Endo experience improves for patients
We may talk fondly of the “good old days” but I’m not sure there ever were in endodontics. For both endodontist and patient, today’s materials and technology make treatment quicker and easier, with more reliable outcomes.
Take this patient (follow the x-ray images left to right) who presented with infection and swelling at the tip of the root of the upper right central incisor. The most likely cause was an incomplete seal of the original root filling, hardly surprising as the apical opening was large (over ISO 150).
Twenty years ago, there were only two options for a case like this. Either an apicectomy, (root end surgery, never ideal when the root filling is so poor to start with) or removal of the root filling and then a protracted course of treatment over an 18 month period using calcium hydroxide to stimulate root end closure, followed by the final root filling. This was a complex process involving multiple visits by the patient.
Thanks to modern technology and new materials I completed the case in a single visit last year. The root filling material was removed, the entire length of the canal visualized with the operating microscope and an apical plug of MTA (mineral trioxide aggregrate) was placed precisely at the end of the canal to seal it and the rest of the canal was filled with conventional gutta percha. At the recent review appointment, I saw healing had been achieved within the year. All this in one visit!