Kreena Specialist Endodontics

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Kreena Specialist Endodontics Endodontics/ Root canal treatment I am a specialist in Endodontics, also known as root canal treatment. Tel: 0208 689 6171. Tel: 0118 933 3121.

This treatment aims to remove the infected root canal tissue and save your natural tooth. I receive referrals at Brigstock Dental Practice (South London) and Oaktree Dental Practice (Berkshire) from dentists and patients directy. All treatment is carried out using modern techniques and a microscope, which allows superior visualisation of the complex root canal anatomy. Our skilled and friendly team strive to provide excellent care and give a comfortable service, for even the most anxious patients. We endevour to see patients with minimal delay and offer flexible appointment times, including weekends. Brigstock Dental Practice: 97 Brigstock Road, Thornton Heath, Surrey, CR7 7JL. Email: [email protected]
Website: www.brigstockdental.co.uk

The Oaktree Dental Practice, 8 West End Road, Mortimer, Berkshire, RG7 3ST. Email: [email protected]
Website: www.oaktreedentalpractice.co.uk

That MB2 will come for you eventually 😉rootcanalretreatment
06/10/2026

That MB2 will come for you eventually 😉

rootcanalretreatment

DSWORLD 2026 & PEERS - it was a real pleasure to be part of it. I was speaking about one of my favourite topics: Managin...
05/10/2026

DSWORLD 2026 & PEERS - it was a real pleasure to be part of it. I was speaking about one of my favourite topics: Managing Anatomical Complications in Endodontics, and I loved the ‘Speed Dating’ idea.

It was a nice surprise to see my face on the Key Opinion Leader poster 😀

Congratulations Dentsply Sirona for an epic conference this year! The organisation was top notch, the endodontic line up was 💪🏼… & you guys know how to throw a proper party ⭐️ Gio Scialo Kristian Stuart DentsplySirona Jon-Paul Hawkins ⭐️
Looking forward to trying Minima ❤️

16/09/2026

🎥 Found this one in the archives… External Cervical Resorption surgical repair from 2019.

I came across the original raw footage while preparing for a lecture on ECR and thought this case was definitely worth sharing.

This young patient had already undergone an attempted repair elsewhere but still had persistent pain from the tooth and gingivae.

Clinically, the buccal gingivae were inflamed with some recession around the previous repair. CBCT revealed recurrent resorption — and also a severe root dilaceration that wasn’t apparent on the 2D radiograph.

My approach:
🦷 Root canal treatment through the previous buccal repair (buccal access)
🔬 Surgical access to the resorptive defect
✨ Debridement and composite repair of the ECR lesion

A challenging case combining unusual anatomy, endodontics and surgery — exactly the sort of case I love treating.

I saw the patient a few years later and she was stable and doing well.

Hope you enjoy the video. How would you have approached this one?

EndodonticSurgery CBCT DentalEducation SaveTeeth kreenaendo

Apexification procedure for a lovely dentist patient ❤️- A more tricky one because the walls tapered slightly in the mid...
15/09/2026

Apexification procedure for a lovely dentist patient ❤️
- A more tricky one because the walls tapered slightly in the mid canal before widening out again in the apical part
-I use a collagen membrane as standard in these cases now (Haemocollagen Septodont)
-MTA apical plug (>5mm) to get an apical seal
-Composite core placed deep into the canal to reinforce thin coronal dentine walls
Do we need a cuspal coverage restoration?

Had a lovely time discussing my Endo Journey! Thank you David Baker simplyendo for inviting me to be part of it ⭐️
07/09/2026

Had a lovely time discussing my Endo Journey! Thank you David Baker simplyendo for inviting me to be part of it ⭐️

Regeneration → Apexification → Apical Microsurgery 🦷An 11-year-old patient was referred with an abscess associated with ...
12/08/2026

Regeneration → Apexification → Apical Microsurgery 🦷

An 11-year-old patient was referred with an abscess associated with the UR2. The tooth had a very immature root with an open apex, so we initially decided to attempt a regenerative endodontic procedure, with the aim of gaining further root length and dentinal wall thickness.

Regenerative procedure:

* Local anaesthesia + rubber dam isolation
* Access with minimal mechanical instrumentation
* Copious, gentle irrigation with low-concentration NaOCl, kept a few millimetres short of the apex
* Calcium hydroxide intracanal medicament, kept a few millimetres short of the apex
* Temporary restoration

At the second visit, the buccal abscess had resolved
* Local anaesthesia without vasoconstrictor to facilitate bleeding
* EDTA irrigation to expose dentinal growth factors and support stem-cell attachment/differentiation
* Canal dried
* Apical tissues gently irritated with a sterile file to induce bleeding into the canal
* Blood clot allowed to form approximately 2–3 mm below the CEJ
* Biodentine placed over the blood clot
* GIC + composite coronal seal

Although the abscess resolved, the periapical lesion remained at the 1.5-year review, and we decided to proceed with root canal treatment and apexification.

Despite two further calcium hydroxide dressings, the canal was impossible to dry properly. I obturated as best I could using a membrane and Biodentine apical barrier. The alternative at this stage was a through-and-through surgical approach, which I did not feel the patient would cope well with at the time.

Unfortunately, the abscess reappeared approximately one year later.

By this stage, the patient was 13 and we proceeded with apical microsurgery. The apex had a blunderbuss, figure-of-8 morphology, making it extremely difficult to achieve a predictable seal via an orthograde approach.

He was still extremely nervous, but coped incredibly well with the surgery ⭐️
🙏 for healing now!

Internal resorption: INTERESTING FACTS:* 🦷 The pulp has to be vital to sustain the resorption. Internal resorption requ...
07/08/2026

Internal resorption: INTERESTING FACTS:

* 🦷 The pulp has to be vital to sustain the resorption. Internal resorption requires vital inflamed pulp tissue in the resorptive area to sustain the clastic cells, and therefore is relatively rare. Resorption arrests after pulp necrosis (as in the above case where a lesion was present)
* 📸 It classically looks like a smooth, symmetrical “ballooning” of the canal on a PA radiograph.
* 🔍 The lesion stays centred on the canal on angled radiographs — unlike external cervical resorption, where the canal can usually be traced through/behind the lesion.
* 🤫 It is often completely asymptomatic and discovered incidentally on radiographs.
* ⚠️ If resorption progresses through the root wall resulting in a perforation, it makes treatment more challenging
* 🧊 Sensibility testing can be confusing. The coronal pulp may become necrotic while vital tissue remains apical to the resorptive defect.
* 🖥️ CBCT can be extremely useful for determining the true size of the defect, remaining dentine thickness and whether perforation has occurred.
* 🛑 Root canal treatment removes the tissue driving the resorptive process, so timely diagnosis can arrest progression.
* 🧪 Cleaning is the challenge. The irregular resorptive cavity is difficult to instrument mechanically, making effective irrigation and activation particularly important.

SpecialistEndodontist EndodonticTreatment RootCanalTreatment

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97 Brigstock Road
London
CR77JL

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+442086896171

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