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.

Single visit re-root canal treatment

 Single visit re-root canal treatment of 19 with periapical abscess with discharging sinus

patient was 35 years old came to our clinic with the chief complain of swelling and pain on lower left side of the jaw. on examination and radio graph i found there was a under filled root canal treatment with cap and discharging sinus on lower left 1st molar tooth.

 so after removing the cap, pre-endo build-up of distal wall by flow-able composite and isolation by rubber dam was done. old gps were removed by densply re treatment file D1, D2, D3. canals were prepared upto X2 (6% tapper 25 ASI)for mesial canals and X3(7%tapper 30 ASI) for distal canal. Sodium hypoclorite was used as irrigant.root canal seal was done by warm vertical compaction. intraoral drainage of the abscess was done. patient was precribed antibiotic and mouthwash (i usually don't prescribe antibiotic during root canal treatment, in this case abscess was too severe).

Quad-helix with obturator in cleft palate patient

 Initial intra-oral photo

Quad-helix with obturator

Quad-helix with obturator in mouth

Arch expansion achieved with Quad-helix

Class III malocclusion

 Non-extraction Orthodontic camouflage of class III malocclusion

BEFORE TREATMENT

UPPER ARCH EXPANSION BY 16 MIL SS WIRE WITH OPENING LOOP 

AFTER TREATMENT

Generalized spacing

"Doctor I have spaced teeth,can u correct them in a short time without adding and removing anything?" that's all patient said and i took 5 months to satisfy her by fixed braces system.

BEFORE

AFTER

Class II division 2 malocclusion

She had buck teeth (class 2 division ii malocclusion) and I took 1 year to make her smile by Fixed Braces System

BEFORE TREATMENT

      

INITIAL LEVELING AND ALIGNMENT BY 12 MIL SS ARCHWIRE

CORRECTION OF DEEP OVERBITE BY 16 MIL SS REVERSE CURVE OF SPEE ARCHWIRE ON LOWER ARCH

FINISHING AND TORQUE EXPRESSION BY 17*25 MIL SS ARCHWIRE

AFTER TREATMENT

Generalized spacing

Generalized spacing closure by Fixed Braces system

 Treatment time: 6 months

BEFORE

   

AFTER