علی مرسلی - متخصص درمان ریشه

علی مرسلی - متخصص درمان ریشه دکتر علی مرسلی

جراح – دندانپزشک، متخصص درمان ریشه
بورد تخصصی اندودانتیکس

The focus of this post is not the maxillary first molar, which I treated endodontically 11 years ago. The tooth in quest...
19/08/2026

The focus of this post is not the maxillary first molar, which I treated endodontically 11 years ago. The tooth in question is the adjacent maxillary premolar, which brought the patient back to the office a few days ago because of recurrent caries beneath the crown and the need to assess whether retreatment was indicated.
On the two initial radiographs—one taken before crown removal and the other afterward—the possibility of a two-canal anatomy was not particularly evident.
However, after achieving proper isolation by building a composite wall, cleaning the access cavity, and removing a small amount of dentin with a Mueller bur, I noticed an or***ce located several millimeters deeper and more apically than expected.
No matter how much experience you gain in endodontics or how many different cases you encounter, there will always be cases that present a new approach and a fresh challenge.
Endodontics may seem repetitive, but it is never truly repetitive—and it always has a surprise waiting for you.

The plan was to perform endodontic retreatment on these canine and premolar teeth. According to my prosthodontist collea...
18/08/2026

The plan was to perform endodontic retreatment on these canine and premolar teeth. According to my prosthodontist colleague, both teeth were considered maintainable, with a moderate prognosis.
However, as soon as the canal or***ces were accessed, a crack extending into the root became visible under microscopic magnification.
Endodontic retreatment was completed for the maxillary first premolar. For the adjacent canine, after removal of the gutta-percha and thorough irrigation, calcium hydroxide was placed as an intracanal medicament. The canine was then referred for extraction and implant replacement.


#اندو

Two cases of separated endodontic instruments in the mesial roots of mandibular molars.In both cases, a small fragment o...
17/08/2026

Two cases of separated endodontic instruments in the mesial roots of mandibular molars.

In both cases, a small fragment of an instrument had separated inside the canal.
However, the small size of the fragment is not necessarily a positive sign. It may indicate that the instrument fractured at an early stage, during inadequate canal preparation, possibly involving an instrument with an active tip, resulting in obstruction of the canal pathway.
Bypassing or retrieving separated instruments in such cases is not always straightforward.
In both cases, the separated instrument was successfully bypassed. However, following canal preparation and shaping, the previously separated fragment was either displaced or became no longer visible due to the high radiopacity of the canal filling material.

Second mandibular molar endodontic treatment with two distal canals and a single mesial canal!Endodontics may seem to fo...
17/08/2026

Second mandibular molar endodontic treatment with two distal canals and a single mesial canal!

Endodontics may seem to follow a set of familiar principles and recurring challenges, yet at the same time, it presents some of the most diverse anatomical and clinical variations.
Sometimes, certain cases are so unusual that our eyes, memory, and even our problem-solving mindset are simply not accustomed to them.
In this case, I initially couldn’t accept that the mesial root had only one canal. I spent considerable time carefully evaluating the anatomy and making sure that the mesial root was indeed single-canal.
The sealer used in this case is a bioceramic sealer from DiaDent. After several years of using this sealer in numerous cases, I can confidently say that it is a high-quality bioceramic sealer with excellent handling properties.

Four-year follow-up of a mandibular second molar root canal treatment.The definitive restorative treatment performed aft...
01/08/2026

Four-year follow-up of a mandibular second molar root canal treatment.

The definitive restorative treatment performed after endodontic therapy was not ideal, yet it has successfully maintained both the function and structural integrity of the tooth over the past four years.
Interestingly, the adjacent mandibular first molar, which had only a small carious lesion requiring a simple restoration at that time, progressed over the same four-year period to extensive coronal destruction. It now requires root canal treatment followed by comprehensive restorative rehabilitation.
This case is a good reminder that while the quality of the final restoration is important, long-term tooth survival is influenced by many biological and restorative factors, and even less-than-perfect restorations can sometimes provide years of satisfactory service.

The canal system was obturated using AH Plus Jet epoxy resin–based sealer.

Vital pulp therapy (VPT)—such as in this maxillary second molar—may occasionally become symptomatic over time and eventu...
01/08/2026

Vital pulp therapy (VPT)—such as in this maxillary second molar—may occasionally become symptomatic over time and eventually require root canal treatment.
However, in the vast majority of cases, failure is related to poor case selection or improper ex*****on of the procedure, rather than an inherent limitation of vital pulp therapy itself.

In this case, the patient was pregnant three years ago. Instead of performing root canal treatment on a mature tooth with a closed apex, vital pulp therapy was selected. Three years later, the tooth became symptomatic and required endodontic treatment.
As expected after successful pulp healing, significant canal calcification had occurred. However, calcification should not be interpreted as an indication that canal negotiation is impossible.
With the aid of an operating microscope, canal or***ces can often be identified much more accurately, allowing successful negotiation even in heavily calcified cases.

For obturation, DiaDent Biosealer was used with the warm vertical compaction technique.

Case 1 & 2: Two apical plug cases.One of the most common specialized procedures we perform as endodontists is the treatm...
29/07/2026

Case 1 & 2:
Two apical plug cases.

One of the most common specialized procedures we perform as endodontists is the treatment of necrotic immature anterior teeth with open apices.
Managing these cases and achieving apical closure in young patients with incompletely developed roots can be challenging, regardless of the technique used.
In the past, I used MTA in most of my cases. However, I currently use CEM cement as an apical plug.
Some of my colleagues in Iran use a material called Cold Ceramic. For several reasons, I personally do not have the same level of confidence in this material as I do in CEM cement, and therefore I do not use it for apical plugging.
However, regardless of the material selected, what truly matters is achieving a homogeneous, well-adapted apical plug with an adequate apical seal.
Mastering this technique requires practice, repetition, and experience.
#اندو

Root Canal Treatment of a Maxillary First Molar with Severe CurvatureIn severely curved canals, the primary goal is to p...
29/07/2026

Root Canal Treatment of a Maxillary First Molar with Severe Curvature

In severely curved canals, the primary goal is to preserve the original canal anatomy while minimizing procedural errors:

Careful assessment of the canal anatomy
Proper access and coronal preflaring
Establishing a reproducible glide path with small hand files
Pre-curving the files and using minimal apical pressure
Frequent irrigation and recapitulation
Using smaller, highly flexible files with an appropriate instrumentation technique
Avoiding excessive force and being mindful of the risks of ledging, transportation, and file separation

And above all: focus, patience, and no rush to reach the final preparation.
The preparation of severely curved canals is a slower and more delicate process. Any attempt to rush the procedure or take shortcuts can compromise the original canal pathway and ultimately jeopardize the outcome of the treatment.

Case 1: Five-year follow-up after primary root canal treatment of a maxillary molar.Case 2: Nonsurgical retreatment of a...
27/07/2026

Case 1: Five-year follow-up after primary root canal treatment of a maxillary molar.
Case 2: Nonsurgical retreatment of a maxillary molar.
Case 3: Primary root canal treatment of a maxillary second molar.
In all three cases, the path to a successful endodontic outcome follows the same fundamental principles:

Isolation.
Locating and preparing all canals.
Bringing every canal to the working length.

Whether it is an initial treatment or a retreatment, the principles and the workflow remain fundamentally the same.
These steps are not optional, nor are they something to be compromised or overlooked—unless, of course, we are not aiming for a predictable and successful outcome.

EndodonticPrinciples MaxillaryMolar Endodontist

Two canals in mandibular second premolars are relatively common, occurring in approximately 10–20% of cases. However, in...
25/07/2026

Two canals in mandibular second premolars are relatively common, occurring in approximately 10–20% of cases. However, in this particular case, although one of the final radiographs appears to suggest a Vertucci Type III configuration, tactile sensation during file negotiation, together with the distal angulated radiograph, indicates a Vertucci Type VII configuration.
#اندو #اندودنتیست

Address

تهران جلال آل احمد، زیر پل گیشا (نصر)، پلاک ۷۱ طبقه چهارم مقابل ساختمان بانک کشاورزی/تلفن ۰۲۱۸۸۲۸۳۰۰۶ و ۰۲۱۸۸۲۸۳۰۰۷
Tehran

Opening Hours

Monday 10:00 - 18:00
Tuesday 10:00 - 17:00
Wednesday 10:00 - 18:00
Thursday 10:00 - 17:00
Saturday 10:00 - 17:00
Sunday 10:00 - 17:00

Telephone

+989023232902

Website

Alerts

Be the first to know and let us send you an email when علی مرسلی - متخصص درمان ریشه posts news and promotions. Your email address will not be used for any other purpose, and you can unsubscribe at any time.

Contact The Practice

Send a message to علی مرسلی - متخصص درمان ریشه:

Shortcuts

Share