Newcastle Endodontics

28/06/2024

Exciting day of endo teaching for the Northern Deanery

11/01/2024

09/05/2023

We normally recommend crowns after root fillings on molar teeth, but this coronation weekend it’s us with the crowns on 👑

09/03/2023

Great to be back in Edinburgh examining at the Royal College. Good luck to everyone sitting the Membership in Advanced General Dental Surgery this weekend!

19/10/2022

Busy few days at the European Endodontic Society meeting in Budapest. Dr Gemmell and Dr Edwards were both attending to keep up to date with the latest advances in endodontics and also moderating lectures from international speakers. We even found time for a beer!

02/02/2022

This patient's normal dentist recognised that the root filling needed to manage an abscess in this maxillary second molar was going to be tricky. The mesial root curvature was negotiated and once the pulp system was disinfected, the chronic infection healed. The tooth has been sealed with a root filling and amalgam Nayyar core and the patient is now planning a crown with their normal dentist.

05/01/2022

This tooth had previously been root filled and there was an infection draining adjacent to the tooth. The tooth also was badly discoloured. The old filling in the tooth was replaced and the root filling was removed. The space inside the tooth was disinfected which removed the source of the infection. The discolouration was treated by internally bleaching the tooth making it look as good as new.

04/01/2022

This patient presented to her normal dentist with a pink spot on her upper right lateral incisor tooth. A diagnosis was made of external cervical root resorption (ECR). The patient in her early teens had recently been undertaking a course of orthodontic treatment and the maxillary brace was removed when the discolouration was noted- Mavridou et al (2017) report orthodontic treatment as the most common predisposing factor in ECR with the maxillary central incisor the most commonly affected tooth (followed by the maxillary canine and then maxillary lateral incisor).

Interestingly, on the CBCT scan, there is an area of external replacement resorption where there is bone replacing the root surface and a separate area where there is soft tissue replacing the lost tooth structure (causing the pink appearance of the tooth)

The patient had been told the prognosis for treatment was hopeless and that the tooth would need to be extracted and she would have to wear a partial denture until old enough to consider a dental implant so attended for a second opinion. We agreed to at least try and defer the loss of the tooth so the defect was cleaned by a surgical approach. After cleaning, the defect was restored with composite. As the defect was very closely associated with the large pulp space in this tooth the tooth was also endodontically treated. Endodontic treatment is not always required as the pulp can often remain vital if the defect is detected early enough. In this case, we decided to endodontically treat the tooth as I could not be sure there was no microbial ingress into the pulp space and also because it would allow placement of a fibre post in the pulp space. The fibre post was placed without removing any remaining dentine but extended below the level of the defect which will hopefully reduce the risk of the tooth snapping.

On review, the soft tissues were healing well with good papilla formation. Oral hygiene instruction was re-enforced and the patient will be reviewed in 12 months.

23/12/2021

Congratulations to Dr Xander Howell for successfully passing the Membership in Advanced General Dental Surgery exam at The Royal College of Surgeons in Edinburgh. This intensive examination has only been passed by a handful of UK dentists and recognises a competence in the treatment planning, problem solving and ex*****on of complex dental cases. A real achievement, well done!

18/07/2021

This week Dr Gemmell and Dr Howell have been to Coventry to develop advanced surgical skills which allow us to offer more options to manage complex problems with teeth and avoid having to have teeth extracted

09/03/2021

This premolar tooth had a long standing infection despite previous root canal treatment. The old root filling was removed and an extra unfilled nerve space was located. The tooth was disinfected and the infection adjacent to the tooth which has been present for over a year healed within two days. The space inside the tooth was re-sealed and a fibre post re-enforced filling was placed in the centre of the tooth.

26/01/2021

This patient was assaulted last year resulting in serious damage to both this upper central incisor teeth. The upper right central incisor tooth had been knocked backwards (palatal luxation) and the upper left central incisor knocked out of his mouth (avulsion). The tooth was out of his mouth for more than an hour before being found. He was seen by an on call dentist in hospital who re-implanted the upper left central incisor and surgically repositioned the upper right incisor before splinting the teeth. Both central incisor teeth had fractured roots. When I saw him, the splint was modified and after disinfecting the space inside the tooth, we sealed the end of the roots with a bioceramic material (Biodentine) and placed a composite material deep into the tooth.

The healing of the teeth was reviewed today and a healthy periodontal ligament has formed around the fractured apex and also around the new root end. There is healthy bone between the fracture line and aesthetically the outcome looks good. This is a really nice case to demonstrate how the correct early management of dental trauma can give some hope to seriously damaged teeth.