Complex endodontics from Domenico Ricucci: 5 cases
Lesson program
Case 1: "Biological and mechanical considerations in the multidisciplinary treatment of a cracked maxillary molar"
The pathology:
– The maxillary molar was restored 16 years ago with an amalgam filling. Endodontic treatment was not performed
– Сrack in the marginal ridge
– Pain symptome is positive
– Periapical pathology.
Questions of the lesson:
– Isolation during endodontic treatment
– Removal of the fracture of the tooth crown
– Endodontic access. Root canals preparation and irrigation
– Root canal obturation
– Build-up. Preparing for an indirect restoration
– Impressions
– Digital design of the indirect restoration
– Cementation of an indirect restoration
– Finishing of the restoration
– Long-term treatment result
– The histologic and microbiologic events occurring in dentin cracks and causing pulp degeneration.
Case 2: "Complex endodontic retreatment of a crowned maxillary second premolar"
The pathology:
– The maxillary second premolar was previously endodontically treated (20 years ago)
– Was restored several times with direct restorations, 5 years ago - with an indirect restoration
– Broken file in the root canal.
Questions of the lesson:
– Removing the crown
– Removal of the fiberglass post from the root canal: ultrasonic method
– Removing broken file
– Root canals preparation and irrigation
– Root canal obturation
– Preparing a tooth for restoration with an indirect restoration
– Installation of fiberglass pins. Build-up
– Impressions
– Temporary prosthetics
– Digital modeling of indirect restoration
– Long-term results.
Case 3: "The pivotal role of endodontics in the multidisciplinary treatment of a maxillary molar"
The pathology:
– The first maxillary molar was restored with an amalgam filling
– Pain symptom is positive
– Periodontal pocket.
Questions of the lesson:
– Endodontic access. Removing pulp stones
– Finding additional root canals
– Root canals preparation and irrigation
– Root canal obturation
– Preparation of a tooth for restoration with an indirect restoration. Build-up
– Tooth restoration with indirect restoration
– Long-term results
– Biological considerations about the role of marginal bacterial leakage in causing pulp degeneration.
Case 4: "Rehabilitation of a quadrant with direct and indirect restorations, maintaining pulp vitality"
The pathology:
– Fracture of the crowns of the first and second maxillary molars
– Extensive restorations of the first and second maxillary molars (performed over 20 years ago).
Questions of the lesson:
– Comprehensive treatment planning
– Carious cavity preparation: indication of caries
– Rules for the formation of a cavity
– Preparation for indirect restoration. Build-up
– Temporary prosthetics
– Histological and microbiological facts of concerning non-cavitated white spot enamel lesions. Treatment recommendations.
Case 5: "Surgical management of a case with exuberant extraradicular infection, refractory to orthograde retreatment"
The pathology:
– Previously endodontically treated lateral and central maxillary incisors
– Functioning fistulas
– Periapical pathology.
Questions of the lesson:
– Temporary filling of root canals
– Removal of filler from the root canal
– Root canals preparation and irrigation
– Indications for endosurgery
– Detailed protocol of endosurgical surgery to remove exuberant extraradicular infection
– Long-term results of endosurgical operation
– Radicular cyst biopsy.
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