Xander Howell - North East Endodontic Referrals

Xander Howell - North East Endodontic Referrals Providing a high standard of both Endodontic and general dentistry in a state of the art clinic

Can’t be hard work all the time!Come on England!
20/07/2023

Can’t be hard work all the time!

Come on England!

Four month healing review carried out today on an open apex completed earlier this year. Good bony infill is noted, so t...
18/07/2023

Four month healing review carried out today on an open apex completed earlier this year. Good bony infill is noted, so the patient is currently unlikely to need the apicectomy they were consented for at the consultation

The previous root filling had failed, likely down to the poor apical seal. The tooth was opened and thoroughly disinfected and medicated. At the second stage the tooth was completely symptom free. The open apex was sealed with Sure-Seal Root PT bioceramic putty (the overfill seen is calcium hydroxide and iodoform dressing material that resorbs)

At four months good bony healing was noted, so the patient has been discharged back to their dentist for ongoing care

This lady was referred in having decoronated her UR2. The referring clinician requested orthodontic extrusion followed b...
12/07/2023

This lady was referred in having decoronated her UR2. The referring clinician requested orthodontic extrusion followed by RCT and a post and core.

Given the patients age and the apical hook on the root it was felt that orthodontic extrusion would take far too long. The root had 4mm pocketing circumferentially and the patient had a low lip line, so we decided to carry out some non-surgical crown lengthening.

The tooth was the root treated, using a careful glide path to negotiate the apical bend. It was finished off with Reciproc R25, irrigated with NaOCl and EDTA, and filled with a single cone and AH+. A fibre post and composite core was completed and she has gone back to her dentist for a definitive crown

02/06/2023

This case treated by had a very large cavity in the back of the tooth which was sealed with a composite resin restoration prior to removing all bacteria from within the tooth and sealing with a root filling. Now the root filling is completed we recommend root filled teeth are protected with a crown to stop cracks forming in the teeth in the future.

Nice to finally get my certificate through from the Royal College of Surgeons for my Membership in Advanced General Dent...
08/04/2022

Nice to finally get my certificate through from the Royal College of Surgeons for my Membership in Advanced General Dental Surgery. A very challenging exam, but all worth while!

Happy to talk to anyone considering putting themselves forward for it in the future!

Will have to get a new sign ordered for the practice to update my qualifications now! 😄

A nice case with bioceramic putty obturation of a lateral canalThis patient was referred to a colleague for an implant a...
08/03/2022

A nice case with bioceramic putty obturation of a lateral canal

This patient was referred to a colleague for an implant assessment to replace the failing UL1. Our implant dentist asked for my opinion as to whether endodontic therapy could work, as the periapical infection had perforated the buccal plate and meant grafting would almost tainoy be required.

The patient presented with a draining sinus from a tooth that was root filled around 25 years ago. It had a wide cast post that the referring GDP had been unable to remove.

After lengthy discussion with the patient, we agreed to try removing the post and entreating the tooth, with the understanding that there was a high risk of root fracture.

Once the crown was removed, ultrasonics were used to carefully remove the large cast post. Thorough inspection of the tooth showed no evidence of fracture, so we proceeded with RCT.

It was unclear what the previous obturation material was, it had a soft putty like consistency, so ultrasonics with water were used to remove the material ensuring none was pushed through the apex and avoiding contact with the canal walls. Once removed, the tooth was irrigated thoroughly with activated 5.25% NaOCl

As the apex was wide and open, it was sealed with a bioceramic putty plug,and then a fibre post and composite core was constructed. A temporary crown was placed and sent back the the referring GDP for a definitive crown.

The post operative radiograph showed a well obturated tooth, with a nicely filled lateral canal

A nice surgical case for a Friday morning!A regular patient of the practice presented complaining of a sore gum in the L...
25/02/2022

A nice surgical case for a Friday morning!

A regular patient of the practice presented complaining of a sore gum in the LL5 region. Examination showed a pink hue present at the gingival margin with associated pocketing and cavitation. A diagnosis of external inflammatory cervical resorption was made

CBCT is essential for planning of these cases, and one was taken to assess the extent of the lesion. After discussion with the patient it was decided to surgically repair the defect followed by RCT of the LL5.

A 2-sided flap was raised, taking care to protect the mental nerve. The soft tissue was removed from the lesion and it was thoroughly debrided and restored with RMGIC.

Following flap closure, the RCT was completed as a single stage treatment. The canal was prepared to Reciproc R-25, irrigated with 5.25% hypochlorite and a final flush with 17% EDTA and sealed with One-Fil bioceramic sealed. The access cavity was restored with a passively seating fibre post and composite core

Happy Valentines Day!
14/02/2022

Happy Valentines Day!

Happy MB-Tuesday!Pt was referred for endodontic management of the UL6, which the GDP didn’t feel comfortable completing ...
08/02/2022

Happy MB-Tuesday!

Pt was referred for endodontic management of the UL6, which the GDP didn’t feel comfortable completing due to the depth of the mesial caries

Initial examination showed thtooth to be mildly TTP with some tenderness in the buccal sulcus. There was a large MOP temporary dressing in the tooth. We agreed with the pt to carry out a pre-endo build up followed by RCT, with the definitive crown to be provided by his GPD

At the first appt the old restoration and caries were cleared and a mesial marginal gingivetomy performed to allow a new core to be build with sealed margins. All canals we found and shaped to length with Reciproc R25 and the tooth was medicated with iodoform and calcium hydroxide

At the follow up appt all symptoms had settled so the tooth was obturated with GP and a bioceramic sealer. The pt has been discharged back to his GDP for the definitive crown

Address

Kingston Park Advanced Dentistry, 1 Stuart Court
Newcastle Upon Tyne
NE32QF

Opening Hours

Monday 9am - 7:30pm
Tuesday 9am - 5:30pm
Wednesday 9am - 5:30pm
Thursday 9am - 5:30pm
Friday 9am - 5:30pm

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