Dr. Sneha Sh*tole

30/12/2020

Sharing 3D cleaning technique by great Dr. Prof. Dr. Alfredo Iandolo

30/09/2020

A referred case of periapical cyst with 11,12 and huge periapical lesion with 21 with internal and external resorption with 11.
On opening with 12 & 21- continuous abscess discharge seen.
11- internal resorption visible on rvg.
Instrumentation - 11- hand k- file minimal filing done due to less PCD present.Intracanal medicament was changed for 2 weeks after 8 days.
Obturation-Mta placed apically upto 6mm with 11 and backfill done with obtura III.
Downpak and backfill with 12 & 21

9 months follow up shown.

https://www.instagram.com/p/CFxL7g2lnCI5K8AiT7xS2kf75CzBlZkk_peCg00/?igshid=1l4l9vrcuq0kf

27/09/2020

So much to learn for one picture 👏🏻🙌🏻

“When there are two root canals in the same root most of the time there will be connections”
Use 3D Cleaning and 3D Obturation.
Endodontic treatment of first maxillary molar.
Shaping: HyFlex EDM
3D Cleaning: Internal Heating + Endoultra
3D Obturation: Hot Modified Technique, the first 3D Obturation technique using a biosealer.

22/09/2020

Routine endodontics!
Acute Curvature at apical third with distal canal of 46..
Instrumentation with hyflex CM, intracanal heating and sonic agitation with PATs followed by cwc...

https://www.instagram.com/p/CFbuiKnlkMSw4VgPrkNAeLivvPOKaTSf0U7SkY0/?igshid=hu9hou1livao

28/08/2020

3D cleaning makes Imposible anatomy to I M Possible!!!
Excellent work by Prof.Dr. Alfredo Iandolo

Apical Third of Maxillary Premolar

15/08/2020

Trying my hands on editing

13/08/2020

Tricky eight's!!
Apprehensive patient with minimal accessibility
Hook shape curve with distal root
Instrumentation with hyflex cm files
Irrigation : Intracanal heating with sonic agitation
Obturation:Wvc

https://www.instagram.com/p/CD1NI3qFj5PC7k5hVRVqgYJvdLzNxsJlzfdXM80/?igshid=ylb7qr9ed9x6

07/08/2020

Classification of C-shaped canal in maxillary first and second molar.

03/08/2020

Most Frustating issue faced and re-treatment cases encountered are of instrument separation.

Frequency of endodontic instrument separation:

- According to clinical studies, the overall endodontic instrument separation frequency (either rotary or hand files) is between 1.83% and 8.2%.
- The frequency of rotary instrument separation ranges between 0.13 - 10% and includes several kinds and types of instruments.
- The manual instrument separation frequency
is 0.25% to 6%..
- The highest frequency of instrument separation is presented during the treatment of molars (77% - 89% of all cases).
- A greater risk of separation occurs during treatment of lower molars (50% - 55%) compared to upper molars (25% - 33.3%). Regarding upper molars, the separation of endodontic instruments is 3 times more liable to occur in the mesio-buccal root canals than the disto-buccal ones( reason is due to the distal curvature of the mesial root.
- As far as the lower molars are concerned, the mesial root canals present a distal and a buccolingual curvature. In fact, the lingual curvature of the mesio-buccal root canal is more severe than the buccal curvature of the mesio-lingual root canal. As a result, the frequency of instrument separation in the mesio-buccal root canals is 3 times more common than in the mesio- lingual ones.

- With respect to the root canal curvature, separation frequency rises proportionally to increased curvature:
-> 7% in straight root canals,
-> 35% in averagedly curved ones
-> 58% in intensely curved ones.

- Regarding the location of the separated fragment, a higher rate of separation is observed in the apical third (41% - 82.7%), a lower one in the mesial third (14.8% - 32%) and an even lower one in the coronal third (2.5% - 20%).

- The most common separation site is 2mm from the tip of the instrument. The most common sizes of instruments undergoing separation are No 20-40 (ISO). As to taper, separation most commonly happens in files with a taper between 4% and 9%.

1.Vouzara Triantafyllia, Chares M, Lyroudia kleoniki.Separated instruments in endodontics: Frequency, Treatment and Prognosis. Balk J Dent Med; 2018;Vol:28:123-132.
2. Suter B, Lussi A, Sequeira P. Probability of removing fractured instruments from root canals. Int Endod J, 2005;38:112-123.
3. Tzanetakis GN, Kontakiotis EG, DV, Marzelou MP. Prevalence and management of instrument fracture in the postgraduate endodontic program at the Dental School
of Athens: A five-year retrospective clinical study. J Endod, 2008;34:675-678.
4.Ungerechts C, Bårdsen A FI. Instrument fracture in root canals - where, why, when and what? A study from a student
clinic. Int Endod J, 2014;47:183-190.
5.Di Fiore PM, Genov KA, Komaroff E, Li Y, Lin L. Nickel- titanium rotary instrument fracture: A clinical practice assessment. Int Endod J, 2006;39:700-708.
6. Iqbal MK, Kohli MR, Kim JS. A retrospective clinical study of incidence of root canal instrument separation in an endodontics graduate program: A PennEndo database study.
J Endod, 2006;32:1048-1052.

Below given is a referred case of broken instrument in calcified mesio-lingual canal with acute curvature at apex...

https://www.instagram.com/p/CDb4x6TlhFZmEBFZpF2oqbVXVfpjFk2oTFcwqo0/?igshid=g2mpegz2jf4n

02/08/2020

Must read!!!

Conservative Shaping and 3D Cleaning: A Powerful Weapon.
With the benefits of 3D Cleaning/Irrigant activation is possible to shape in a conservative way and to obtain good results.
This will be useful in case of long and/or Curved root canals.

*Aust Endod J 2019. Dentinal tubule pe*******on and root canal cleanliness following ultrasonic activation of intracanal-heated sodium hypochlorite. Alfredo Iandolo, Dina Abdellatif, Massimo Amato, Giuseppe Pantaleo, Andrea Blasi, Vittorio Franco , Prasanna Neelakantan.

*Int Endod J 2019. Influence of apical preparation size and irrigation technique on root canal debridement: a histological analysis of round and oval root canals O. Y. S. Lee, K. Khan, K. Y. Li, H. Shetty, R. S. Abiad, G. S. P. Cheung & P. Neelakantan.

01/08/2020

Excellent example of apical v***r lock by Prof. Dr. Alfredo Iandolo sir

How do you manage V***r Locks during your treatments?
Do you use any particular technique or you don't give importance to it?

31/07/2020

Let's see the Power of intracanal heating and sonic agitation!!
After obturating the palatal canal could see the loop getting filled with sealer during downpak and while going downwards the apical third multiple POE got filled partially due to maximum sealer occupied by palatal loop...with distal root lateral canal filled..

Presenting a case of symptomatic Apical periodontitis with 27

Instrumentation:
Shaping : 25/04 with MB 1and MB 2, 25/04 with distal and 30/04 with palatal canal using Hyflex cm files
Irrigation protocol : 5.25% hypo throughout shaping, 17% EDTA 1ml/canal for 1min activation WID waterpik flosser, internal heating of hypo for 8secs/canal, 5ml/ canal for 5 mins and final flush with saline.
Obturation : CWC and backfill with Obtura III...

Rest details in slides

https://www.instagram.com/p/CDRqyaJlsNT6Prq3ITEULdeca3JjBaRogouD1o0/?igshid=1vohau5vkcxeh