{"id":671,"date":"2017-08-31T20:40:49","date_gmt":"2017-08-31T20:40:49","guid":{"rendered":"http:\/\/www.endostlaurent.ca\/?p=671\/"},"modified":"2018-01-25T05:03:53","modified_gmt":"2018-01-25T05:03:53","slug":"endodontic-microsurgery","status":"publish","type":"post","link":"https:\/\/endostlaurent.com\/en\/2017\/08\/31\/endodontic-microsurgery\/","title":{"rendered":"ENDODONTIC MICROSURGERY"},"content":{"rendered":"<h3 style=\"text-align: center;\"><em>A case study by Dr. Chafic Safi, Centre Endodontique St-Laurent<\/em><\/h3>\n<p>&nbsp;<\/p>\n<p>A 55-year-old\u00a0Caucasian female patient presented herself at our clinic with\u00a0the following primary complaint:<\/p>\n<blockquote><p>\u201cI can\u2019t chew on my tooth.\u201d<\/p><\/blockquote>\n<p>&nbsp;<\/p>\n<h2 class=\"title left\">Analysis<\/h2>\n<p>History of chief complaint revealed that the patient started to develop symptoms upon chewing a couple of weeks ago. She consulted her dentist who referred her to our office.<\/p>\n<p>Her chief complaint was reproduced upon percussion of her lower right first molar (#46).<\/p>\n<p>Clinical and conventional radiological exam further revealed that the tooth has a crown, a post, a root canal treatment, and a J-shaped periapical radiolucency around the mesial root. The periapical image also suggests a possible missed canal in the mesial root.<\/p>\n<p>Probing and mobility were within normal limits.<\/p>\n<h3>Diagnosis<\/h3>\n<p>The diagnosis was a <strong>previously treated tooth and symptomatic apical periodontitis.<\/strong><\/p>\n\n\t\t<style type=\"text\/css\">\n\t\t\t#gallery-1 {\n\t\t\t\tmargin: auto;\n\t\t\t}\n\t\t\t#gallery-1 .gallery-item {\n\t\t\t\tfloat: left;\n\t\t\t\tmargin-top: 10px;\n\t\t\t\ttext-align: center;\n\t\t\t\twidth: 50%;\n\t\t\t}\n\t\t\t#gallery-1 img {\n\t\t\t\tborder: 2px solid #cfcfcf;\n\t\t\t}\n\t\t\t#gallery-1 .gallery-caption {\n\t\t\t\tmargin-left: 0;\n\t\t\t}\n\t\t\t\/* see gallery_shortcode() in wp-includes\/media.php *\/\n\t\t<\/style>\n\t\t<div id='gallery-1' class='gallery galleryid-671 gallery-columns-2 gallery-size-medium'><dl class='gallery-item'>\n\t\t\t<dt class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC1-En.png'><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"157\" src=\"https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC1-En-300x157.png\" class=\"attachment-medium size-medium\" alt=\"L\u2019imagerie en 3D du canal m\u00e9sio-lingual manqu\u00e9\" aria-describedby=\"gallery-1-663\" srcset=\"https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC1-En-300x157.png 300w, https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC1-En-768x402.png 768w, https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC1-En-1024x536.png 1024w, https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC1-En.png 1306w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a>\n\t\t\t<\/dt>\n\t\t\t\t<dd class='wp-caption-text gallery-caption' id='gallery-1-663'>\n\t\t\t\tFigure 1 (eng): L\u2019imagerie en 3D du canal m\u00e9sio-lingual manqu\u00e9, tissus p\u00e9riapicaux normaux au distal, Foramen mentionnier \/ CBCT imaging of Missed mesio-lingual canal, normal distal periapical tissues, mesio-lingual radiolucency, and mental foramen\n\t\t\t\t<\/dd><\/dl><dl class='gallery-item'>\n\t\t\t<dt class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC1-Fr.png'><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"159\" src=\"https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC1-Fr-300x159.png\" class=\"attachment-medium size-medium\" alt=\"L\u2019imagerie en 3D du canal m\u00e9sio-lingual manqu\u00e9\" aria-describedby=\"gallery-1-664\" srcset=\"https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC1-Fr-300x159.png 300w, https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC1-Fr-768x406.png 768w, https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC1-Fr-1024x542.png 1024w, https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC1-Fr.png 1308w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a>\n\t\t\t<\/dt>\n\t\t\t\t<dd class='wp-caption-text gallery-caption' id='gallery-1-664'>\n\t\t\t\tFigure 1 (fr): L\u2019imagerie en 3D du canal m\u00e9sio-lingual manqu\u00e9, tissus p\u00e9riapicaux normaux au distal, Foramen mentionnier \/ CBCT imaging of Missed mesio-lingual canal, normal distal periapical tissues, mesio-lingual radiolucency, and mental foramen\n\t\t\t\t<\/dd><\/dl><br style=\"clear: both\" \/>\n\t\t<\/div>\n\n<h2 class=\"title left\">Treatment<\/h2>\n<p>The treatment options offered to the patient were:<\/p>\n<ol>\n<li>Endodontic microsurgery (commonly known as apicoectomy). Prognosis: Favorable<\/li>\n<li>Non-surgical root canal retreatment. Prognosis: Guarded<\/li>\n<li>Extraction. Prognosis: Favorable<\/li>\n<\/ol>\n<h3 id=\"tw-target-text\" class=\"tw-data-text tw-ta tw-text-medium\" dir=\"ltr\" data-placeholder=\"Translation\">Treatment Selection<\/h3>\n<p>The patient opted for an <a href=\"http:\/\/www.endostlaurent.ca\/en\/endodontic-surgery\/\"><strong>endodontic microsurgery.<\/strong><\/a><\/p>\n<h3>Potential Complications<\/h3>\n<p>The following potential complications were discussed with\u00a0the patient:<\/p>\n<ol>\n<li>Re-infection of the periapical tissues<\/li>\n<li>Possible damage to surrounding teeth<\/li>\n<li>Local paresthesia of the lower right lip and chin, which is why a CBCT was taken to assess proximity of the mental nerve<\/li>\n<li>Possibility of cracked tooth as suggested by J-shaped lesion<\/li>\n<\/ol>\n<h3>The Treatment<\/h3>\n<p>CBCT imaging confirmed the following:<\/p>\n<ol>\n<li>Absence of radiolucency on the distal root<\/li>\n<li>Missed mesio-lingual canal<\/li>\n<li>Safe distance form the mental foramen<\/li>\n<\/ol>\n<p>Endodontic microsurgery was performed using magnification and illumination. 3 mm of the mesial root were resected using a Lindemann burr. After ultrasonic retro-preparation of both mesial canals, Bioceramic Root Repair Material was used to fill and seal the root canal space. No sign of cracked tooth or root fracture was observed.<\/p>\n<h3>Follow-up<\/h3>\n<p>A 6-month follow-up radiograph shows complete healing\u00a0with reformation of normal periodontal space and lamina dura around the mesial root. The patient is asymptomatic, the crown is still in place and the tooth is saved.<\/p>\n<p>No signs of paresthesia were ever felt.<\/p>\n<p>&nbsp;<\/p>\n<hr \/>\n<h2 class=\"title left\">More information<\/h2>\n<h3><strong>Advantages of Endodontic Microsurgery<\/strong><\/h3>\n<ul>\n<li>Safe and conservative approach<\/li>\n<li>High success rate<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<hr \/>\n<h2 class=\"title left\">Additional Images<\/h2>\n\n\t\t<style type=\"text\/css\">\n\t\t\t#gallery-2 {\n\t\t\t\tmargin: auto;\n\t\t\t}\n\t\t\t#gallery-2 .gallery-item {\n\t\t\t\tfloat: left;\n\t\t\t\tmargin-top: 10px;\n\t\t\t\ttext-align: center;\n\t\t\t\twidth: 33%;\n\t\t\t}\n\t\t\t#gallery-2 img {\n\t\t\t\tborder: 2px solid #cfcfcf;\n\t\t\t}\n\t\t\t#gallery-2 .gallery-caption {\n\t\t\t\tmargin-left: 0;\n\t\t\t}\n\t\t\t\/* see gallery_shortcode() in wp-includes\/media.php *\/\n\t\t<\/style>\n\t\t<div id='gallery-2' class='gallery galleryid-671 gallery-columns-3 gallery-size-medium'><dl class='gallery-item'>\n\t\t\t<dt class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC2.png'><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"199\" src=\"https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC2-300x199.png\" class=\"attachment-medium size-medium\" alt=\"Radiographie pr\u00e9-op\u00e9ratoire\" aria-describedby=\"gallery-2-665\" srcset=\"https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC2-300x199.png 300w, https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC2-768x510.png 768w, https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC2.png 975w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a>\n\t\t\t<\/dt>\n\t\t\t\t<dd class='wp-caption-text gallery-caption' id='gallery-2-665'>\n\t\t\t\tFigure 2: Radiographie pr\u00e9-op\u00e9ratoire \/ Pre-operative radiograph\n\n\t\t\t\t<\/dd><\/dl><dl class='gallery-item'>\n\t\t\t<dt class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC3.png'><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"186\" src=\"https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC3-300x186.png\" class=\"attachment-medium size-medium\" alt=\"Radiographie finale\" aria-describedby=\"gallery-2-666\" srcset=\"https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC3-300x186.png 300w, https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC3-768x477.png 768w, https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC3.png 975w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a>\n\t\t\t<\/dt>\n\t\t\t\t<dd class='wp-caption-text gallery-caption' id='gallery-2-666'>\n\t\t\t\tFigure 3: Radiographie finale \/ Post-operative radiograph\n\t\t\t\t<\/dd><\/dl><dl class='gallery-item'>\n\t\t\t<dt class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC4.png'><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"201\" src=\"https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC4-300x201.png\" class=\"attachment-medium size-medium\" alt=\"Radiographie du suivi au 6\u00e8me mois\" aria-describedby=\"gallery-2-667\" srcset=\"https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC4-300x201.png 300w, https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC4-768x514.png 768w, https:\/\/endostlaurent.com\/wp-content\/uploads\/2017\/08\/Microchirurgie-endodontiqueC4.png 975w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a>\n\t\t\t<\/dt>\n\t\t\t\t<dd class='wp-caption-text gallery-caption' id='gallery-2-667'>\n\t\t\t\tFigure 4: Radiographie du suivi au 6\u00e8me mois \/ 6-month follow-up radiograph\n\t\t\t\t<\/dd><\/dl><br style=\"clear: both\" \/>\n\t\t<\/div>\n\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A case study by Dr. Chafic Safi, Centre Endodontique St-Laurent &nbsp; A 55-year-old\u00a0Caucasian female patient presented herself at our clinic with\u00a0the following primary complaint: \u201cI&hellip;<\/p>\n","protected":false},"author":2,"featured_media":788,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[44],"tags":[32,11,15,33,41,42,14,34,35],"class_list":["post-671","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-etude-de-cas-case-study-en","tag-cas-dentaire-en","tag-case","tag-case-study","tag-clinique-dentaire-en","tag-dental-case","tag-endodontic-microsurgery","tag-endodontics","tag-endodontie-en","tag-etudes-de-cas-en"],"acf":[],"_links":{"self":[{"href":"https:\/\/endostlaurent.com\/en\/wp-json\/wp\/v2\/posts\/671"}],"collection":[{"href":"https:\/\/endostlaurent.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/endostlaurent.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/endostlaurent.com\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/endostlaurent.com\/en\/wp-json\/wp\/v2\/comments?post=671"}],"version-history":[{"count":0,"href":"https:\/\/endostlaurent.com\/en\/wp-json\/wp\/v2\/posts\/671\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/endostlaurent.com\/en\/wp-json\/wp\/v2\/media\/788"}],"wp:attachment":[{"href":"https:\/\/endostlaurent.com\/en\/wp-json\/wp\/v2\/media?parent=671"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/endostlaurent.com\/en\/wp-json\/wp\/v2\/categories?post=671"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/endostlaurent.com\/en\/wp-json\/wp\/v2\/tags?post=671"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}