Dr. Arshad's Dental Care

19/07/2026

Separated File Removal in a Challenging Mandibular Second Molar
Case Highlights:
• Referred case of separated file in the mesiobuccal canal
• Tooth was mesially tilted, with limited mouth opening
• The mesiobuccal and mesiolingual canals were confluent.
• A periapical lesion with active infection was present.
• Continuous drainage through the patent mesiolingual canal caused persistent contamination of the mesiobuccal canal, making visualization and file retrieval considerably more difficult.
Clinical Strategy:
• The mesiolingual canal was first cleaned and shaped to establish drainage control.
• Intracanal medication was placed to reduce the infection and create a more favorable environment for retrieval (visible on the radiograph).
• Once the canal was adequately controlled, attention was directed towards removal of the separated instrument.
The Four-Step Retrieval Protocol:
1️⃣ Staging –2️⃣ Exposure – and 3️⃣ Ultrasonic Preparation let to file flexing. Time for step 4
4️⃣ Loop Device Retrieval – Used only when flexing is evident.
✅ The separated instrument was successfully removed with BTR Pen.
As this was a referral for instrument retrieval, the patient was referred back to the treating dentist to complete the root canal treatment after successful removal of the separated file.

10/07/2026

🦷 Complex Endodontic Case – Tooth #25
A Retreatment case exhibiting complex anatomy (Gulabivala type 2-3) 🔍
📍 Presentation:
Food impaction between #25 and #26. Secondary caries #25
📍 Clinical Challenge:
Palatal canal joining the branch of main buccal canal.
📍 Management:
✨ Previous root filing removed with rotary files. (Avoid Solvent in complex cases)
✨Patency achieved in buccal canal using #8–10 K-files
✨ Vigorous disinfenction with Passive Ultrasonic Irrigation (PUI)
✨ Calcium hydroxide dressing placed for 2 weeks ✅
✨ Final Warm Vertical Obturation for a dense 3D seal 🔥

04/06/2026

21/05/2026

https://youtu.be/KOA9DSUpOrQ
In this vlog, we will observe a method of separated file by passing. We will also see the sequential use of K files 10, 15 and 20 followed by a E flex blue NiTi 15/04 rotary file in a reciprocating motion. This case had a separated instrument in buccal canal of tooth #15. Canal configuration was vertucci type II. Watch the whole video. If you have any questions please ask in the comments section.

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https://youtu.be/KOA9DSUpOrQ

In this vlog, we will observe a method of separated file by passing. We will also see the sequential use of K files 10, 15 and 20 followed by a E flex blue ...

20/05/2026

🦷 Tooth #34 | Complex Anatomy Case
Mandibular first premolar with Vertucci Type V configuration 🔍
Presented with a single or***ce, dividing deep inside the root into two separate canals and portals 🚧
✨ Lingual canal was severely sclerosed and negotiated to full working length
✨ Preparation with Orodeka Plex V 04 CM wire files
✨ PUI with Ultra X 🔊
✨ Warm vertical obturation 🔥
✨ Completed in a single visit ✅

01/05/2026

A farewell gathering was held to bid goodbye to our valued team member, Mr. Sheeraz, who has recently moved on from our practice. We wish him all the very best in his future endeavors.

25/04/2026

🦷 Complex Endodontic Case – Tooth #35
A fascinating case featuring three root canals (Vertucci Type VIII) 🔍
📍 Presentation:
Patient reported with a buccal draining sinus
📍 Clinical Challenge:
A long, narrow canal trunk dividing into three separate canals at ~15 mm from the reference point — all initially blocked 🚧
📍 Management:
✨ Initial Negotiation/ Patency achieved using #8–10 K-files
✨ Blockade further managed with Orodeka Plex-V 15/03
✨ Final shaping completed with Orodeka Plex-V 04 CM wire files (20/04)
✨ Calcium hydroxide dressing placed for 1 week → complete resolution of symptoms ✅
✨ Passive Ultrasonic Irrigation (PUI) with Ultra X for enhanced disinfection 🔊
✨ Final Warm Vertical Obturation for a dense 3D seal 🔥