Rafael Michiels Dentistry

01/05/2026

Not every retreatment fails because of biology.
Sometimes it fails because access to the biology has been lost.

This maxillary first premolar presented with:
• two dentatus screws
• a massive composite core buildup
• a separated Hedström file
• and extremely limited visibility and access

Cases like this are a reminder that retreatment is often more about precision, strategy, and patience than force.

Under high magnification, the existing buildup was carefully dismantled, the dentatus screws were removed, and the fractured instrument was successfully retrieved before re-establishing proper canal disinfection.

The tooth was then rebuilt with a fiber post and dual-cure composite core, allowing the tooth to remain restorable and ready for definitive coronal coverage.

One of the most satisfying parts of endodontics is turning a seemingly hopeless situation back into a predictable restorative foundation.

Microscope dentistry changes everything.

Which part of this case would you consider the biggest challenge:
the screw removal, the instrument retrieval, or achieving long-term restorability?

04/06/2025

Concerning fixed rates for treatments which is the biggest dream of our socialist secretary of healthcare, because a filling is a filling... sometimes pictures tell more than words...

14/05/2024

Are you always repeating the same post-op instructions?
Yeah, me too! Here´s a quick fix! Limit your instructions to the basics and design leaflets which go into more detail for different procedures! They look great, it´s a great service to your patient, they will avoid many phonecalls afterwards and they can be a part of your branding. Become efficient!

06/11/2023

A few will probably still remember this case. Now I have a 1 year follow-up! 1 year ago this patient presented with an intrusion of tooth 22. First diagnosis by OMFS was that it probably needed extraction... I took a cbct, tooth was mostly intact. I opted for spontaneous eruption, but after a few weeks it was clear the tooth needed some help. Orthodontic extrusion was started and everything went well. Root canal treatment was performed because of pulp necrosis and the patient is now set for orthodontic treatment in general. #دكتورالاسنان #牙醫 #歯科医 #치과의사 #зубной врач

30/10/2023

Here is a nice case with a 9 year follow-up! Patient was referred for retreatment of tooth 47. There were also 2 fractured files. Patient preferred tot try and save the tooth. It took me 2 visite of 2 hours each and while the RCT might not be the most esthetic, it clearly works! 9 years and still going strong! Greetings from sunny Tenerife! #دكتورالاسنان #牙醫 #歯科医 #치과의사 #зубной врач

24/10/2023

You win some, you lose some! Last year I did a partial pulpotomy (distal canal) with biodentin on tooth 36, since it was heavily calcified, no apical signs of infection, bleeding pulp and no clinical complaints were present. It failed and today I had to do the RCT on this calcified molar. The distal canal was still vital, so I guess my pulpotomy actually worked... mesials took quite some effort to locate. #دكتورالاسنان #牙醫 #歯科医 #치과의사 #зубной врач

19/10/2023

New case!

07/07/2022

New video online,

Soon I will post some cases again, in the meanwhile tell me if I am talking bu****it or not?

INSIDE: How to brush your teeth as a dentist? You probably have been brushing your teeth wrong for a long time! Let me help you to brush correctly. I will sh...

23/06/2022

New video online, what would you like as a future topic?

https://youtu.be/LghgL8oCTgM

09/06/2022

New youtube video is online! Go check it out and comment on what to improve!

INSIDE: What is really going on in your mouth when the dentist fills a cavity? I will show you step by step how I remove an old amalgam filling and replace i...

06/01/2022

Hello Everybody! Happy 2022!!

Here is my first case of the new year on this page!
Tooth 26, necrotic, needed a RCT. Single visit, 1h45 min treatment. Explanation is on the slides and with every separate picture.

Cheers,

Rafa