Midline Diastema Closure

BEFORE

AFTER

Chipped incisal edge restoration

Initial Intra-oral Photo

After restoration

Our publication on oral hygiene practice and dental status of autistic children in BD from the department of Orthodontics,BSMMU

https://www.bmrcbd.org/Bulletin/bulletin_html/4602/460203.php 

Root canal treatment

Routine endo work

chronic periapical periodontitis.

patient was complaining of pain while bitting food.

patient was 70 years old, diabetic, hypertensive.

Isolation was done by rubber dam.

working length was determined by the X-smart duo(endo-motor plus apex locator).

canal was prepared up to X2( 6% tapper 25 number ASI)

5.25% sodium hypochlorite was used alone as active irrigant(ultrasonic irrigation).

LSTR was used for intracanal medicament.

paper point was used for drying the canal.

seal was done by single gp point and warm vertical compaction.

as i am using seal apex aka calcium-based sealer and presence of necrotic pulp and periapical lesion i had done sealer puffing.

One year follow up case of instrument separation

 A follow-up case of one of my instrument separation cases with chronic periapical periodontitis on 44 after a year.

patient was 45 years of age without any significant medical condition.

periapical lesion was due to secondary caries under a previously done composite filling.

so after isolation with rubber dam i had started the root canal.I broke a x1 file (4% tapper 17no ASI) at the apical third where canal become curved towards apex.the reason was after negotiating the canal with hand 10 k  file, i skipped the hand 15 k file and used the x1 file instead which is corresponds to 17no file.as the canal was curved at the apex, the file broke.skipping instrument size should be avoided and in case of narrow canal hand preparation should be done upto at least 20 no ASI before approaching to rotary files.

as i m a bypass lover(or can't do retrieval :D) i had bypassed the broken file and prepared the canal manually upto 35 k file.i had used sodium hypoclorite for irrigation after ultrasonic activation.

canal was sealed by gp points and seal apex by warm lateral compaction after initial cold lateral compaction.

i've followed up the patient after 1 year.everything looks good.the periapical lesion has gone.

Single visit Root Canal Treatment

 Routine single visit rct on 16 and tooth preparation for PFM crown

All canals are prepared up to x2(25/.06), Mb2 up to 20/.04.

sealed by warm vertical compaction technique.

build-up by Beautifill bulk.

impression by condensation silicon.

Re-root canal treatment

 Re-rct on 30 (multi-visit)

1st visit: removed the cap, pre-endo build up of distal wall, old gps were removed by densply re-treatment files D1, D2, D3, hypoclorite dressing was given.

2nd visit: there were ledges in every canals, so i bypassed the ledges. the procedure i usually follow 

1. take a 10 k file and pre-curve 30deg at its tip

2. insert the file at the direction of ledge, slowly rotate 180deg at the ledge.

3. i am using EDTA as an adjunct.i repeat the above procedure until the ledge is bypassed. 

LSTR was used as intra-canal medicament.

3rd visit: all canals were prepared upto X3 (7% tapper,30 ASI), hypoclorite dressing was given. canals were sealed by single gp cone.