. 5B. A flowable composite resin was dispensed into the canal.

Restoration of an Endodontically Treated Maxillary Central Incisor<br/> Figure 6. <span style='font-size: 16px; font-weight: normal'> 6A. The endodontic post was seated in the canal. 6B. The flowable composite resin was light cured for 60 seconds with a halogen light.</span>

Figure 6 - 6A. The endodontic post was seated in the canal. 6B. The flowable composite resin was light cured for 60 seconds with a halo...

Figure 6 - 6A. The endodontic post was seated in the canal. 6B. The flowable composite resin was light cured for 60 seconds with a halogen light.

Restoration of an Endodontically Treated Maxillary Central Incisor<br/> Figure 7. <span style='font-size: 16px; font-weight: normal'> 7A. The core was established with the successive addition of composite resin. 7B. The completed core build-up permitted prosthetic preparation.</span>

Figure 7 - 7A. The core was established with the successive addition of composite resin. 7B. The completed core build-up permitted pros...

Figure 7 - 7A. The core was established with the successive addition of composite resin. 7B. The completed core build-up permitted prosthetic preparation.

Restoration of an Endodontically Treated Maxillary Central Incisor<br/> Figure 8. <span style='font-size: 16px; font-weight: normal'> The core (#9) and the adjacent preparation (#8) were recorded in a polyvinylsiloxane impression that was forwarded to the laboratory.</span>

Figure 8 - The core (#9) and the adjacent preparation (#8) were recorded in a polyvinylsiloxane impression that was forwarded to the la...

Figure 8 - The core (#9) and the adjacent preparation (#8) were recorded in a polyvinylsiloxane impression that was forwarded to the laboratory.

Restoration of an Endodontically Treated Maxillary Central Incisor<br/> Figure 9. <span style='font-size: 16px; font-weight: normal'> The impression was used to create epoxy resin models upon which the definitive restorations would be fabricated.</span>

Figure 9 - The impression was used to create epoxy resin models upon which the definitive restorations would be fabricated.

Restoration of an Endodontically Treated Maxillary Central Incisor<br/> Figure 10. <span style='font-size: 16px; font-weight: normal'> The all-ceramic coping was fabricated from a highly translucent ceramic ingot.</span>

Figure 10 - The all-ceramic coping was fabricated from a highly translucent ceramic ingot.

Restoration of an Endodontically Treated Maxillary Central Incisor<br/> Figure 11. <span style='font-size: 16px; font-weight: normal'> Lingual view of the all-ceramic copings on the model. Note the different crown design necessary for tooth #8 and #9.</span>

Figure 11 - Lingual view of the all-ceramic copings on the model. Note the different crown design necessary for tooth #8 and #9.

Restoration of an Endodontically Treated Maxillary Central Incisor<br/> Figure 12. <span style='font-size: 16px; font-weight: normal'> Facial view of the definitive all-ceramic restorations on the resin model.</span>

Figure 12 - Facial view of the definitive all-ceramic restorations on the resin model.

Restoration of an Endodontically Treated Maxillary Central Incisor<br/> Figure 13. <span style='font-size: 16px; font-weight: normal'> Lingual view of the full-coverage crowns allows the viewing of the underlying core.</span>

Figure 13 - Lingual view of the full-coverage crowns allows the viewing of the underlying core.

Restoration of an Endodontically Treated Maxillary Central Incisor<br/> Figure 14. <span style='font-size: 16px; font-weight: normal'> Facial view of the all-ceramic crown restorations following cementation. Note the harmony between the crowns and natural teeth.</span>

Figure 14 - Facial view of the all-ceramic crown restorations following cementation. Note the harmony between the crowns and natural te...

Figure 14 - Facial view of the all-ceramic crown restorations following cementation. Note the harmony between the crowns and natural teeth.

Restoration of an Endodontically Treated Maxillary Central Incisor<br/> Figure 15. <span style='font-size: 16px; font-weight: normal'> 15A. Vital tooth #8 viewed under transillumination. 15B. Nonvital tooth #9 viewed under transillumination. Note the similar light diffusion.</span>

Figure 15 - 15A. Vital tooth #8 viewed under transillumination. 15B. Nonvital tooth #9 viewed under transillumination. Note the similar...

Figure 15 - 15A. Vital tooth #8 viewed under transillumination. 15B. Nonvital tooth #9 viewed under transillumination. Note the similar light diffusion.

Restoration of an Endodontically Treated Maxillary Central Incisor<br/> Figure 16. <span style='font-size: 16px; font-weight: normal'> Postoperative radiograph demonstrates the position of the endodontic post beneath the definitive restorations.</span>

Figure 16 - Postoperative radiograph demonstrates the position of the endodontic post beneath the definitive restorations.

Restoration of an Endodontically Treated Maxillary Central Incisor<br/> Figure 17. <span style='font-size: 16px; font-weight: normal'> Postoperative facial view of the patient at natural smile. Note the aesthetic enhancement achieved with the all-ceramic restorations and the glass fiber-reinforced translucent post.</span>

Figure 17 - Postoperative facial view of the patient at natural smile. Note the aesthetic enhancement achieved with the all-ceramic res...

Figure 17 - Postoperative facial view of the patient at natural smile. Note the aesthetic enhancement achieved with the all-ceramic restorations and the glass fiber-reinforced translucent post.

Zirconia Posts for Restoring Endodontically Treated Teeth

Use of a zirconia post for treatment of a maxillary central incisor - Use of a zirconia post for treatment of a maxillary central incisor

Use of a zirconia post for treatment of a maxillary central incisor - Use of a zirconia post for treatment of a maxillary central incisor Contributed by Adriana Ferreira Quintas, DDS, MS on 3/14/2012

Use of a zirconia post for treatment of a maxillary central incisor<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative aspect of the metal-ceramic crown restoration demonstrates deficient marginal fit and compromised aesthetics.</span>

Figure 1 - Preoperative aspect of the metal-ceramic crown restoration demonstrates deficient marginal fit and compromised aesthetics.

Use of a zirconia post for treatment of a maxillary central incisor<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> The zirconia post is luted prior to placement of the core buildup material.</span>

Figure 2 - The zirconia post is luted prior to placement of the core buildup material.

Use of a zirconia post for treatment of a maxillary central incisor<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> The core is incrementally built up with a hybrid composite resin.</span>

Figure 3 - The core is incrementally built up with a hybrid composite resin.

Use of a zirconia post for treatment of a maxillary central incisor<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Preparation of the post and core buildup is completed to facilitate placement of the all-ceramic crown restoration.</span>

Figure 4 - Preparation of the post and core buildup is completed to facilitate placement of the all-ceramic crown restoration.

Use of a zirconia post for treatment of a maxillary central incisor<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Postoperative facial view of the completed aesthetic post and core with definitive and all-ceramic crown restoration.</span>

Figure 5 - Postoperative facial view of the completed aesthetic post and core with definitive and all-ceramic crown restoration.

Use of a zirconia post for treatment of fractured tooth #4 - Use of a zirconia post for treatment of fractured tooth #4

Use of a zirconia post for treatment of fractured tooth #4 - Use of a zirconia post for treatment of fractured tooth #4 Contributed by Adriana Ferreira Quintas, DDS, MS on 3/14/2012

$Use of a zirconia post for treatment of fractured tooth #4 Figure 1. Preoperative lateral view of tooth #4(15) exhibits a buccal cusp with a fracture line that requires aesthetic restoration.$ Figure 1 - Preoperative lateral view of tooth #4(15) exhibits a buccal cusp with a fracture line that requires aesthetic restoration.

Figure 1 - Preoperative lateral view of tooth #4(15) exhibits a buccal cusp with a fracture line that requires aesthetic restoration.

$Use of a zirconia post for treatment of fractured tooth #4 Figure 2. Radiograph of the zirconia post prior to impression taking for the indirect core buildup.$ Figure 2 - Radiograph of the zirconia post prior to impression taking for the indirect core buildup.

Figure 2 - Radiograph of the zirconia post prior to impression taking for the indirect core buildup.

$Use of a zirconia post for treatment of fractured tooth #4 Figure 3. Self-curing acrylic resin is applied in order to facilitate the intraradicular impression.$ Figure 3 - Self-curing acrylic resin is applied in order to facilitate the intraradicular impression.

Figure 3 - Self-curing acrylic resin is applied in order to facilitate the intraradicular impression.

$Use of a zirconia post for treatment of fractured tooth #4 Figure 4. Right lateral view following tooth preparation demonstrates sufficient cervical dentin in order to provide ferrule effect and avoid root fracture.$ Figure 4 - Right lateral view following tooth preparation demonstrates sufficient cervical dentin in order to provide ferrule effect an...

Figure 4 - Right lateral view following tooth preparation demonstrates sufficient cervical dentin in order to provide ferrule effect and avoid root fracture.

$Use of a zirconia post for treatment of fractured tooth #4 Figure 5. Postoperative radiograph demonstrates post placement following cementation.$ Figure 5 - Postoperative radiograph demonstrates post placement following cementation.

Figure 5 - Postoperative radiograph demonstrates post placement following cementation.

$Use of a zirconia post for treatment of fractured tooth #4 Figure 6. Postoperative lateral view of the definitive restoration.$ Figure 6 - Postoperative lateral view of the definitive restoration.

Figure 6 - Postoperative lateral view of the definitive restoration.

Indirect Restoration of Compromised Teeth Using Zirconia Posts - Indirect Restoration of Compromised Teeth Using Zirconia Posts

Indirect Restoration of Compromised Teeth Using Zirconia Posts - Indirect Restoration of Compromised Teeth Using Zirconia Posts Contributed by Mauro Fradeani, MD, DDS on 4/4/2012

Indirect Restoration of Compromised Teeth Using Zirconia Posts<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative facial view of two maxillary central incisors with a gray-blue discoloration that compromises aesthetics.</span>

Figure 1 - Preoperative facial view of two maxillary central incisors with a gray-blue discoloration that compromises aesthetics.

Indirect Restoration of Compromised Teeth Using Zirconia Posts<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> The indirect technique requires the core pattern to be waxed to the zirconium post.</span>

Figure 2 - The indirect technique requires the core pattern to be waxed to the zirconium post.

Indirect Restoration of Compromised Teeth Using Zirconia Posts<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Facial view of the two cemented zirconium posts following the completion of an internal bleaching procedure.</span>

Figure 3 - Facial view of the two cemented zirconium posts following the completion of an internal bleaching procedure.

Indirect Restoration of Compromised Teeth Using Zirconia Posts<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Postoperative facial view of the definitive all-ceramic restorations. Integration of the restorations with the soft tissue contributes to the improved aesthetics.</span>

Figure 4 - Postoperative facial view of the definitive all-ceramic restorations. Integration of the restorations with the soft tissue c...

Figure 4 - Postoperative facial view of the definitive all-ceramic restorations. Integration of the restorations with the soft tissue contributes to the improved aesthetics.

Cementation for Contemporary Porcelain Crowns - Cementation for Contemporary Porcelain Crowns

Cementation for Contemporary Porcelain Crowns - Cementation for Contemporary Porcelain Crowns Contributed by Bernard Touati, DDS, DSO on 4/27/2012

Cementation for Contemporary Porcelain Crowns<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> A 30 year old female patient presented with severe discoloration. Teeth #8(11) and #9(21) were nonvital, and teeth #7(12) and #10(22) were vital.</span>

Figure 1 - A 30 year old female patient presented with severe discoloration. Teeth #8(11) and #9(21) were nonvital, and teeth #7(12) an...

Figure 1 - A 30 year old female patient presented with severe discoloration. Teeth #8(11) and #9(21) were nonvital, and teeth #7(12) and #10(22) were vital.

Cementation for Contemporary Porcelain Crowns<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> A high-strength zirconia post and core material was selected for the ceramic restoration of teeth #8 and #9.</span>

Figure 2 - A high-strength zirconia post and core material was selected for the ceramic restoration of teeth #8 and #9.

Cementation for Contemporary Porcelain Crowns<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> The post and cores were cemented with a self-polymerizing resin cement. Aluminum oxide copings (0.6mm) were tried-in for teeth #7 and #10.</span>

Figure 3 - The post and cores were cemented with a self-polymerizing resin cement. Aluminum oxide copings (0.6mm) were tried-in for tee...

Figure 3 - The post and cores were cemented with a self-polymerizing resin cement. Aluminum oxide copings (0.6mm) were tried-in for teeth #7 and #10.

Cementation for Contemporary Porcelain Crowns<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Postoperative occlusal view following cementation demonstrates aesthetic translucency.</span>

Figure 4 - Postoperative occlusal view following cementation demonstrates aesthetic translucency.

Cementation for Contemporary Porcelain Crowns<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Postoperative facial view following cementation using a resin adhesive. The patient requested bright restorations, and the remaining dentition were bleached.</span>

Figure 5 - Postoperative facial view following cementation using a resin adhesive. The patient requested bright restorations, and the r...

Figure 5 - Postoperative facial view following cementation using a resin adhesive. The patient requested bright restorations, and the remaining dentition were bleached.

Aesthetic Replacement of Metal-Ceramic Posts and Crowns Using Zirconia Posts and CAD/CAM Crowns - Aesthetic Replacement of Metal-Ceramic Posts an...

Aesthetic Replacement of Metal-Ceramic Posts and Crowns Using Zirconia Posts and CAD/CAM Crowns - Aesthetic Replacement of Metal-Ceramic Posts and Crowns Using Zirconia Posts and CAD/CAM Crowns Contributed by Adriana F. Quintas, DDS, MS, PhD on 6/18/2012

Aesthetic Replacement of Metal-Ceramic Posts and Crowns Using Zirconia Posts and CAD/CAM Crowns<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative view of metal-ceramic crowns on teeth #7(12) through #10(22).</span>

Figure 1 - Preoperative view of metal-ceramic crowns on teeth #7(12) through #10(22).

Aesthetic Replacement of Metal-Ceramic Posts and Crowns Using Zirconia Posts and CAD/CAM Crowns<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Periapical radiographs demonstrate the positioning of the metallic posts in teeth #7 through #9(21).</span>

Figure 2 - Periapical radiographs demonstrate the positioning of the metallic posts in teeth #7 through #9(21).

Aesthetic Replacement of Metal-Ceramic Posts and Crowns Using Zirconia Posts and CAD/CAM Crowns<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> The metallic post in tooth #7 was replaced by a cast zirconia post.</span>

Figure 3 - The metallic post in tooth #7 was replaced by a cast zirconia post.

Aesthetic Replacement of Metal-Ceramic Posts and Crowns Using Zirconia Posts and CAD/CAM Crowns<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> In tooth #10, only a composite resin core was placed.</span>

Figure 4 - In tooth #10, only a composite resin core was placed.

Aesthetic Replacement of Metal-Ceramic Posts and Crowns Using Zirconia Posts and CAD/CAM Crowns<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Alumina crowns were used to restore teeth #7 through #10.</span>

Figure 5 - Alumina crowns were used to restore teeth #7 through #10.

Aesthetic Replacement of Metal-Ceramic Posts and Crowns Using Zirconia Posts and CAD/CAM Crowns<br/> Figure 6. <span style='font-size: 16px; font-weight: normal'> Despite the clinicians use of different substrates, the definitive results were homogenous.</span>

Figure 6 - Despite the clinician's use of different substrates, the definitive results were homogenous.

Restorative Aspects in Crown Fractures

Dentin Sealing and Pulp Capping a Fractured Anterior Crown - Dentin Sealing and Pulp Capping a Fractured Anterior Crown

Dentin Sealing and Pulp Capping a Fractured Anterior Crown - Dentin Sealing and Pulp Capping a Fractured Anterior Crown Contributed by Didier Dietschi, DMD on 3/27/2012

$Dentin Sealing and Pulp Capping a Fractured Anterior Crown Figure 1. Preoperative view demonstrates a crown fracture of the left central incisor that involves the cervical third of the tooth.$ Figure 1 - Preoperative view demonstrates a crown fracture of the left central incisor that involves the cervical third of the tooth.

Figure 1 - Preoperative view demonstrates a crown fracture of the left central incisor that involves the cervical third of the tooth.

Dentin Sealing and Pulp Capping a Fractured Anterior Crown<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Occlusal view of the pulp exhibits minimal exposure. The surface, however, is covered with an extravagated fluid that may potentially compromise adhesion.</span>

Figure 2 - Occlusal view of the pulp exhibits minimal exposure. The surface, however, is covered with an extravagated fluid that may po...

Figure 2 - Occlusal view of the pulp exhibits minimal exposure. The surface, however, is covered with an extravagated fluid that may potentially compromise adhesion.

Dentin Sealing and Pulp Capping a Fractured Anterior Crown<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> A concavity is created at the facture line in the recuperated fragment to create a space for the placement of a calcium hydroxide barrier.</span>

Figure 3 - A concavity is created at the facture line in the recuperated fragment to create a space for the placement of a calcium hydr...

Figure 3 - A concavity is created at the facture line in the recuperated fragment to create a space for the placement of a calcium hydroxide barrier.

Dentin Sealing and Pulp Capping a Fractured Anterior Crown<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Postoperative view of the reattached fragment. Note the lighter color exhibited by the fragment as a result of tissue dehydration.</span>

Figure 4 - Postoperative view of the reattached fragment. Note the lighter color exhibited by the fragment as a result of tissue dehydr...

Figure 4 - Postoperative view of the reattached fragment. Note the lighter color exhibited by the fragment as a result of tissue dehydration.

Dentin Sealing and Pulp Capping a Fractured Anterior Crown<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Postoperative radiograph 2.5 months following pulp capping and adhesive fixation of the fragment.</span>

Figure 5 - Postoperative radiograph 2.5 months following pulp capping and adhesive fixation of the fragment.

Dentin Sealing and Pulp Capping a Fractured Anterior Crown<br/> Figure 6. <span style='font-size: 16px; font-weight: normal'> Additional trauma to the same tooth resulted in fragment detachment. The formation of tertiary dentin at the level of pulp exposure indicates the biological success of the treatment.</span>

Figure 6 - Additional trauma to the same tooth resulted in fragment detachment. The formation of tertiary dentin at the level of pulp e...

Figure 6 - Additional trauma to the same tooth resulted in fragment detachment. The formation of tertiary dentin at the level of pulp exposure indicates the biological success of the treatment.

Case 1 - Tooth Fragment Reattachment Following Trauma - Tooth Fragment Reattachment Following Trauma

Case 1 - Tooth Fragment Reattachment Following Trauma - Tooth Fragment Reattachment Following Trauma Contributed by Didier Dietschi, DMD on 3/27/2012

$Case 1 - Tooth Fragment Reattachment Following Trauma Figure 1. Preoperative facial view of a central incisor with a mid-tooth fracture as a result of a sports related traumatic injury.$ Figure 1 - Preoperative facial view of a central incisor with a mid-tooth fracture as a result of a sports related traumatic injury.

Figure 1 - Preoperative facial view of a central incisor with a mid-tooth fracture as a result of a sports related traumatic injury.

$Case 1 - Tooth Fragment Reattachment Following Trauma Figure 2. The fracture line neared the pulp chamber but did not result in an exposition. It facilitated direct application of the adhesive agent.$ Figure 2 - The fracture line neared the pulp chamber but did not result in an exposition. It facilitated direct application of the adhe...

Figure 2 - The fracture line neared the pulp chamber but did not result in an exposition. It facilitated direct application of the adhesive agent.

Case 1 - Tooth Fragment Reattachment Following Trauma<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Postoperative facial view demonstrates undisturbed function and aesthetics that occurred following proper storage of fragment in a humid environment.</span>

Figure 3 - Postoperative facial view demonstrates undisturbed function and aesthetics that occurred following proper storage of fragmen...

Figure 3 - Postoperative facial view demonstrates undisturbed function and aesthetics that occurred following proper storage of fragment in a humid environment.

Case 2 - Tooth Fragment Reattachment Following Trauma - Case 2 - Tooth Fragment Reattachment Following Trauma

Case 2 - Tooth Fragment Reattachment Following Trauma - Case 2 - Tooth Fragment Reattachment Following Trauma Contributed by Didier Dietschi, DMD on 3/27/2012

$Case 2 - Tooth Fragment Reattachment Following Trauma Figure 1. Preoperative facial view of a fractured central incisor.$ Figure 1 - Preoperative facial view of a fractured central incisor.

Figure 1 - Preoperative facial view of a fractured central incisor.

Case 2 - Tooth Fragment Reattachment Following Trauma<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Intraoperative view during reattachment of the recuperated fragment.</span>

Figure 2 - Intraoperative view during reattachment of the recuperated fragment.

Case 2 - Tooth Fragment Reattachment Following Trauma<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Two-month postoperative view demonstrates a satisfactory functional and aesthetic result following fragment reattachment.</span>

Figure 3 - Two-month postoperative view demonstrates a satisfactory functional and aesthetic result following fragment reattachment.

$Case 2 - Tooth Fragment Reattachment Following Trauma Figure 4. The tooth exhibited a slight fracture of the incisal edge without fragment loss following additional trauma.$ Figure 4 - The tooth exhibited a slight fracture of the incisal edge without fragment loss following additional trauma.

Figure 4 - The tooth exhibited a slight fracture of the incisal edge without fragment loss following additional trauma.

Direct Resin Repair of Class IV Fracture - Direct Resin Repair of Class IV Fracture

Direct Resin Repair of Class IV Fracture - Direct Resin Repair of Class IV Fracture Contributed by Didier Dietschi, DMD on 3/27/2012

$Direct Resin Repair of Class IV Fracture Figure 1. Preoperative facial view of a fractured central incisor.$ Figure 1 - Preoperative facial view of a fractured central incisor.

Figure 1 - Preoperative facial view of a fractured central incisor.

Direct Resin Repair of Class IV Fracture<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> A composite mock-up was fabricated in order to reestablish the correct tooth dimension and form. This information was fixed with a silicone mold.</span>

Figure 2 - A composite mock-up was fabricated in order to reestablish the correct tooth dimension and form. This information was fixed...

Figure 2 - A composite mock-up was fabricated in order to reestablish the correct tooth dimension and form. This information was fixed with a silicone mold.

Direct Resin Repair of Class IV Fracture<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> The silicon matrix was used as a support to build up the palatal surface of the restoration.</span>

Figure 3 - The silicon matrix was used as a support to build up the palatal surface of the restoration.

Direct Resin Repair of Class IV Fracture<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Additional increments of dentin, enamel, and incisal composite materials were subsequently placed to complete the restoration.</span>

Figure 4 - Additional increments of dentin, enamel, and incisal composite materials were subsequently placed to complete the restoratio...

Figure 4 - Additional increments of dentin, enamel, and incisal composite materials were subsequently placed to complete the restoration.

Direct Resin Repair of Class IV Fracture<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Postoperative view of the direct restoration with reestablished aesthetics and function, without additional tooth substance loss.</span>

Figure 5 - Postoperative view of the direct restoration with reestablished aesthetics and function, without additional tooth substance...

Figure 5 - Postoperative view of the direct restoration with reestablished aesthetics and function, without additional tooth substance loss.

Direct Resin Replacement of Existing Composite Restoration - Direct Resin Replacement of Existing Composite Restoration

Direct Resin Replacement of Existing Composite Restoration - Direct Resin Replacement of Existing Composite Restoration Contributed by Didier Dietschi, DMD on 3/27/2012

Direct Resin Replacement of Existing Composite Restoration<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Mock-up view demonstrates wear and discoloration that are common to previous generations of composite resins.</span>

Figure 1 - Mock-up view demonstrates wear and discoloration that are common to previous generations of composite resins.

Direct Resin Replacement of Existing Composite Restoration<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> New composite resin restorations were placed to fulfill the patients aesthetics and functional desires.</span>

Figure 2 - New composite resin restorations were placed to fulfill the patient's aesthetics and functional desires.

Direct Resin Replacement of Existing Composite Restoration<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Postoperative facial view 4 years following treatment. Contemporary aesthetic materials facilitate the preservation of form and function.</span>

Figure 3 - Postoperative facial view 4 years following treatment. Contemporary aesthetic materials facilitate the preservation of form...

Figure 3 - Postoperative facial view 4 years following treatment. Contemporary aesthetic materials facilitate the preservation of form and function.

Repair of Crown Fracture Using Porcelain Veneer Restorations - Repair of Crown Fracture Using Porcelain Veneer Restorations

Repair of Crown Fracture Using Porcelain Veneer Restorations - Repair of Crown Fracture Using Porcelain Veneer Restorations Contributed by Didier Dietschi, DMD on 3/27/2012

$Repair of Crown Fracture Using Porcelain Veneer Restorations Figure 1. Preoperative facial view demonstrates a slight fracture in tooth #8(11) and a severe fracture in tooth #11(21).$ Figure 1 - Preoperative facial view demonstrates a slight fracture in tooth #8(11) and a severe fracture in tooth #11(21).

Figure 1 - Preoperative facial view demonstrates a slight fracture in tooth #8(11) and a severe fracture in tooth #11(21).

Repair of Crown Fracture Using Porcelain Veneer Restorations<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Following conservative preservation techniques, the long-term biomechanics of the tooth were preserved.</span>

Figure 2 - Following conservative preservation techniques, the long-term biomechanics of the tooth were preserved.

Repair of Crown Fracture Using Porcelain Veneer Restorations<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Preparations were performed within the enamel layer.</span>

Figure 3 - Preparations were performed within the enamel layer.

Repair of Crown Fracture Using Porcelain Veneer Restorations<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Postoperative facial view demonstrates the completed ceramic veneer restorations. Both the patients and clinicians aesthetics and functional expectations were achieved.</span>

Figure 4 - Postoperative facial view demonstrates the completed ceramic veneer restorations. Both the patient's and clinician's aesthet...

Figure 4 - Postoperative facial view demonstrates the completed ceramic veneer restorations. Both the patient's and clinician's aesthetics and functional expectations were achieved.

Comprehensive Treatment of Traumatic Fracture and Luxation Injuries in the Anterior Permanent Dentition - The increase incidence of traumatic inj...

Comprehensive Treatment of Traumatic Fracture and Luxation Injuries in the Anterior Permanent Dentition - The increase incidence of traumatic injuries in anterior teeth is a consequence of modern leisure activities. the key factors to successful functional and aesthetic rehabilitation of such injuri...

Comprehensive Treatment of Traumatic Fracture and Luxation Injuries in the Anterior Permanent Dentition<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Facial view 2 weeks following splinting of the traumatized anterior teeth with composite and an orthodontic wire.</span>

Figure 4 - Facial view 2 weeks following splinting of the traumatized anterior teeth with composite and an orthodontic wire.

$Comprehensive Treatment of Traumatic Fracture and Luxation Injuries in the Anterior Permanent Dentition Figure 5. Occlusal view demonstrates severe crown-to-root fracturing of tooth #9.$ Figure 5 - Occlusal view demonstrates severe crown-to-root fracturing of tooth #9.

Figure 5 - Occlusal view demonstrates severe crown-to-root fracturing of tooth #9.

Comprehensive Treatment of Traumatic Fracture and Luxation Injuries in the Anterior Permanent Dentition<br/> Figure 6. <span style='font-size: 16px; font-weight: normal'> Periapical radiograph of tooth #9 following splint removal.</span>

Figure 6 - Periapical radiograph of tooth #9 following splint removal.

Comprehensive Treatment of Traumatic Fracture and Luxation Injuries in the Anterior Permanent Dentition<br/> Figure 7. <span style='font-size: 16px; font-weight: normal'> Occlusal view of tooth #9 during palatal gingivectomy and canal preparation for an endodontic post.</span>

Figure 7 - Occlusal view of tooth #9 during palatal gingivectomy and canal preparation for an endodontic post.

Comprehensive Treatment of Traumatic Fracture and Luxation Injuries in the Anterior Permanent Dentition<br/> Figure 8. <span style='font-size: 16px; font-weight: normal'> Tooth #9 was orthodontically extruded. The orthodontic appliance was designed to protect the adjacent teeth from detrimental forces.</span>

Figure 8 - Tooth #9 was orthodontically extruded. The orthodontic appliance was designed to protect the adjacent teeth from detrimental...

Figure 8 - Tooth #9 was orthodontically extruded. The orthodontic appliance was designed to protect the adjacent teeth from detrimental forces.

Comprehensive Treatment of Traumatic Fracture and Luxation Injuries in the Anterior Permanent Dentition<br/> Figure 9. <span style='font-size: 16px; font-weight: normal'> 9A. Radiographic evaluation revealed endodontic complications in teeth #7 and #8. 9B. The optimal length of the primary gutta-percha point was verified with respect to the apical foramen.</span>

Figure 9 - 9A. Radiographic evaluation revealed endodontic complications in teeth #7 and #8. 9B. The optimal length of the primary gutt...

Figure 9 - 9A. Radiographic evaluation revealed endodontic complications in teeth #7 and #8. 9B. The optimal length of the primary gutta-percha point was verified with respect to the apical foramen.

Comprehensive Treatment of Traumatic Fracture and Luxation Injuries in the Anterior Permanent Dentition<br/> Figure 10. <span style='font-size: 16px; font-weight: normal'> The zirconia post and ceramic core complex for the restoration of tooth #9 is demonstrated. The illuminated complex reveals its aesthetic properties. </span>

Figure 10 - The zirconia post and ceramic core complex for the restoration of tooth #9 is demonstrated. The illuminated complex reveals...

Figure 10 - The zirconia post and ceramic core complex for the restoration of tooth #9 is demonstrated. The illuminated complex reveals its aesthetic properties.

Comprehensive Treatment of Traumatic Fracture and Luxation Injuries in the Anterior Permanent Dentition<br/> Figure 11. <span style='font-size: 16px; font-weight: normal'> Retraction cords were placed to maintain the gingival architecture during preparation following completion of a gingivectomy on the labial aspect.</span>

Figure 11 - Retraction cords were placed to maintain the gingival architecture during preparation following completion of a gingivectom...

Figure 11 - Retraction cords were placed to maintain the gingival architecture during preparation following completion of a gingivectomy on the labial aspect.

Comprehensive Treatment of Traumatic Fracture and Luxation Injuries in the Anterior Permanent Dentition<br/> Figure 12. <span style='font-size: 16px; font-weight: normal'> All-ceramic crown restorations were fabricated in the dental laboratory.</span>

Figure 12 - All-ceramic crown restorations were fabricated in the dental laboratory.

Comprehensive Treatment of Traumatic Fracture and Luxation Injuries in the Anterior Permanent Dentition<br/> Figure 13. <span style='font-size: 16px; font-weight: normal'> Magnified facial view of the definitive all-ceramic restorations on teeth #8 and #9.</span>

Figure 13 - Magnified facial view of the definitive all-ceramic restorations on teeth #8 and #9.

Comprehensive Treatment of Traumatic Fracture and Luxation Injuries in the Anterior Permanent Dentition<br/> Figure 14. <span style='font-size: 16px; font-weight: normal'> Postoperative radiographs immediately following cementation demonstrate the successful restoration of teeth #7 through #10.</span>

Figure 14 - Postoperative radiographs immediately following cementation demonstrate the successful restoration of teeth #7 through #10....

Figure 14 - Postoperative radiographs immediately following cementation demonstrate the successful restoration of teeth #7 through #10.

Comprehensive Treatment of Traumatic Fracture and Luxation Injuries in the Anterior Permanent Dentition<br/> Figure 15. <span style='font-size: 16px; font-weight: normal'> Postoperative facial view of the anterior maxillary region. Partial ceramic laminate veneers were placed on teeth #7 and #10.</span>

Figure 15 - Postoperative facial view of the anterior maxillary region. Partial ceramic laminate veneers were placed on teeth #7 and #1...

Figure 15 - Postoperative facial view of the anterior maxillary region. Partial ceramic laminate veneers were placed on teeth #7 and #10.

Metal-Ceramic Post and Core Restorations

Replacement of Nonvital Tooth #9 with Metal-Ceramic Post and Core - Replacement of Nonvital Tooth #9 with Metal-Ceramic Post and Core

Replacement of Nonvital Tooth #9 with Metal-Ceramic Post and Core - Replacement of Nonvital Tooth #9 with Metal-Ceramic Post and Core Contributed by Mauro Fradeani, MD, DDS on 4/4/2012

Replacement of Nonvital Tooth #9 with Metal-Ceramic Post and Core<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative view of an unaesthetic porcelain-fused-to-metal (PFM) crown restoration with cervical and incisal asymmetry.</span>

Figure 1 - Preoperative view of an unaesthetic porcelain-fused-to-metal (PFM) crown restoration with cervical and incisal asymmetry.

Replacement of Nonvital Tooth #9 with Metal-Ceramic Post and Core<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> The varied probing depth between the central incisors allows slight gingival modification of tooth #9(21).</span>

Figure 2 - The varied probing depth between the central incisors allows slight gingival modification of tooth #9(21).

Replacement of Nonvital Tooth #9 with Metal-Ceramic Post and Core<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Facial view of the cemented PFM post and core.</span>

Figure 4 - Facial view of the cemented PFM post and core.

Replacement of Nonvital Tooth #9 with Metal-Ceramic Post and Core<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Postoperative facial view of the definitive PFM restoration, which demonstrates gingial and incisal symmetry.</span>

Figure 5 - Postoperative facial view of the definitive PFM restoration, which demonstrates gingial and incisal symmetry.

Replacement of Nonvital Tooth #9 with Metal-Ceramic Post and Core<br/> Figure 6. <span style='font-size: 16px; font-weight: normal'> Right lateral view of the definitive PFM restoration exhibits proper integration with the adjacent teeth.</span>

Figure 6 - Right lateral view of the definitive PFM restoration exhibits proper integration with the adjacent teeth.

Replacement of Nonvital Tooth #9 with Metal-Ceramic Post and Core<br/> Figure 7. <span style='font-size: 16px; font-weight: normal'> Left lateral view of the restoration of tooth #9(21). Note that the color of the root does not influence the aesthetic result.</span>

Figure 7 - Left lateral view of the restoration of tooth #9(21). Note that the color of the root does not influence the aesthetic resul...

Figure 7 - Left lateral view of the restoration of tooth #9(21). Note that the color of the root does not influence the aesthetic result.

Cementation for Metal-Ceramic Crown Restorations - Cementation for Metal-Ceramic Crown Restorations

Cementation for Metal-Ceramic Crown Restorations - Cementation for Metal-Ceramic Crown Restorations Contributed by Bernard Touati, DDS on 4/27/2012

Cementation for Metal-Ceramic Crown Restorations<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Tooth #8(11) was nonvital and had previous endodontic treatment. Tooth #9(21) was vital; the composite restoration was defective.</span>

Figure 1 - Tooth #8(11) was nonvital and had previous endodontic treatment. Tooth #9(21) was vital; the composite restoration was defec...

Figure 1 - Tooth #8(11) was nonvital and had previous endodontic treatment. Tooth #9(21) was vital; the composite restoration was defective.

Cementation for Metal-Ceramic Crown Restorations<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> The teeth and existing metal-ceramic post and core on tooth #8 were prepared. The cervical region of tooth #8(11) was highly discolored.</span>

Figure 2 - The teeth and existing metal-ceramic post and core on tooth #8 were prepared. The cervical region of tooth #8(11) was highly...

Figure 2 - The teeth and existing metal-ceramic post and core on tooth #8 were prepared. The cervical region of tooth #8(11) was highly discolored.

Cementation for Metal-Ceramic Crown Restorations<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> A pickup impression was used to communicate the tissue architecture and emergence profile to the laboratory technician.</span>

Figure 3 - A pickup impression was used to communicate the tissue architecture and emergence profile to the laboratory technician.

Cementation for Metal-Ceramic Crown Restorations<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Postoperative facial view. The metal-ceramic crown restorations were cemented with a resin-modified glass-ionomer adhesive.</span>

Figure 4 - Postoperative facial view. The metal-ceramic crown restorations were cemented with a resin-modified glass-ionomer adhesive.

Endodontic Treatment and Post Buildup for Maxillary First Molar - Endodontic treatment, post buildup, and placement of crown restoration for maxi...

Endodontic Treatment and Post Buildup for Maxillary First Molar - Endodontic treatment, post buildup, and placement of crown restoration for maxillary right first molar. Contributed by Paul R. Chalifoux, DDS on 12/10/2012

Endodontic Treatment and Post Buildup for Maxillary First Molar<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative occlusal view of defective amalgam on a maxillary right molar that requires endodontic treatment, post buildup, and a crown restoration.</span>

Figure 1 - Preoperative occlusal view of defective amalgam on a maxillary right molar that requires endodontic treatment, post buildup,...

Figure 1 - Preoperative occlusal view of defective amalgam on a maxillary right molar that requires endodontic treatment, post buildup, and a crown restoration.

Endodontic Treatment and Post Buildup for Maxillary First Molar<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Occlusal view of cementation of posts into the palatal and mesiobuccal canals.</span>

Figure 2 - Occlusal view of cementation of posts into the palatal and mesiobuccal canals.

Endodontic Treatment and Post Buildup for Maxillary First Molar<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Postoperative occlusal view of the appearance of the porcelain-fused-to-metal crown restorations.</span>

Figure 3 - Postoperative occlusal view of the appearance of the porcelain-fused-to-metal crown restorations.

Endodontic Treatment and Post Buildup for Maxillary First Molar<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Postoperative radiograph of the completed restoration.</span>

Figure 4 - Postoperative radiograph of the completed restoration.

Provosional Restoration of Nonvital Premolar Tooth Using Segmentally Parallel Post - Endodontic treatment and provisionalization of tooth #6.

Provosional Restoration of Nonvital Premolar Tooth Using Segmentally Parallel Post - Endodontic treatment and provisionalization of tooth #6. Contributed by Paul R. Chalifoux, DDS on 12/10/2012

Provosional Restoration of Nonvital Premolar Tooth Using Segmentally Parallel Post<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative x-ray of the endodontically treated tooth.</span>

Figure 1 - Preoperative x-ray of the endodontically treated tooth.

Provosional Restoration of Nonvital Premolar Tooth Using Segmentally Parallel Post<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> The post is removed from the hand-piece and tried in the canal.</span>

Figure 2 - The post is removed from the hand-piece and tried in the canal.

Provosional Restoration of Nonvital Premolar Tooth Using Segmentally Parallel Post<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> The length of the segmentally parallel post is marked with a notch made by a high-speed drill and carbide bur.</span>

Figure 3 - The length of the segmentally parallel post is marked with a notch made by a high-speed drill and carbide bur.

$Provosional Restoration of Nonvital Premolar Tooth Using Segmentally Parallel Post Figure 4. The post is placed into position with the latch portion acting as a handle. The handle is then manipulated until fractured from the post.$ Figure 4 - The post is placed into position with the latch portion acting as a handle. The handle is then manipulated until fractured f...

Figure 4 - The post is placed into position with the latch portion acting as a handle. The handle is then manipulated until fractured from the post.

Provosional Restoration of Nonvital Premolar Tooth Using Segmentally Parallel Post<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Composite resin is placed to serve as a core and provisional restoration prior to placement of the definitive crown restoration.</span>

Figure 5 - Composite resin is placed to serve as a core and provisional restoration prior to placement of the definitive crown restorat...

Figure 5 - Composite resin is placed to serve as a core and provisional restoration prior to placement of the definitive crown restoration.

Provosional Restoration of Nonvital Premolar Tooth Using Segmentally Parallel Post<br/> Figure 6. <span style='font-size: 16px; font-weight: normal'> Postoperative x-ray of the endodontically treated tooth following post and filling placement.</span>

Figure 6 - Postoperative x-ray of the endodontically treated tooth following post and filling placement.

Aluminous Ceramic Posts for the Restoration of Endodontically Treated Teeth

Sintered Alumina Posts for Maxillary Central Incisor - Sintered Alumina Posts for Maxillary Central Incisor

Sintered Alumina Posts for Maxillary Central Incisor - Sintered Alumina Posts for Maxillary Central Incisor Contributed by Mauro Fradeani, MD, DDS on 4/4/2012

Sintered Alumina Posts for Maxillary Central Incisor<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative facial view of two endodontically treated teeth with failing composite resin restorations.</span>

Figure 1 - Preoperative facial view of two endodontically treated teeth with failing composite resin restorations.

$Sintered Alumina Posts for Maxillary Central Incisor Figure 2. Due to possible shrinkage, vertical incisions are performed in stone to permit fracture without damage to the post and core.$ Figure 2 - Due to possible shrinkage, vertical incisions are performed in stone to permit fracture without damage to the post and core....

Figure 2 - Due to possible shrinkage, vertical incisions are performed in stone to permit fracture without damage to the post and core.

$Sintered Alumina Posts for Maxillary Central Incisor Figure 3. The intact post and core following fracture.$ Figure 3 - The intact post and core following fracture.

Figure 3 - The intact post and core following fracture.

Sintered Alumina Posts for Maxillary Central Incisor<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Glass infiltration is performed on the two sintered posts.</span>

Figure 4 - Glass infiltration is performed on the two sintered posts.

Sintered Alumina Posts for Maxillary Central Incisor<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Lingual view of the central incisor abutments prior to treatment. Note the condition of the large failed restorations.</span>

Figure 5 - Lingual view of the central incisor abutments prior to treatment. Note the condition of the large failed restorations.

Sintered Alumina Posts for Maxillary Central Incisor<br/> Figure 6. <span style='font-size: 16px; font-weight: normal'> Lingual view of cemented aluminum posts and cores.</span>

Figure 6 - Lingual view of cemented aluminum posts and cores.

Sintered Alumina Posts for Maxillary Central Incisor<br/> Figure 7. <span style='font-size: 16px; font-weight: normal'> Facial view of the aluminum posts and cores following the cementation procedure.</span>

Figure 7 - Facial view of the aluminum posts and cores following the cementation procedure.

Sintered Alumina Posts for Maxillary Central Incisor<br/> Figure 8. <span style='font-size: 16px; font-weight: normal'> Postoperative facial view of the definitive all-ceramic restorations. Note the enhanced aesthetics achieved with this procedure.</span>

Figure 8 - Postoperative facial view of the definitive all-ceramic restorations. Note the enhanced aesthetics achieved with this proced...

Figure 8 - Postoperative facial view of the definitive all-ceramic restorations. Note the enhanced aesthetics achieved with this procedure.

Sintered Alumina Posts for Maxillary Central Incisor<br/> Figure 9. <span style='font-size: 16px; font-weight: normal'> Right lateral view demonstrates the satisfactory integration of the two all-ceramic restorations.</span>

Figure 9 - Right lateral view demonstrates the satisfactory integration of the two all-ceramic restorations.

Sintered Alumina Posts for Maxillary Central Incisor<br/> Figure 10. <span style='font-size: 16px; font-weight: normal'> Left lateral view exhibits the harmony of the definitive restorations with the adjacent teeth.</span>

Figure 10 - Left lateral view exhibits the harmony of the definitive restorations with the adjacent teeth.

Nickel-Titanium Rotary Instruments for Endodontic Therapy

Crown-Down Techniques - Crown-Down Techniques

Crown-Down Techniques - Crown-Down Techniques Contributed by Jean-Michel Dietschi, DMD on 5/21/2012

Crown-Down Techniques<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Radiograph following preparation with the prototypical instrument. Note the absence of ledges or evident transportation of the canal path.</span>

Figure 1 - Radiograph following preparation with the prototypical instrument. Note the absence of ledges or evident transportation of t...

Figure 1 - Radiograph following preparation with the prototypical instrument. Note the absence of ledges or evident transportation of the canal path.

Crown-Down Techniques<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Radiograph of root canal treatment made with Ni-Ti prototypes in combination with Manual NitiFlex instruments.</span>

Figure 2 - Radiograph of root canal treatment made with Ni-Ti prototypes in combination with Manual NitiFlex instruments.

Crown-Down Techniques<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Radiograph of root canal treatment made with Ni-Ti prototype obturation with vertical compaction of GP and AH plus.</span>

Figure 3 - Radiograph of root canal treatment made with Ni-Ti prototype obturation with vertical compaction of GP and AH plus.

Management of Enamel Cracks and Horizontal Fracture with Pulp Exposure

Restoration of a Traumatic Injury to the Anterior Maxilla - Restoration of a Traumatic Injury to the Anterior Maxilla

Restoration of a Traumatic Injury to the Anterior Maxilla - Restoration of a Traumatic Injury to the Anterior Maxilla Contributed by Alan V. Sulikowski, DMD, OD on 5/22/2012

$Restoration of a Traumatic Injury to the Anterior Maxilla Figure 1. Preoperative view demonstrates enamel cracks on tooth #6(13) and a horizontal fracture at the gingival level of tooth #7(12), with pulp exposure. Pulp was not exposed on tooth #8(11) or #9(21).$ Figure 1 - Preoperative view demonstrates enamel cracks on tooth #6(13) and a horizontal fracture at the gingival level of tooth #7(12)...

Figure 1 - Preoperative view demonstrates enamel cracks on tooth #6(13) and a horizontal fracture at the gingival level of tooth #7(12), with pulp exposure. Pulp was not exposed on tooth #8(11) or #9(21).

$Restoration of a Traumatic Injury to the Anterior Maxilla Figure 2. Clinical evaluation also revealed the presence of enamel cracks and infractions involving the facial and incisal areas of tooth #6(13). The prognosis of tooth #7 was further complicated by an oblique secondary fracture that extended subgingivally on the lingual aspect.$ Figure 2 - Clinical evaluation also revealed the presence of enamel cracks and infractions involving the facial and incisal areas of to...

Figure 2 - Clinical evaluation also revealed the presence of enamel cracks and infractions involving the facial and incisal areas of tooth #6(13). The prognosis of tooth #7 was further complicated by an oblique secondary fracture that extended subgingivally on the lingual aspect.

$Restoration of a Traumatic Injury to the Anterior Maxilla Figure 3. Soft tissue attachment enabled in situ maintenance of the fractured segment. Despite the extend of the horizontal fracture on tooth #8(11), the pulp was not exposed, and the tooth tested vital. The distal aspect remained intact with a minor interproximal stain.$ Figure 3 - Soft tissue attachment enabled in situ maintenance of the fractured segment. Despite the extend of the horizontal fracture o...

Figure 3 - Soft tissue attachment enabled in situ maintenance of the fractured segment. Despite the extend of the horizontal fracture on tooth #8(11), the pulp was not exposed, and the tooth tested vital. The distal aspect remained intact with a minor interproximal stain.

Restoration of a Traumatic Injury to the Anterior Maxilla<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Radiographic evaluation confirmed normal peridontal structures.</span>

Figure 4 - Radiographic evaluation confirmed normal peridontal structures.

Restoration of a Traumatic Injury to the Anterior Maxilla<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> A preliminary diagnostic analysis of the existing mesiodistal and gingivooclusal dimensions was performed to visualize the three-dimensional space distribution.</span>

Figure 5 - A preliminary diagnostic analysis of the existing mesiodistal and gingivooclusal dimensions was performed to visualize the t...

Figure 5 - A preliminary diagnostic analysis of the existing mesiodistal and gingivooclusal dimensions was performed to visualize the three-dimensional space distribution.

$Restoration of a Traumatic Injury to the Anterior Maxilla Figure 6. The secondary subgingival supraosseous fracture on tooth #7 was removed from the linguogingival aspect. A flapless approach was selected to restore the osseous contours, root anatomy, and biologic width. Teeth #6 and #9 were conservatively prepared to preserve as much tooth structure as possible. A post space was prepared in tooth #7, and the margins were defined for a full-coverage restoration.$ Figure 6 - The secondary subgingival supraosseous fracture on tooth #7 was removed from the linguogingival aspect. A flapless approach...

Figure 6 - The secondary subgingival supraosseous fracture on tooth #7 was removed from the linguogingival aspect. A flapless approach was selected to restore the osseous contours, root anatomy, and biologic width. Teeth #6 and #9 were conservatively prepared to preserve as much tooth structure as possible. A post space was prepared in tooth #7, and the margins were defined for a full-coverage restoration.

$Restoration of a Traumatic Injury to the Anterior Maxilla Figure 7. Due to the lack of remaining tooth structure and the geometry of the gingival fracture on the lingual aspect of tooth #8, a full-coverage crown was prepared. A final impression was obtained to register the post space and margins using a polyether impression material.$ Figure 7 - Due to the lack of remaining tooth structure and the geometry of the gingival fracture on the lingual aspect of tooth #8, a...

Figure 7 - Due to the lack of remaining tooth structure and the geometry of the gingival fracture on the lingual aspect of tooth #8, a full-coverage crown was prepared. A final impression was obtained to register the post space and margins using a polyether impression material.

Restoration of a Traumatic Injury to the Anterior Maxilla<br/> Figure 8. <span style='font-size: 16px; font-weight: normal'> Partial-coverage porcelain restorations were completed on the master models for teeth #6 and #9, and full-coverage restorations were designed for teeth #7 and #8.</span>

Figure 8 - Partial-coverage porcelain restorations were completed on the master models for teeth #6 and #9, and full-coverage restorati...

Figure 8 - Partial-coverage porcelain restorations were completed on the master models for teeth #6 and #9, and full-coverage restorations were designed for teeth #7 and #8.

Restoration of a Traumatic Injury to the Anterior Maxilla<br/> Figure 9. <span style='font-size: 16px; font-weight: normal'> A single restorative material was used during the fabrication of the porcelain laminate and crown restorations to ensure harmonious integration and uniform shade. A porcelain-fused-to-metal post and core was also fabricated and delivered for cementation at the same time for tooth #7.</span>

Figure 9 - A single restorative material was used during the fabrication of the porcelain laminate and crown restorations to ensure har...

Figure 9 - A single restorative material was used during the fabrication of the porcelain laminate and crown restorations to ensure harmonious integration and uniform shade. A porcelain-fused-to-metal post and core was also fabricated and delivered for cementation at the same time for tooth #7.

Restoration of a Traumatic Injury to the Anterior Maxilla<br/> Figure 10. <span style='font-size: 16px; font-weight: normal'> Reinforcement rods were incorporated in the geometry of the preparation for areas where extensive tooth structure was missing and shear load was anticipated.</span>

Figure 10 - Reinforcement rods were incorporated in the geometry of the preparation for areas where extensive tooth structure was missi...

Figure 10 - Reinforcement rods were incorporated in the geometry of the preparation for areas where extensive tooth structure was missing and shear load was anticipated.

Restoration of a Traumatic Injury to the Anterior Maxilla<br/> Figure 11. <span style='font-size: 16px; font-weight: normal'> No differences were observed in shade and translucency following adhesive cementation of the porcelain laminate and jacket crown restorations. The surface texture and luster were meticulously recreated using the stone-cast surface to harmonize surface light reflection throughout the maxillary arch.</span>

Figure 11 - No differences were observed in shade and translucency following adhesive cementation of the porcelain laminate and jacket...

Figure 11 - No differences were observed in shade and translucency following adhesive cementation of the porcelain laminate and jacket crown restorations. The surface texture and luster were meticulously recreated using the stone-cast surface to harmonize surface light reflection throughout the maxillary arch.

Restoration of a Traumatic Injury to the Anterior Maxilla<br/> Figure 12. <span style='font-size: 16px; font-weight: normal'> Luster was carefully controlled using preoperative photographs, and incisal characterization was created using the internal live stain technique.</span>

Figure 12 - Luster was carefully controlled using preoperative photographs, and incisal characterization was created using the "interna...

Figure 12 - Luster was carefully controlled using preoperative photographs, and incisal characterization was created using the "internal live stain" technique.

Restoration of a Traumatic Injury to the Anterior Maxilla<br/> Figure 13. <span style='font-size: 16px; font-weight: normal'> Use of a type II preparation enabled control of the opacity and translucency for full and partial coverage restorations to restore the patients function without modifying the existing aesthetic principles.</span>

Figure 13 - Use of a type II preparation enabled control of the opacity and translucency for full and partial coverage restorations to...

Figure 13 - Use of a type II preparation enabled control of the opacity and translucency for full and partial coverage restorations to restore the patient's function without modifying the existing aesthetic principles.

Restoration of a Traumatic Injury to the Anterior Maxilla<br/> Figure 14. <span style='font-size: 16px; font-weight: normal'> Postoperative view following endodontic, periodontal, and prosthodontic treatment using porcelain crown and laminate restorations.</span>

Figure 14 - Postoperative view following endodontic, periodontal, and prosthodontic treatment using porcelain crown and laminate restor...

Figure 14 - Postoperative view following endodontic, periodontal, and prosthodontic treatment using porcelain crown and laminate restorations.

Treatment of Teeth with Open Apices Using Mineral Trioxide Aggregate

Incisal Edge Fracture of Maxillary Central Incisor - Incisal Edge Fracture of Maxillary Central Incisor

Incisal Edge Fracture of Maxillary Central Incisor - Incisal Edge Fracture of Maxillary Central Incisor Contributed by Shahrokh Shabahang, DDS, MS on 5/29/2012

$Incisal Edge Fracture of Maxillary Central Incisor Figure 1. 1A. Preoperative radiograph demonstrates incisal edge fracture of tooth #8(11) at the level of the pulp horn. 1B. Shallow pulpotomy was completed, and a pulp cap and provisional restoration were placed.$ Figure 1 - 1A. Preoperative radiograph demonstrates incisal edge fracture of tooth #8(11) at the level of the pulp horn. 1B. Shallow pu...

Figure 1 - 1A. Preoperative radiograph demonstrates incisal edge fracture of tooth #8(11) at the level of the pulp horn. 1B. Shallow pulpotomy was completed, and a pulp cap and provisional restoration were placed.

Incisal Edge Fracture of Maxillary Central Incisor<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> 2A. Three-month radiograph demonstrates closure of apices. 2B. One-year radiograph exhibits continued root development and closure of the apices.</span>

Figure 2 - 2A. Three-month radiograph demonstrates closure of apices. 2B. One-year radiograph exhibits continued root development and c...

Figure 2 - 2A. Three-month radiograph demonstrates closure of apices. 2B. One-year radiograph exhibits continued root development and closure of the apices.

Incisal Edge Fracture of Maxillary Central Incisor<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Radiograph of the central incisors 2 years post-operatively. Note the complete apical closure and normal periapical architecture.</span>

Figure 3 - Radiograph of the central incisors 2 years post-operatively. Note the complete apical closure and normal periapical architec...

Figure 3 - Radiograph of the central incisors 2 years post-operatively. Note the complete apical closure and normal periapical architecture.

Incisal Edge Fracture and Periapical Lesion in Maxillary Central Incisors - Incisal Edge Fracture and Periapical Lesion in Maxillary Central Inci...

Incisal Edge Fracture and Periapical Lesion in Maxillary Central Incisors - Incisal Edge Fracture and Periapical Lesion in Maxillary Central Incisors Contributed by Shahrokh Shabahang, DDS, MS on 5/29/2012

Incisal Edge Fracture and Periapical Lesion in Maxillary Central Incisors<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative radiograph of the maxillary right central incisor. Note partially developed apex and periapical radiolucent lesion.</span>

Figure 1 - Preoperative radiograph of the maxillary right central incisor. Note partially developed apex and periapical radiolucent les...

Figure 1 - Preoperative radiograph of the maxillary right central incisor. Note partially developed apex and periapical radiolucent lesion.

$Incisal Edge Fracture and Periapical Lesion in Maxillary Central Incisors Figure 2. A 3 mm apical plug of MTA was placed in the fractured tooth.$ Figure 2 - A 3 mm apical plug of MTA was placed in the fractured tooth.

Figure 2 - A 3 mm apical plug of MTA was placed in the fractured tooth.

Incisal Edge Fracture and Periapical Lesion in Maxillary Central Incisors<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> 3A. Radiograph demonstrates complete canal abturation and restoration of the coronal tooth structure. 6B. The 6-month radiograph demonstrates formation of an apical barrier plug and complete resolution of the lesion.</span>

Figure 3 - 3A. Radiograph demonstrates complete canal abturation and restoration of the coronal tooth structure. 6B. The 6-month radiog...

Figure 3 - 3A. Radiograph demonstrates complete canal abturation and restoration of the coronal tooth structure. 6B. The 6-month radiograph demonstrates formation of an apical barrier plug and complete resolution of the lesion.

Treatment of Maxillary Central Incisor Following Trauma - Treatment of Maxillary Central Incisor Following Trauma

Treatment of Maxillary Central Incisor Following Trauma - Treatment of Maxillary Central Incisor Following Trauma Contributed by Shahrokh Shabahang, DDS, MS on 5/29/2012

Treatment of Maxillary Central Incisor Following Trauma<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative radiograph indicates the loss of the lamina dura from the root of the left maxillary central incisor.</span>

Figure 1 - Preoperative radiograph indicates the loss of the lamina dura from the root of the left maxillary central incisor.

Treatment of Maxillary Central Incisor Following Trauma<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Facial view that demonstrates the infraocclusion and coronal discoloration of the left maxillary central incisor.</span>

Figure 2 - Facial view that demonstrates the infraocclusion and coronal discoloration of the left maxillary central incisor.

Treatment of Maxillary Central Incisor Following Trauma<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Two-year recall radiograph of the left maxillary central incisor demonstrates replacement of resorption of the midroot.</span>

Figure 3 - Two-year recall radiograph of the left maxillary central incisor demonstrates replacement of resorption of the midroot.

Treatment of Maxillary Central Incisor Following Trauma<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Clinical view of the transplanted supernumerary lateral incisor following stabilization with sutures and bonded mesh. The splint was maintained for 2 weeks.</span>

Figure 4 - Clinical view of the transplanted supernumerary lateral incisor following stabilization with sutures and bonded mesh. The sp...

Figure 4 - Clinical view of the transplanted supernumerary lateral incisor following stabilization with sutures and bonded mesh. The splint was maintained for 2 weeks.

Treatment of Maxillary Central Incisor Following Trauma<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> 5A. Radiograph of the transplanted tooth with no indications of apical closure. A large radiolucent lesion circumscribes the root apex. 5B. Radiograph immediately following obturation and restoration of the access cavity.</span>

Figure 5 - 5A. Radiograph of the transplanted tooth with no indications of apical closure. A large radiolucent lesion circumscribes the...

Figure 5 - 5A. Radiograph of the transplanted tooth with no indications of apical closure. A large radiolucent lesion circumscribes the root apex. 5B. Radiograph immediately following obturation and restoration of the access cavity.

Treatment of Maxillary Central Incisor Following Trauma<br/> Figure 6. <span style='font-size: 16px; font-weight: normal'> One-year recall radiograph exhibits complete resolution of the periradicular lesion and the formation of a thick layer of hard tissue apical to the MTA.</span>

Figure 6 - One-year recall radiograph exhibits complete resolution of the periradicular lesion and the formation of a thick layer of ha...

Figure 6 - One-year recall radiograph exhibits complete resolution of the periradicular lesion and the formation of a thick layer of hard tissue apical to the MTA.

Treatment of Maxillary Central Incisor Following Trauma<br/> Figure 7. <span style='font-size: 16px; font-weight: normal'> Two-year recall radiograph indicates thickening of the apical barrier.</span>

Figure 7 - Two-year recall radiograph indicates thickening of the apical barrier.

Laboratory-Fabricated Indirect Resin Crowns

Metal-Free Full-Coverage Crown Restorations - Metal-Free Full-Coverage Crown Restorations

Metal-Free Full-Coverage Crown Restorations - Metal-Free Full-Coverage Crown Restorations Contributed by Irfan Ahmad, BDS on 6/4/2012

Metal-Free Full-Coverage Crown Restorations<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative view of defective crown restorations on teeth #8(11) and #9(21), which caused periodontal inflammation.</span>

Figure 1 - Preoperative view of defective crown restorations on teeth #8(11) and #9(21), which caused periodontal inflammation.

Metal-Free Full-Coverage Crown Restorations<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> The defective crown restorations are removed to reveal a metallic core in tooth #9.</span>

Figure 2 - The defective crown restorations are removed to reveal a metallic core in tooth #9.

Metal-Free Full-Coverage Crown Restorations<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Facial view demonstrates the position of the zirconia post in situ prior to cementation.</span>

Figure 3 - Facial view demonstrates the position of the zirconia post in situ prior to cementation.

Metal-Free Full-Coverage Crown Restorations<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Facial view demonstrates retraction cord in place prior to impression making.</span>

Figure 4 - Facial view demonstrates retraction cord in place prior to impression making.

Metal-Free Full-Coverage Crown Restorations<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Sagittal view of uniform tooth reduction. The central incisor preparation with polyglass crown outline exhibits precise and calculated tooth reduction.</span>

Figure 5 - Sagittal view of uniform tooth reduction. The central incisor preparation with polyglass crown outline exhibits precise and...

Figure 5 - Sagittal view of uniform tooth reduction. The central incisor preparation with polyglass crown outline exhibits precise and calculated tooth reduction.

Metal-Free Full-Coverage Crown Restorations<br/> Figure 6. <span style='font-size: 16px; font-weight: normal'> Rounded line angles are evident on the model, particularly at the axial wall/tooth margin interface.</span>

Figure 6 - Rounded line angles are evident on the model, particularly at the axial wall/tooth margin interface.

Metal-Free Full-Coverage Crown Restorations<br/> Figure 7. <span style='font-size: 16px; font-weight: normal'> Postoperative facial view of cemented crown restorations on the maxillary central incisors. Vitality and enhanced aesthetics are clearly evident.</span>

Figure 7 - Postoperative facial view of cemented crown restorations on the maxillary central incisors. Vitality and enhanced aesthetics...

Figure 7 - Postoperative facial view of cemented crown restorations on the maxillary central incisors. Vitality and enhanced aesthetics are clearly evident.

Laboratory Fabricated Indirect Resin Fixed Partial Denture - Laboratory Fabricated Indirect Resin Fixed Partial Denture

Laboratory Fabricated Indirect Resin Fixed Partial Denture - Laboratory Fabricated Indirect Resin Fixed Partial Denture Contributed by Irfan Ahmad, BDS on 6/4/2012

Laboratory Fabricated Indirect Resin Fixed Partial Denture<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative facial view of significant aesthetic and functional compromise.</span>

Figure 1 - Preoperative facial view of significant aesthetic and functional compromise.

Laboratory Fabricated Indirect Resin Fixed Partial Denture<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Occlusal view indicates the preoperative dental status. Note the form of the maxillary ridge.</span>

Figure 2 - Occlusal view indicates the preoperative dental status. Note the form of the maxillary ridge.

Laboratory Fabricated Indirect Resin Fixed Partial Denture<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Facial view immediately following the removal of the defective restoration.</span>

Figure 3 - Facial view immediately following the removal of the defective restoration.

Laboratory Fabricated Indirect Resin Fixed Partial Denture<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Occlusal view demonstrates refined tooth preparations and surgical intervention at the pontic site.</span>

Figure 4 - Occlusal view demonstrates refined tooth preparations and surgical intervention at the pontic site.

Laboratory Fabricated Indirect Resin Fixed Partial Denture<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Translucent posts are inserted. The red rings indicate proper post lengths.</span>

Figure 5 - Translucent posts are inserted. The red rings indicate proper post lengths.

Laboratory Fabricated Indirect Resin Fixed Partial Denture<br/> Figure 6. <span style='font-size: 16px; font-weight: normal'> Definitive tooth preparations with health gingiva and the creation of an ovate pontic site for missing tooth #8.</span>

Figure 6 - Definitive tooth preparations with health gingiva and the creation of an ovate pontic site for missing tooth #8.

Laboratory Fabricated Indirect Resin Fixed Partial Denture<br/> Figure 7. <span style='font-size: 16px; font-weight: normal'> Prior to impressions, the preparations are surrounded by healthy gingiva.</span>

Figure 7 - Prior to impressions, the preparations are surrounded by healthy gingiva.

Laboratory Fabricated Indirect Resin Fixed Partial Denture<br/> Figure 8. <span style='font-size: 16px; font-weight: normal'> Facial view of plaster model demonstrates fiber-reinforcement of the fixed partial denture (FPD).</span>

Figure 8 - Facial view of plaster model demonstrates fiber-reinforcement of the fixed partial denture (FPD).

Laboratory Fabricated Indirect Resin Fixed Partial Denture<br/> Figure 9. <span style='font-size: 16px; font-weight: normal'> Occlusal view of FPD framework try-in to verify fit and buccolingual dimensions.</span>

Figure 9 - Occlusal view of FPD framework try-in to verify fit and buccolingual dimensions.

Laboratory Fabricated Indirect Resin Fixed Partial Denture<br/> Figure 10. <span style='font-size: 16px; font-weight: normal'> Occlusal view of simultaneous translucency and flourescence at incisal edges of the definitive crown and FPD restorations.</span>

Figure 10 - Occlusal view of simultaneous translucency and flourescence at incisal edges of the definitive crown and FPD restorations.

Laboratory Fabricated Indirect Resin Fixed Partial Denture<br/> Figure 11. <span style='font-size: 16px; font-weight: normal'> The luster of the restorations is readily apparent from an occlusal perspective.</span>

Figure 11 - The luster of the restorations is readily apparent from an occlusal perspective.

Laboratory Fabricated Indirect Resin Fixed Partial Denture<br/> Figure 12. <span style='font-size: 16px; font-weight: normal'> Occlusal postoperative view of cemented crown and FPD restorations.</span>

Figure 12 - Occlusal postoperative view of cemented crown and FPD restorations.

Laboratory Fabricated Indirect Resin Fixed Partial Denture<br/> Figure 13. <span style='font-size: 16px; font-weight: normal'> Postoperative facial view of cemented polyglass restorations.</span>

Figure 13 - Postoperative facial view of cemented polyglass restorations.

Restorative Challenges Associated with Endodontically Treated Teeth

Management of Discoloration and Edge-to-Edge Occlusal Relationship in Vital Tooth - Management of Discoloration and Edge-to-Edge Occlusal Relatio...

Management of Discoloration and Edge-to-Edge Occlusal Relationship in Vital Tooth - Management of Discoloration and Edge-to-Edge Occlusal Relationship in Vital Tooth Contributed by Adriana F. Quintas, DDS, MS, PhD on 6/18/2012

Management of Discoloration and Edge-to-Edge Occlusal Relationship in Vital Tooth<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Anterior view of a vital tooth with severe discoloration and an edge-to-edge occlusal relationship.</span>

Figure 1 - Anterior view of a vital tooth with severe discoloration and an edge-to-edge occlusal relationship.

Management of Discoloration and Edge-to-Edge Occlusal Relationship in Vital Tooth<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Preoperative view demonstrates severe discoloration in the anterior region which was still vital.</span>

Figure 2 - Preoperative view demonstrates severe discoloration in the anterior region which was still vital.

Management of Discoloration and Edge-to-Edge Occlusal Relationship in Vital Tooth<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Postoperative appearance following placement of an ETT with a feldspathic veneer restoration on the vital tooth.</span>

Figure 3 - Postoperative appearance following placement of an ETT with a feldspathic veneer restoration on the vital tooth.

Management of Discoloration and Edge-to-Edge Occlusal Relationship in Vital Tooth<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Tooth #8(11) became nonvital and discolored two to three years postoperatively. Although endodontic treatment and internal bleaching were performed, the laminate veneer required replacement with a more opaque ceramic.</span>

Figure 4 - Tooth #8(11) became nonvital and discolored two to three years postoperatively. Although endodontic treatment and internal b...

Figure 4 - Tooth #8(11) became nonvital and discolored two to three years postoperatively. Although endodontic treatment and internal bleaching were performed, the laminate veneer required replacement with a more opaque ceramic.

Aesthetic Replacement of Defective PFM Crowns on Nonvital Teeth #7 Through #9 - Aesthetic Replacement of Defective PFM Crowns on Nonvital Teeth #...

Aesthetic Replacement of Defective PFM Crowns on Nonvital Teeth #7 Through #9 - Aesthetic Replacement of Defective PFM Crowns on Nonvital Teeth #7 Through #9 Contributed by Irfan Ahmad, BDS on 6/22/2012

Aesthetic Replacement of Defective PFM Crowns on Nonvital Teeth #7 Through #9<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative view of the defective bonded crowns on teeth #7, #8, and #9.</span>

Figure 1 - Preoperative view of the defective bonded crowns on teeth #7, #8, and #9.

Aesthetic Replacement of Defective PFM Crowns on Nonvital Teeth #7 Through #9<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Inadequate intraradicular stabilization of the maxillary central incisors was evident by a short metallic post and composite resin cores.</span>

Figure 2 - Inadequate intraradicular stabilization of the maxillary central incisors was evident by a short metallic post and composite...

Figure 2 - Inadequate intraradicular stabilization of the maxillary central incisors was evident by a short metallic post and composite resin cores.

Aesthetic Replacement of Defective PFM Crowns on Nonvital Teeth #7 Through #9<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Initial preparation of teeth #7, #8, and #9 for all-ceramic full-coverage crown restorations and root surface modifications of the central incisor.</span>

Figure 3 - Initial preparation of teeth #7, #8, and #9 for all-ceramic full-coverage crown restorations and root surface modifications...

Figure 3 - Initial preparation of teeth #7, #8, and #9 for all-ceramic full-coverage crown restorations and root surface modifications of the central incisor.

Aesthetic Replacement of Defective PFM Crowns on Nonvital Teeth #7 Through #9<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Zirconia posts in situ and marked with green and blue indelible ink for length determination.</span>

Figure 4 - Zirconia posts in situ and marked with green and blue indelible ink for length determination.

Aesthetic Replacement of Defective PFM Crowns on Nonvital Teeth #7 Through #9<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> A light-viscosity wash was used in lumen of inner shoulder around the zirconia post in tooth #8.</span>

Figure 5 - A light-viscosity wash was used in lumen of inner shoulder around the zirconia post in tooth #8.

Aesthetic Replacement of Defective PFM Crowns on Nonvital Teeth #7 Through #9<br/> Figure 6. <span style='font-size: 16px; font-weight: normal'> A putty-light combination was used to locate the post and record the outer and inner shoulders on the root surface of the maxillary right central incisors.</span>

Figure 6 - A putty-light combination was used to locate the post and record the outer and inner shoulders on the root surface of the ma...

Figure 6 - A putty-light combination was used to locate the post and record the outer and inner shoulders on the root surface of the maxillary right central incisors.

Aesthetic Replacement of Defective PFM Crowns on Nonvital Teeth #7 Through #9<br/> Figure 7. <span style='font-size: 16px; font-weight: normal'> The first dental biological impression with the retraction cord in place.</span>

Figure 7 - The first dental biological impression with the retraction cord in place.

Aesthetic Replacement of Defective PFM Crowns on Nonvital Teeth #7 Through #9<br/> Figure 8. <span style='font-size: 16px; font-weight: normal'> The first dental biological impression with a putty-light combination impression</span>

Figure 8 - The first dental biological impression with a putty-light combination impression

Aesthetic Replacement of Defective PFM Crowns on Nonvital Teeth #7 Through #9<br/> Figure 9. <span style='font-size: 16px; font-weight: normal'> The first dental biological impression with a plaster model showing gingival deflection to reveal clearly discernible preparation margins.</span>

Figure 9 - The first dental biological impression with a plaster model showing gingival deflection to reveal clearly discernible prepar...

Figure 9 - The first dental biological impression with a plaster model showing gingival deflection to reveal clearly discernible preparation margins.

Aesthetic Replacement of Defective PFM Crowns on Nonvital Teeth #7 Through #9<br/> Figure 10. <span style='font-size: 16px; font-weight: normal'> The second dental biological impression using three different consistencies of putty that are injected around teeth #7, #8, and #9.</span>

Figure 10 - The second dental biological impression using three different consistencies of putty that are injected around teeth #7, #8,...

Figure 10 - The second dental biological impression using three different consistencies of putty that are injected around teeth #7, #8, and #9.

Aesthetic Replacement of Defective PFM Crowns on Nonvital Teeth #7 Through #9<br/> Figure 11. <span style='font-size: 16px; font-weight: normal'> Impression of preparations using different putty viscosities for the second dental biological impression.</span>

Figure 11 - Impression of preparations using different putty viscosities for the second dental biological impression.

Aesthetic Replacement of Defective PFM Crowns on Nonvital Teeth #7 Through #9<br/> Figure 12. <span style='font-size: 16px; font-weight: normal'> Saggital sections of the second dental biological impressions with dies for teeth #7, #8, and #9. Note the imperceptible fit of all three dies into the different consistencies.</span>

Figure 12 - Saggital sections of the second dental biological impressions with dies for teeth #7, #8, and #9. Note the imperceptible fi...

Figure 12 - Saggital sections of the second dental biological impressions with dies for teeth #7, #8, and #9. Note the imperceptible fit of all three dies into the different consistencies.

Aesthetic Replacement of Defective PFM Crowns on Nonvital Teeth #7 Through #9<br/> Figure 13. <span style='font-size: 16px; font-weight: normal'> Centric occlusion bite registration over preparations was later obtained.</span>

Figure 13 - Centric occlusion bite registration over preparations was later obtained.

Aesthetic Replacement of Defective PFM Crowns on Nonvital Teeth #7 Through #9<br/> Figure 14. <span style='font-size: 16px; font-weight: normal'> Gingival biological impression - removal of acrylic temporaries to reveal soft tissues in a nondeflected state.</span>

Figure 14 - Gingival biological impression - removal of acrylic temporaries to reveal soft tissues in a nondeflected state.

Aesthetic Replacement of Defective PFM Crowns on Nonvital Teeth #7 Through #9<br/> Figure 15. <span style='font-size: 16px; font-weight: normal'> Gingival biological impression - impression using light putty to record healthy interdental marginal gingivae.</span>

Figure 15 - Gingival biological impression - impression using light putty to record healthy interdental marginal gingivae.

Aesthetic Replacement of Defective PFM Crowns on Nonvital Teeth #7 Through #9<br/> Figure 16. <span style='font-size: 16px; font-weight: normal'> Gingival biological impression - plaster cast showing tissue architecture.</span>

Figure 16 - Gingival biological impression - plaster cast showing tissue architecture.

Aesthetic Replacement of Defective PFM Crowns on Nonvital Teeth #7 Through #9<br/> Figure 17. <span style='font-size: 16px; font-weight: normal'> Postoperative view of the definitive cemented all-ceramic full coverage crown restorations on teeth #7, #8, and #9.</span>

Figure 17 - Postoperative view of the definitive cemented all-ceramic full coverage crown restorations on teeth #7, #8, and #9.

Single-Unit Crown and Core System for Restoring Teeth #18 and #19 - Restoring posterior mandibular molars successfully treated with a Monobloc te...

Single-Unit Crown and Core System for Restoring Teeth #18 and #19 - Restoring posterior mandibular molars successfully treated with a Monobloc technique Contributed by Timothy Adams, DDS on 8/6/2012

Single-Unit Crown and Core System for Restoring Teeth #18 and #19<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative view of compromised posterior teeth following the completion of endodontic treatment.</span>

Figure 1 - Preoperative view of compromised posterior teeth following the completion of endodontic treatment.

Single-Unit Crown and Core System for Restoring Teeth #18 and #19<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Due to the leakage and wedging effect of the amalgam restorations, a preparation design was required that was more aggressive than originally anticipated.</span>

Figure 2 - Due to the leakage and wedging effect of the amalgam restorations, a preparation design was required that was more aggressiv...

Figure 2 - Due to the leakage and wedging effect of the amalgam restorations, a preparation design was required that was more aggressive than originally anticipated.

Single-Unit Crown and Core System for Restoring Teeth #18 and #19<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Occlusal view of the master model demonstrates the required preparation design.</span>

Figure 3 - Occlusal view of the master model demonstrates the required preparation design.

Single-Unit Crown and Core System for Restoring Teeth #18 and #19<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> The adhesive single-unit crown and core system has demonstrated increased strength characteristics and the ability to distribute occlusal forces evenly to the roots.</span>

Figure 4 - The adhesive single-unit crown and core system has demonstrated increased strength characteristics and the ability to distri...

Figure 4 - The adhesive single-unit crown and core system has demonstrated increased strength characteristics and the ability to distribute occlusal forces evenly to the roots.

Single-Unit Crown and Core System for Restoring Teeth #18 and #19<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> The definitive restoration is tried-in on the master model prior to seating.</span>

Figure 5 - The definitive restoration is tried-in on the master model prior to seating.

Single-Unit Crown and Core System for Restoring Teeth #18 and #19<br/> Figure 6. <span style='font-size: 16px; font-weight: normal'> 6A. Preoperative radiograph prior to endodontic and prosthetic treatment. 6B. Postoperative radiograph depicts integration of single-unit crown and core.</span>

Figure 6 - 6A. Preoperative radiograph prior to endodontic and prosthetic treatment. 6B. Postoperative radiograph depicts integration o...

Figure 6 - 6A. Preoperative radiograph prior to endodontic and prosthetic treatment. 6B. Postoperative radiograph depicts integration of single-unit crown and core.

Single-Unit Crown and Core System for Restoring Teeth #18 and #19<br/> Figure 7. <span style='font-size: 16px; font-weight: normal'> The definitive restorations exhibit optimal form, function, and aesthetics.</span>

Figure 7 - The definitive restorations exhibit optimal form, function, and aesthetics.

Illustrated Concepts for Root Canal Irrigation

Protocol for Placement of Intracanal Medicaments - Protocol for Placement of Intracanal Medicaments

Protocol for Placement of Intracanal Medicaments - Protocol for Placement of Intracanal Medicaments Contributed by R. Scott Gatewood, DMD on 6/18/2012

Protocol for Placement of Intracanal Medicaments<br/> Figure 6. <span style='font-size: 16px; font-weight: normal'> Finally, the clinician must restore the tooth structures once root canal treatment is complete.</span>

Figure 6 - Finally, the clinician must restore the tooth structures once root canal treatment is complete.

Irreversible Pulpitis

Management of Irreversible Pulpitis - Management of Irreversible Pulpitis

Management of Irreversible Pulpitis - Management of Irreversible Pulpitis Contributed by Thomas A. Jovicich, DMD on 7/17/2012

Management of Irreversible Pulpitis<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative image of tooth #18(37). Tooth exhibited severe pain to cold and was diagnosed with irreversible pulpitis.</span>

Figure 1 - Preoperative image of tooth #18(37). Tooth exhibited severe pain to cold and was diagnosed with irreversible pulpitis.

Management of Irreversible Pulpitis<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Treatment of tooth #18 was accomplished in one visit, using the large, assorted twisted files.</span>

Figure 2 - Treatment of tooth #18 was accomplished in one visit, using the large, assorted twisted files.

Periapical Pathosis

Management of Periapical Pathosis - Management of Periapical Pathosis

Management of Periapical Pathosis - Management of Periapical Pathosis Contributed by Thomas A. Jovicich, DMD on 7/17/2012

Management of Periapical Pathosis<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative image radiograph of tooth #20(35), which was diagnosed with periapical pathosis.</span>

Figure 1 - Preoperative image radiograph of tooth #20(35), which was diagnosed with periapical pathosis.

Management of Periapical Pathosis<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Tooth #20 was treated endodontically with large, assorted twisted files.</span>

Figure 2 - Tooth #20 was treated endodontically with large, assorted twisted files.

Shaping of the Endodontic Canal

Proper Shaping of the Root Canal Space in Tooth #2 - Proper Shaping of the Root Canal Space in Tooth #2

Proper Shaping of the Root Canal Space in Tooth #2 - Proper Shaping of the Root Canal Space in Tooth #2 Contributed by Thomas A. Jovicich, DMD on 7/17/2012

Proper Shaping of the Root Canal Space in Tooth #2<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Tooth #2(17) exhibited carious tissue exposed by the general clinician.</span>

Figure 1 - Tooth #2(17) exhibited carious tissue exposed by the general clinician.

Proper Shaping of the Root Canal Space in Tooth #2<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Endodontic therapy was completed on tooth #2 with large, assorted twisted files. Note the presence of a significant lateral portal of exit.</span>

Figure 2 - Endodontic therapy was completed on tooth #2 with large, assorted twisted files. Note the presence of a significant lateral...

Figure 2 - Endodontic therapy was completed on tooth #2 with large, assorted twisted files. Note the presence of a significant lateral portal of exit.

Management of Radicular Anomalies

Treatment Options for the Radicular Lingual Groove - Diagnosing various forms of radicular lingual grooves and their prognoses.

Treatment Options for the Radicular Lingual Groove - Diagnosing various forms of radicular lingual grooves and their prognoses. Contributed by Tom G. Gound, DDS, MS on 11/21/2012

Treatment Options for the Radicular Lingual Groove<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Case 1. Radiograph of a radicular lingual groove in maxillary left lateral incisor. Note radiolucent parapulpal line superimposed over root canal.</span>

Figure 1 - Case 1. Radiograph of a radicular lingual groove in maxillary left lateral incisor. Note radiolucent "parapulpal line" super...

Figure 1 - Case 1. Radiograph of a radicular lingual groove in maxillary left lateral incisor. Note radiolucent "parapulpal line" superimposed over root canal.

Treatment Options for the Radicular Lingual Groove<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Case 2. Radiograph of RLG in the maxillary lateral incisor. Endodontic treatment was completed 10 years previously; RLG was not diagnosed. Tooth was extracted.</span>

Figure 2 - Case 2. Radiograph of RLG in the maxillary lateral incisor. Endodontic treatment was completed 10 years previously; RLG was...

Figure 2 - Case 2. Radiograph of RLG in the maxillary lateral incisor. Endodontic treatment was completed 10 years previously; RLG was not diagnosed. Tooth was extracted.

Treatment Options for the Radicular Lingual Groove<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Palatal view of the maxillary site with gingival irritation present.</span>

Figure 3 - Palatal view of the maxillary site with gingival irritation present.

Treatment Options for the Radicular Lingual Groove<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Palatal view. Periodontal probing reveals a 10-mm pocket.</span>

Figure 4 - Palatal view. Periodontal probing reveals a 10-mm pocket.

Treatment Options for the Radicular Lingual Groove<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> 5A. Radiograph of the extracted maxillary lateral incisor with one canal. 5B. Photograph of the extracted tooth with mild form of simple radicular lingual groove.</span>

Figure 5 - 5A. Radiograph of the extracted maxillary lateral incisor with one canal. 5B. Photograph of the extracted tooth with mild fo...

Figure 5 - 5A. Radiograph of the extracted maxillary lateral incisor with one canal. 5B. Photograph of the extracted tooth with mild form of simple radicular lingual groove.

Treatment Options for the Radicular Lingual Groove<br/> Figure 6. <span style='font-size: 16px; font-weight: normal'> Case 3. Radiograph of maxillary lateral incisor. Endodontic therapy began 1 year previously; RLG was diagnosed and the tooth was extracted.</span>

Figure 6 - Case 3. Radiograph of maxillary lateral incisor. Endodontic therapy began 1 year previously; RLG was diagnosed and the tooth...

Figure 6 - Case 3. Radiograph of maxillary lateral incisor. Endodontic therapy began 1 year previously; RLG was diagnosed and the tooth was extracted.

Treatment Options for the Radicular Lingual Groove<br/> Figure 7. <span style='font-size: 16px; font-weight: normal'> Preoperative clinical view. The groove is evident on the lingual surface.</span>

Figure 7 - Preoperative clinical view. The groove is evident on the lingual surface.

Treatment Options for the Radicular Lingual Groove<br/> Figure 8. <span style='font-size: 16px; font-weight: normal'> 8A. Lingual view of the extracted tooth. A large groove is evident between the fused roots. 8B. Radiograph exhibits the second root and canal; neither was evident on preoperative radiographs.</span>

Figure 8 - 8A. Lingual view of the extracted tooth. A large groove is evident between the fused roots. 8B. Radiograph exhibits the seco...

Figure 8 - 8A. Lingual view of the extracted tooth. A large groove is evident between the fused roots. 8B. Radiograph exhibits the second root and canal; neither was evident on preoperative radiographs.

Treatment Options for the Radicular Lingual Groove<br/> Figure 9. <span style='font-size: 16px; font-weight: normal'> 9A. Case 4. Radiograph of the files in both canals. 9B. Lateral view of radiograph of the files in both canals. Note parapulpal line.</span>

Figure 9 - 9A. Case 4. Radiograph of the files in both canals. 9B. Lateral view of radiograph of the files in both canals. Note parapul...

Figure 9 - 9A. Case 4. Radiograph of the files in both canals. 9B. Lateral view of radiograph of the files in both canals. Note parapulpal line.

Treatment Options for the Radicular Lingual Groove<br/> Figure 10. <span style='font-size: 16px; font-weight: normal'> Case 5. Clinical evaluation of a 9-mm suppurative periodontal pocket palatal to the maxillary left central incisor. No apparent inflammation is present.</span>

Figure 10 - Case 5. Clinical evaluation of a 9-mm suppurative periodontal pocket palatal to the maxillary left central incisor. No appa...

Figure 10 - Case 5. Clinical evaluation of a 9-mm suppurative periodontal pocket palatal to the maxillary left central incisor. No apparent inflammation is present.

Treatment Options for the Radicular Lingual Groove<br/> Figure 11. <span style='font-size: 16px; font-weight: normal'> Radiograph sent by referring clinician. Root canal therapy had been deemed impossible due to periodontal-pulpal involvement. Significant radiolucency suggests complex RLG.</span>

Figure 11 - Radiograph sent by referring clinician. Root canal therapy had been deemed impossible due to periodontal-pulpal involvement...

Figure 11 - Radiograph sent by referring clinician. Root canal therapy had been deemed impossible due to periodontal-pulpal involvement. Significant radiolucency suggests complex RLG.

Treatment Options for the Radicular Lingual Groove<br/> Figure 12. <span style='font-size: 16px; font-weight: normal'> Saucerization of the entire groove, including pulp tissue and palatal half of the canal. Medium and fine round diamond burs used to plasty the root to the apex.</span>

Figure 12 - Saucerization of the entire groove, including pulp tissue and palatal half of the canal. Medium and fine round diamond burs...

Figure 12 - Saucerization of the entire groove, including pulp tissue and palatal half of the canal. Medium and fine round diamond burs used to plasty the root to the apex.

Treatment Options for the Radicular Lingual Groove<br/> Figure 13. <span style='font-size: 16px; font-weight: normal'> Dense particulate hydroxyapatite is used to fill the RLG defect to the crest of the surrounding bone. Flap is repositioned an closed with silk suture. Healing is uneventful.</span>

Figure 13 - Dense particulate hydroxyapatite is used to fill the RLG defect to the crest of the surrounding bone. Flap is repositioned...

Figure 13 - Dense particulate hydroxyapatite is used to fill the RLG defect to the crest of the surrounding bone. Flap is repositioned an closed with silk suture. Healing is uneventful.

Treatment Options for the Radicular Lingual Groove<br/> Figure 14. <span style='font-size: 16px; font-weight: normal'> One-year postoperative radiograph indicates increased radiolucency of the apical half of the root.</span>

Figure 14 - One-year postoperative radiograph indicates increased radiolucency of the apical half of the root.

Treatment Options for the Radicular Lingual Groove<br/> Figure 15. <span style='font-size: 16px; font-weight: normal'> Palatal view at 18 months demonstrates gingival tissue health with attachment gain of 7 mm. The palatal aspect of the tooth probed 4 mm without bleeding.</span>

Figure 15 - Palatal view at 18 months demonstrates gingival tissue health with attachment gain of 7 mm. The palatal aspect of the tooth...

Figure 15 - Palatal view at 18 months demonstrates gingival tissue health with attachment gain of 7 mm. The palatal aspect of the tooth probed 4 mm without bleeding.

Treatment Options for the Radicular Lingual Groove<br/> Figure 16. <span style='font-size: 16px; font-weight: normal'> Clinical follow-up at 18 months postoperatively demonstrates that the maxillary left central incisor is comparable to the vital right central incisor in color and contour.</span>

Figure 16 - Clinical follow-up at 18 months postoperatively demonstrates that the maxillary left central incisor is comparable to the v...

Figure 16 - Clinical follow-up at 18 months postoperatively demonstrates that the maxillary left central incisor is comparable to the vital right central incisor in color and contour.

Management of Exposed Vital Pulp

Treatment Options for Exposed Vital Pulp - The exposure of dental pulp generally occurs as the result of accidental trauma or preparation techniq...

Treatment Options for Exposed Vital Pulp - The exposure of dental pulp generally occurs as the result of accidental trauma or preparation techniques utilized during the restoration of carious lesions. While frank carious exposures are optimally treated with pulpectomy and root canal therapy, the ide...

$Treatment Options for Exposed Vital Pulp Figure 2. Preoperative facial view of the fractured tooth #9(21). The partial pulpotomy technique will be used to treat the traumatically exposed pulp.$ Figure 2 - Preoperative facial view of the fractured tooth #9(21). The partial pulpotomy technique will be used to treat the traumatica...

Figure 2 - Preoperative facial view of the fractured tooth #9(21). The partial pulpotomy technique will be used to treat the traumatically exposed pulp.

Treatment Options for Exposed Vital Pulp<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> The central incisor is isolated with a rubber dam and superficially disinfected.</span>

Figure 3 - The central incisor is isolated with a rubber dam and superficially disinfected.

Treatment Options for Exposed Vital Pulp<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> Utilizing a surgical diamond cut, 1 mm to 2 mm of superficial pulp tissue is removed.</span>

Figure 4 - Utilizing a surgical diamond cut, 1 mm to 2 mm of superficial pulp tissue is removed.

Treatment Options for Exposed Vital Pulp<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Once the pulp tissue has been removed, calcium hydroxide is placed as a pulp cap.</span>

Figure 5 - Once the pulp tissue has been removed, calcium hydroxide is placed as a pulp cap.

$Treatment Options for Exposed Vital Pulp Figure 6. 6A Preoperative radiograph of the fractured incisor 6B. The 1-year postoperative radiograph demonstrates continued root development.$ Figure 6 - 6A Preoperative radiograph of the fractured incisor 6B. The 1-year postoperative radiograph demonstrates continued root deve...

Figure 6 - 6A Preoperative radiograph of the fractured incisor 6B. The 1-year postoperative radiograph demonstrates continued root development.

The Use of Magnification in Endodontic Therapy

Investigation of a Lateral Lesion - Use of magnification in diagnosis and treatment planning of male patient with mild symptoms and a sinus tract...

Investigation of a Lateral Lesion - Use of magnification in diagnosis and treatment planning of male patient with mild symptoms and a sinus tract in the mandibular right quadrant. Contributed by Bertrand G. Khayat, DDS, MSD on 12/3/2012

Investigation of a Lateral Lesion<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative radiograph tracing a fistula with a gutta-percha point. A lateral lesion is suspected.</span>

Figure 1 - Preoperative radiograph tracing a fistula with a gutta-percha point. A lateral lesion is suspected.

Investigation of a Lateral Lesion<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Microscopic examination reveals a crack that does not extend completely to the margin of the restoration.</span>

Figure 2 - Microscopic examination reveals a crack that does not extend completely to the margin of the restoration.

Diagnosis and Treatment of Endodontic Lesion - Utilization of magnification in the diagnosis and treatment of a maxillary right central incisor

Diagnosis and Treatment of Endodontic Lesion - Utilization of magnification in the diagnosis and treatment of a maxillary right central incisor Contributed by Bertrand G. Khayat, DDS, MSD on 12/3/2012

Diagnosis and Treatment of Endodontic Lesion<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> View of a surgical site of a maxillary central incisor without magnification.</span>

Figure 1 - View of a surgical site of a maxillary central incisor without magnification.

Diagnosis and Treatment of Endodontic Lesion<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> View of the same site at 16x magnification with a micro-mirror. Three portals of exit can be discerned at the apex.</span>

Figure 2 - View of the same site at 16x magnification with a micro-mirror. Three portals of exit can be discerned at the apex.

Diagnosis and Treatment of Endodontic Lesion<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> The tree apical foramina were prepared with ultrasonic tips and filled with retrofill.</span>

Figure 3 - The tree apical foramina were prepared with ultrasonic tips and filled with retrofill.

Investigating Complex Anatomy After Unsuccessful Endodontic Surgery - Magnification in management of female patient with recurrent symptoms after...

Investigating Complex Anatomy After Unsuccessful Endodontic Surgery - Magnification in management of female patient with recurrent symptoms after previous endodontic surgery. Contributed by Bertrand G. Khayat, DDS, MSD on 12/3/2012

Investigating Complex Anatomy After Unsuccessful Endodontic Surgery<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative radiograph of an unsuccessful endodontic surgery and inadequately placed amalgam retrofill.</span>

Figure 1 - Preoperative radiograph of an unsuccessful endodontic surgery and inadequately placed amalgam retrofill.

Investigating Complex Anatomy After Unsuccessful Endodontic Surgery<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> View of a beveled root surface, revealing a more complex anatomy.</span>

Figure 2 - View of a beveled root surface, revealing a more complex anatomy.

Investigating Complex Anatomy After Unsuccessful Endodontic Surgery<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Ultrasonic preparation of the 3 canals and the isthmus joining them.</span>

Figure 3 - Ultrasonic preparation of the 3 canals and the isthmus joining them.

Investigating Complex Anatomy After Unsuccessful Endodontic Surgery<br/> Figure 4. <span style='font-size: 16px; font-weight: normal'> View of the same site obturated with retrofill material.</span>

Figure 4 - View of the same site obturated with retrofill material.

Investigating Complex Anatomy After Unsuccessful Endodontic Surgery<br/> Figure 5. <span style='font-size: 16px; font-weight: normal'> Immediately postoperative radiograph revealing an unusual appearance of the retrofill.</span>

Figure 5 - Immediately postoperative radiograph revealing an unusual appearance of the retrofill.

Investigating Complex Anatomy After Unsuccessful Endodontic Surgery<br/> Figure 6. <span style='font-size: 16px; font-weight: normal'> Six-month postoperative radiograph, revealing a complete healing.</span>

Figure 6 - Six-month postoperative radiograph, revealing a complete healing.

Detection of Third Endodontic Canal Using Magnification - Identification and treatment of endodontic lesion at the apex of the mesial root of the...

Detection of Third Endodontic Canal Using Magnification - Identification and treatment of endodontic lesion at the apex of the mesial root of the mandibular left first molar. Contributed by Bertrand G. Khayat, DDS, MSD on 12/3/2012

Detection of Third Endodontic Canal Using Magnification<br/> Figure 1. <span style='font-size: 16px; font-weight: normal'> Preoperative radiograph of the mandibular left first molar. The treatment of the two mesial canals initially appears to be adequate.</span>

Figure 1 - Preoperative radiograph of the mandibular left first molar. The treatment of the two mesial canals initially appears to be a...

Figure 1 - Preoperative radiograph of the mandibular left first molar. The treatment of the two mesial canals initially appears to be adequate.

Detection of Third Endodontic Canal Using Magnification<br/> Figure 2. <span style='font-size: 16px; font-weight: normal'> Microscopic examination of the beveled root surface reveals a third untreated anal between the two treated canals.</span>

Figure 2 - Microscopic examination of the beveled root surface reveals a third untreated anal between the two treated canals.

Detection of Third Endodontic Canal Using Magnification<br/> Figure 3. <span style='font-size: 16px; font-weight: normal'> Postoperative view of the 3 canals and the isthmus joining them obturated with retrofill.</span>

Figure 3 - Postoperative view of the 3 canals and the isthmus joining them obturated with retrofill.

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