علی مرسلی - متخصص درمان ریشه

علی مرسلی - متخصص درمان ریشه دکتر علی مرسلی

جراح – دندانپزشک، متخصص درمان ریشه
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9-year follow-up of an upper second molar root canal treatmentSuccess in dentistry isn’t luck.No treatment preserves a t...
20/05/2026

9-year follow-up of an upper second molar root canal treatment

Success in dentistry isn’t luck.
No treatment preserves a tooth for years by chance.
It’s the small details — intertwined like rings in a chain — that create the big picture of a successful outcome.
You can read textbooks, watch YouTube, or use AI to gather data.
But data alone won’t give you that big picture.

To see it, you need a different kind of insight.

RootCanalSuccess

Apicoectomy for upper anterior central & lateral incisorsOne year ago, the upper central incisor received root canal tre...
20/05/2026

Apicoectomy for upper anterior central & lateral incisors

One year ago, the upper central incisor received root canal treatment due to pulp necrosis. At that time, the options for the lateral incisor were discussed: surgical root canal treatment vs. extraction & implant.
Fast forward one year – we performed retrograde surgery. After flap reflection and periapical bone resection, root resorption and exposed gutta-percha were visible in the periapical space – even though conventional periapical X-rays showed a seemingly short working length.

✅ 3–4 mm apical resection of both teeth
✅ Retrograde cavity preparation with ultrasonic tip
✅ Calcium silicate retrograde filling
✅ Bone graft + membrane for regeneration

Slide 1: Me & my colleague during the procedure!
Slide 2: Radiographs & clinical photos – from start to finish
Slide 3: Initial orthograde RCT of the upper central incisor
Slide 4: Retrograde surgery for both maxillary central & lateral incisors

7-year follow-up of an upper second molar root canal , success isn’t simple.Endo success has a formula. But failure? Ma...
19/05/2026

7-year follow-up of an upper second molar root canal , success isn’t simple.
Endo success has a formula. But failure? Many causes.
On paper, keeping a root‑treated tooth for years sounds easy. In reality, it’s a chain of tiny details.
Take this upper second molar – complex canal morphology. The clinician must recognize and master that complexity from day one. That’s the real key.

Follow-up of lower first molar root canal treatment.The patient presented with chief complaint of pain when chewing. Due...
18/05/2026

Follow-up of lower first molar root canal treatment.
The patient presented with chief complaint of pain when chewing. Due to a distal root lesion and a delayed positive response to vitality testing, the pulp was diagnosed as partial necrosis.
The crown was removed using an arch crown remover with short-amplitude taps.
A minimal access cavity was made through the existing restoration. After root canal treatment, the tooth was restored and the crown was immediately permanently cemented.
Three years later, the follow-up shows favorable conditions.

Periapical Microsurgery (Retrograde Apicoectomy) Upper First & Second Premolars:The patient came in with a parulis (fis...
17/05/2026

Periapical Microsurgery (Retrograde Apicoectomy) Upper First & Second Premolars:

The patient came in with a parulis (fistula) on the buccal vestibule in the periapical area of the first premolar.
Both teeth were restored with long prefabricated posts and crowns ,which the patient preferred not to replace.
Given the recurrent lesion on the second premolar as well, we planned a surgical approach for both teeth.
After root‑end resection and retrograde cavity.
preparation, a calcium silicate–based retrofill was placed.
Bone graft and a barrier membrane were used to support periapical regeneration.

Our patient presented with a chief complaint of heat sensitivity. Vitality testing was performed on all maxillary and ma...
13/05/2026

Our patient presented with a chief complaint of heat sensitivity. Vitality testing was performed on all maxillary and mandibular premolars and molars within the involved quadrant. All teeth responded normally to vitality tests except for a previously treated mandibular second molar.
Single-tooth rubber dam isolation was performed for the mandibular second molar, and a heat test using warm water reproduced the patient’s pain. At this stage, the source of the chief complaint was identified.
At this point, I could either request a CBCT scan or rely on conventional periapical radiography. In such cases, my preference is angled conventional radiography. With mesial tube shift angulation, a missed second canal in the mesial root became evident.
Root canal retreatment was initiated based on this initial diagnosis. The missed mesiolingual canal from the previous treatment was located, negotiated, prepared, and obturated. The two previously treated canals were also re-instrumented and retreated according to standard protocols.
The overall prognosis of this case is considered favorable.

8-year follow-up of a maxillary first molar retreatment.Although the overall prognosis for preserving this tooth was con...
13/05/2026

8-year follow-up of a maxillary first molar retreatment.

Although the overall prognosis for preserving this tooth was considered fair to good, extraction and replacement with an implant had also been proposed at the time. However, the patient was highly motivated to keep the natural tooth.
The existing crown was sectioned and removed, the amalgam core was excavated, and nonsurgical root canal retreatment was performed. The previously missed MB2 canal was located, negotiated, cleaned, shaped, and obturated as well.
Eight years later, everything continues to function beautifully for both the tooth and the patient. The patient is happy with the decision to preserve the tooth, and I am equally pleased to see such a favorable long-term outcome from this treatment.

Apicoectomy (retrograde surgery) of the maxillary central and lateral incisors.Different treatment options were consider...
12/05/2026

Apicoectomy (retrograde surgery) of the maxillary central and lateral incisors.
Different treatment options were considered for management of the buccal abscess of endodontic origin associated with these teeth. Ultimately, after discussing the available approaches, retrograde surgery was selected as the final treatment plan due to its faster healing potential, minimal intervention time, and more definitive prognosis.
The lesion was surgically resected. Retrograde cavities were prepared using ultrasonic tips, and calcium silicate-based retrograde filling material was placed in both roots.
Bone substitute material and a membrane were also placed to facilitate the bone regeneration process.

Lege story for legend endodontists!Experienced and legend endodontists know: when a case is referred with a temporary dr...
11/05/2026

Lege story for legend endodontists!

Experienced and legend endodontists know: when a case is referred with a temporary dressing, the tooth has had a prior root canal attempt, but the periapical X-ray looks perfectly normal… the most likely culprit is a canal ledge
A ledge may not be visible on the radiograph, but subtle clues can point to it:
Coronal widening that suddenly ends with the canal disappearing
· A sharp curve where the canal’s radiolucency is visible only up to the beginning of that curve

Ledges are a tough challenge successful bypass doesn’t guarantee predictable outcomes.
The truth? Skill & experience help, but luck plays the biggest role. Tools and technology? Surprisingly, the least !

Here are two ledged canal cases:

First: Mesial root of a molar — both mesial canals were ledged. Successfully bypassed… with a good dose of luck
Second: A 3‑year follow‑up of a successful ledge bypass. Still holding strong

Three-year follow-up of a mandibular first molar non-surgical retreatment with an extensive periapical lesion.Despite th...
11/05/2026

Three-year follow-up of a mandibular first molar non-surgical retreatment with an extensive periapical lesion.
Despite the compromised prosthetic restoration and evident coronal leakage, significant healing compared to the initial condition can still be observed.
Two canals had been missed during the previous root canal treatment. During retreatment, these canals were located, negotiated, cleaned, shaped, and obturated successfully.
If the coronal leakage is not corrected, the risk of lesion recurrence, recurrent caries, and eventual treatment failure remains high.
The patient was advised to seek prosthetic consultation and replacement of the restorations for both the first and second molars as soon as possible.

Surgical retrograde treatment (apicoectomy) on a maxillary central incisor. In a case like this(with a cast post and cro...
10/05/2026

Surgical retrograde treatment (apicoectomy) on a maxillary central incisor.
In a case like this(with a cast post and crown) orthograde root canal retreatment comes with high risks. Plus, given the nature of the problem (foreign material beyond the apex), the success rate of orthograde retreatment isn't great.
After root resection, we placed a retrograde filling and used bone graft powder + membrane for bone regeneration.

bonegraft

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

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