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Dr.Hesham S. Elgendy, Gesr Al Suez, Cairo (2026)

27/01/2026

Ｔｈｅ　Ｈｕｎｔ　Ｂｅｇｉｎｓ (ハンター)
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Patient referred to the clinics with a separated hand file for non- surgical retrieval. Upon examination I found that the upper 6 had a 6mm long hand file in the MB canal extending beyond the apex.
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After coronal flaring using a mix of rotary files and GG burs a straight line access was obtained, and troughing on the inner wall was done using the E6 ultrasonic tip to try to loosen the file and half way through the troughing a secondary fracture occurred.
About 2 mm short of the apex the file started to loosen, after which the Leo pen was used to grip it and pull it out.
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Due to the apical violation of the previous work canal patency was achieved with #20 & #25 files in watch winding motion to reach the apex and create a glide path, Mechanical shaping done using M-pro files up to sizes #40 4% in P and DB and 25 6% in the last part of the MB canal to preserve that root.
Cleaning was done with NaOCl 5.25% with ultrasonic activation and intracanal heating.
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Finally, obturation was completed with CWC and resin sealer, except for the MB canal where first the apex was plugged with a down packed GP, then filled with MTA to enhance the fracture resistance of this root and a small flowable composite was placed on top of it to allow the MTS to set undisturbed.

25/01/2026

🌟 𝑩𝒆𝒍𝒊𝒆𝒗𝒆 𝒊𝒏 𝒕𝒉𝒆 𝒑𝒐𝒘𝒆𝒓 𝒐𝒇 𝒔𝒆𝒄𝒐𝒏𝒅 𝒄𝒉𝒂𝒏𝒄𝒆𝒔! 🌟
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This patient were refereed from another clinic with a missed MB2 canal and a fistula related to it.
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Upon examination, the tooth was found to have a restoration with a metal post placed inside the palatal canal, lacking coronal coverage for 16 years.
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The initial step was to remove the old restoration and post using ultrasonic power in an anti-clockwise rotation.
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Following post removal, the MB2 canal was located, and GP soft points were identified. A combination of GP solvent, manual K files, and Mpro files was employed to remove most GP, achieving canal patency. Mechanical shaping was performed up to sizes #30 4% in the buccal canals and #40 4% in the palatal canal, accompanied by ultrasonic activation and the use of XP endo finisher to thoroughly remove old GP and biofilm, with 5.25% NaOCL for disinfection under high magnification.
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Finally, obturation was completed with CWC and resin sealer.

22/10/2024

(っ◔◡◔)っ 𝔼𝕒𝕤𝕚𝕟𝕘 𝕓𝕒𝕔𝕜 𝕚𝕟𝕥𝕠 𝕚𝕥 𝕏𝔻 𝕨𝕚𝕥𝕙 𝕥𝕙𝕚𝕤 𝕔𝕦𝕣𝕧𝕪 𝕓𝕠𝕪😌
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Patient came to the clinic complaining of pain in the upper Right area so the case were refered to me for evaluation of the pain.
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After Clinical diagnosis and x-rays I found that the Upper Right 4,5,6 had deep cavities in close proximity to the pulp causing in irreversible pulpitis, and this is just the story of the 5.
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After access cavity was properly done Canal patency confirmed with #8 k file, glide path to #15 k file and curvature management done using the zone technique and TCA method using the M3pro file system then Mechanical Rotary Shaping done using M-pro files up to size #25 6%.
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Cleaning done with NaOCL 5.25% with ultrasonic activation and intracanal heating.
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Obturation was done with CWC with resin sealer.

09/08/2023

𝘼 𝙘𝙖𝙣𝙞𝙣𝙚 𝙨𝙤 𝙡𝙤𝙣𝙜 𝙄 𝙘𝙤𝙪𝙡𝙙𝙣’𝙩 𝙛𝙪𝙡𝙡𝙮 𝙜𝙚𝙩 𝙤𝙣 𝙩𝙝𝙚 𝙨𝙚𝙣𝙨𝙤𝙧 𝟑𝟒𝙢𝙢😱
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This was an old case of mine where I didn’t properly read the Xray of my short obturation in the final visit… so I of course recalled the patient once I realized my error to correct it.
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The patient came with lower intensity of the symptoms than the first initial visit but still the symptoms did persist confirming my finding so a retreatment had to be done to eliminate the symptoms and correct the short filling.
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Removal of the old GP was done using the Heat Pen of the obturation system to soften the GP for pe*******on with the M-pro rotary files and XP endo shaper to remove as much GP from canal wall along with US activation and amble irrigation for lubrication and disinfection.
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Shaping the rest of the canal was done with Long Mpro files without the rubber stopper to reach the full length of the canine till size #30 4%.
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Obturation was done using the CWC method, with final restoration done at the same visit.

01/08/2023

(っ◔◡◔)っ 𝙒𝙝𝙮 𝙞𝙨 𝙛𝙞𝙣𝙙𝙞𝙣𝙜 𝙥𝙪𝙡𝙥 𝙨𝙩𝙤𝙣𝙚𝙨 𝙩𝙝𝙞𝙨 𝙢𝙖𝙨𝙨𝙞𝙫𝙚 𝙞𝙨 𝙟𝙪𝙨𝙩 𝙩𝙝𝙚 𝙧𝙤𝙪𝙩𝙞𝙣𝙚 𝙣𝙤𝙬 ?🥲

22/07/2023

(っ◔◡◔)っ𝕋𝕙𝕖 𝕗𝕦𝕣𝕥𝕙𝕖𝕤𝕥 𝕀’𝕕 𝕤𝕖𝕖𝕟 𝕔𝕒𝕟𝕒𝕝𝕤 𝕒𝕡𝕒𝕣𝕥 𝕚𝕟 𝕒 𝕄𝕖𝕤𝕚𝕒𝕝 𝕣𝕠𝕠𝕥 𝕤𝕪𝕤𝕥𝕖𝕞.
This patient were refereed by an excellent college of mine after not locating the MB canal.
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upon examination tooth were heavily destructed due to decay and the pulp floor had very little dentine map left.
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After build up I decided to give it a try before requesting a CBCT scan to trough for the missing canal but sadly without any success (the crater near the ML canal) so I requested a CBCT scan to locate the canal.
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To my surprise I found the MB canal almost 5 mm away from the ML canal [The Mean Average distance is 3 mm], and also severe root resorption of the distal root system requiring management with a missed 2nd distal canal located under a calcification.
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After locating the canals, patency were achieved with #10 k file, Mechanical Rotary Shaping done using M-pro files up to sizes #25 6% for all canals, Cleaning was done with NaOCL 5.25% with US activation, and intracanal CaOH was placed for 7 days to control the resorption before the obturation session.
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Obturation was done using the CWC method with BC sealer and the crater I made filled with MTA and cover with bonded filling, with final restoration done by the referring college.

12/07/2023

(っ◔◡◔)っ 𝔼𝕒𝕤𝕚𝕟𝕘 𝕓𝕒𝕔𝕜 𝕚𝕟𝕥𝕠 𝕚𝕥 𝕏𝔻😌
This patient were refereed from another clinic after not being able to control the infection.
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Upon examination pulp cavity was already exposed with lost temporary filling and recurrent caries of the exposed dentine.
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Since there were already mechanical shaping done I had to resort to a more cleaning approach with minimal extra mechanical shaping.
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After access cavity was properly done with coronal build up …. a mixture of intracanal heating of NaOCL 5.25%, Ultrasonic activation and using XP endo Shaper and Finisher files under high magnification.
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Canal patency confirmed with #10 k file, Mechanical Rotary Shaping done using XP endo Finisher file up to sizes #30 4% and M-pro size #40 4%.
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Obturation was done using the CWC method, with final restoration done at the same visit.

21/05/2023

˜”*°•.˜”*°• 𝒜 𝓅𝒶𝓇𝓉𝒾𝒸𝓊𝓁𝒶𝓇𝓁𝓎 𝒸𝒽𝒶𝓁𝓁𝑒𝓃𝑔𝒾𝓃𝑔 𝒸𝒶𝓈𝑒 𝓉𝑜 𝓉𝒶𝒸𝓀𝓁𝑒 •°*”˜.•°*”˜ 🥹
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The patient came to the clinic with the request to restore a badly broken tooth in the lower right area.
Intraoral examination revealed a decayed lower wisdom with loss of the buccal wall of the distal half of the tooth and gingival overgrowth into the access cavity.
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So, I decided to first go for surgical gingivectomy to expose the margins of the tooth to check for restorability and to do my pre-endo buildup.
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Access cavity was done after isolation to avoid injury to the soft tissue.
Canal patency with #10 & #15 files in watch winding motion to reach the apex and create a glide path, Mechanical shaping done using M-pro files up to sizes #25 6% in all canals, and Cleaning done with NaOCL 5.25% with ultrasonic activation and intracanal heating.
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Obturation done using the CWC method.

19/05/2023

𝕄𝕪 𝕧𝕖𝕣𝕪 𝔽𝕚𝕣𝕤𝕥 𝕔𝕒𝕤𝕖 𝕨𝕚𝕥𝕙 𝕞𝕪 𝕠𝕨𝕟 𝕞𝕚𝕔𝕣𝕠𝕤𝕔𝕠𝕡𝕖. 🥳
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Patient came to the clinic complaining from prolonged lingering pulsating pain elicited by hot drinks related to the upper right 1st molar.
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After diagnosis and examination, the pulp was found to be irreversibly inflamed and patient was referred to me to by our great restorative specialist to start the RCT.
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Pulp was already exposed before complete caries removal.
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After complete caries removal, access refinement and ultrasonic troughing for the MB2 with E12D tip, routine RCT was done and canal patency with #8, #10, #15 and #20 K-files in watch winding motion to reach the apex and create a glide path, Mechanical shaping done using M-pro files up to sizes #25 6% in all 3 buccal canals and #30 4% in the palatal canal and Cleaning done with NaOCL 5.25% with ultrasonic activation and intracanal heating.
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Obturation was done with CWC with resin sealer.

13/05/2023

𝓐 𝓹𝓼𝓸𝓽 𝓲𝓷 𝓱𝓸𝓷𝓸𝓻 𝓸𝓯 𝓽𝓱𝓮 𝓜𝓑𝟤 𝓬𝓪𝓷𝓪𝓵
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˜”*°•.˜”*°• ᴛʜᴀᴛ ʙᴀʙʏ ᴄᴏᴜʟᴅ ʙᴇ sᴏ ᴄʟᴏsᴇ ꜱᴏᴍᴇᴛɪᴍᴇs ᴛʜᴀᴛ ᴛʜᴇ ɪsᴛʜᴍᴜs ʙᴇᴛᴡᴇᴇɴ ɪᴛ ᴀɴᴅ ᴛʜᴇ ᴍʙ₁ ᴏᴘᴇɴs ᴜᴘ ᴅᴜʀɪɴɢ ꜱʜᴀᴘɪɴɢ ....... ᴀɴᴅ ᴏᴛʜᴇʀ ᴛɪᴍᴇs ꜱᴏ ꜰᴀʀ ᴀᴡᴀʏ ʏᴏᴜ ᴍᴀʏ ᴍɪsᴛᴀᴋᴇ ɪᴛ ꜰᴏʀ ᴀ ᴅɪꜰꜰᴇʀᴇɴᴛ ᴄᴀɴᴀʟ. •°*”˜.•°*”˜

13/05/2023

𝓣𝓱𝓮 𝓬𝓾𝓻𝓲𝓸𝓾𝓼 𝓬𝓪𝓼𝓮 𝓸𝓯 𝓽𝓱𝓮 𝓲𝓵𝓵𝓾𝓼𝓲𝓿𝓮 𝟤𝓷𝓭 𝓹𝓪𝓵𝓪𝓽𝓪𝓵 𝓬𝓪𝓷𝓪𝓵✌️❤.
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𝕋𝕙𝕚𝕤 𝕚𝕤 𝕨𝕙𝕪 𝕪𝕠𝕦 𝕤𝕙𝕠𝕦𝕝𝕕 𝕒𝕝𝕨𝕒𝕪𝕤 𝕔𝕙𝕖𝕔𝕜 𝕪𝕠𝕦𝕣 𝕒𝕔𝕔𝕖𝕤𝕤 𝕔𝕒𝕧𝕚𝕥𝕪 𝕗𝕠𝕣 𝕖𝕩𝕥𝕣𝕒 𝕔𝕒𝕟𝕒𝕝𝕤 𝕒𝕗𝕥𝕖𝕣 𝕔𝕠𝕞𝕡𝕝𝕖𝕥𝕖 𝕔𝕝𝕖𝕒𝕟𝕚𝕟𝕘 𝕒𝕟𝕕 𝕤𝕙𝕒𝕡𝕚𝕟𝕘.
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Patient referred to Miu clinics for the treatment of the upper 6&7 Upon examination I found that the upper 6 had a long-broken file “13mm” in the MB canal with poor obturation of the rest of the canals “which were covered in a previous post” and the upper 7 had a large carious lesion with evident pulp exposure, and decision to go for a non-surgical RCT was taken.
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Access cavity was done after isolation to avoid injury to the soft tissue.
Canal patency with #10 & #15 files in watch winding motion to reach the apex and create a glide path, Mechanical shaping done using M-pro files up to sizes #25 6% in all canals, and Cleaning done with NaOCL 5.25% with ultrasonic activation.
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And sure enough, after completing my cleaning and shaping and performing my final check for extra canals, the 2nd P canal were located and shaped.
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Obturation was done with CWC with resin sealer.
*Apologies for missing Preoperative Xrays.

04/05/2023

Broken file case managed with the most basic of tools.
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Patient referred to Miu clinics for the treatment of the upper 6 Upon examination I found that the upper 6 had a long-broken file "13mm" in the MB canal with poor obturation of the P canal and missing DB canal, and decision to go for a non-surgical Rettt was taken.
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My first move was to remove the broken file using the modified tube technique alongside an H file #25 to grip the file and pull it out of the canal.
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After the fragment removal case became a straightforward case, GP soft points were located, and using a combination of GG burs and Mpro files most GP were removed and canal patency were achieved, Mechanical shaping was done using M-pro files up to sizes #25 6% in both buccal canals and #40 4% in the palatal canal.
Alongside ultrasonic activation and use of XP endo finisher to thoroughly remove old GP and biofilm with the use of 5.25% NaOCL for disinfection.
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Obturation was done with CWC with resin sealer.
**Apologies for the bad quality of the post-op Xrays.

Dr.Hesham S. Elgendy

27/01/2026

25/01/2026

22/10/2024

09/08/2023

01/08/2023

22/07/2023

12/07/2023

21/05/2023

19/05/2023

13/05/2023

13/05/2023

04/05/2023

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