You guys are artists/craftsmen. God bless you all. I just had this procedure done today. So much relief and no pain now. Raising a glass to your profession tonight!
I just had a Root Canal done yesterday. It was on a crowned tooth (#19) I've had since 2002 or so, and this video was a lot of fun to watch. I could hear and see everything this video talked about. It's a lot of fun to see a video of the Engineering and Chemistry behind this procedure.
Glad the videos are helpful. It's hard for me to believe I have been doing this for over 40 years. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Gonna get my wisdom tooth removed & another root canal treatment soon. I’m glad I was born in an era where modern dentists & technology exists. Imagine being born 500 years ago and having a cavity or sore wisdom tooth!
Amen brother! I totally agree. What about George Washington with his false teeth? Can you imagine having major teeth problems prior to local anesthesia?
I’ll be seeing the endodontist on Friday because I’m still having discomfort and pain after having two permanent crowns placed a week ago. Thank you all for what you do! My grandfather was a dentist.
Hi Dr. As an endodontist I recommend using full strength sodium hypochlorite for optimal disinfection and tissue dissolution. Diluted hypochlorite has been shown in many studies to be significantly inferior. The use of full strength does not increase the chances of a hypochlorite accident.
Just had this done to me also. Glad I watched it after. Also glad I had a top doc/dentist. He was incredible and so was the technician and so thankful people do this kind of work during the covid epidemic.
Thank you. You might really like DentistryMasterClasses.com. There is a library of all the videos plus comprehensive complete cases and important articles.
You certainly can use composite alone. I just like completely set IRM. I have never had trouble with composite setting when placed over completely set and hard IRM.
@@centerforard thanks for your reply dr. though it was some misunderstanding, i still appriciate the time and effort in doing those videos. best regards
Yes, if it is an anterior tooth. A crown is normally not recommended for an anterior tooth following a root canal unless the tooth is significantly broken down.
Terrific. Glad the videos are helpful. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Glad it was helpful! Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
My doctor said he will have to put a screw after my root canal to give the support. After that crown portion will be done. I never heard of the screw thing. Is he right on his part?
Yes. Composite would be the filling material. I do not like to perform endodontics through a crown. The hole and composite filling material, or whatever filling material, compromises the long term life of the crown. Much better the perform the endo prior to crown placement if you think it is going to be necessary. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Hello Doc, I have two questions please : why cutting the top end of the gutta cones ? And what is the use of local anestesic inside the canal for the final cleaning ? Thank you
I cut the top of the gutta purchase so it is easier to take the pa radiographs. There is nothing magic about the local anesthetic. The 30 gauge needle fits easily into the pulp chamber. It is the 30 gauge needle, not the local anesthetic that is important. If there was plain water in the anesthetic carpules, that would work as well. I just want to rinse out the canals well prior to drying and filling. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513 .
Nice work doc! I'm liking the brassler system. For obturation, we're old school, so we still manually mix cement and coat the Gutta Percha but sometimes I'm short. I take a xray with the GP cone inside and all is perfect. But then I coat the GP w/cement and I come up 1-2mm short,,, urrrgh! Got any ideas? Btw, isn't the Distal canal a lil short? Cheers and thanks for taking the time to do these things!!!
As you know if you do much endo, the apex of the tooth is normally not at the tip of the root and may be several mm coronal to the apex. I use the apex locator to identify the apex, then, once the canal is filed, crown down, so the coronal part of the canal is open wider than the apical portion of the canal, I squirt the BC sealer directly into the canal with a bit of force so it travels all the way down to the apex. When I then place the GP cone, it forces the sealer into all the parts of the canal. I have been taught by more than one endodontist that the obturation (filling) of the canal is not the critical part. The cleaning and filing of the canal is the critical part of the procedure. So long as you thoroughly clean and irrigate the canal to the apex, the endodontic procedure should be successful. Of course we want to thoroughly file and obturate every canal. Sometimes, for a variety of reasons, perfection just doesn't happen.
@@centerforard I’m an Endodontist and agree with what your statement. I’ve done thousands of apicoectomies. What looks like an obturation perfectly to the apex on a PA X-ray is often over extended. Apex locators are accurate. Fill to where it tells you. Be careful though new micro CT studies are showing that the old thought that the major constriction being .5mm short of the radio graphic apex are being proven wrong.
Thank you for your comments. We are all doing the best we can to take care of our patients. Using the Real World Endo method for the past 20 years, with the #10 hand files, rotary Scout files (which are invaluable for finding tiny canals) then the rotary drills (either the sequence rotary files or the EJO2 single rotary file), I cannot remember the last time I had an unsuccessful endodontic outcome. I spend considerable time cleaning and irrigating the canals.
Either way. I will sometimes place accessory cones in the sealer in the canal around the master cone. The most important part of an endodontic procedure is to thoroughly clean and irrigate the canal.
What’s your opinion about the gentle wave procedure for root canals? Supposedly that gets more bacteria out of the microscopic holes in the tooth that regular root canals can’t get?
Know nothing about that method. I have basically zero known problems with endo procedures using the Brasslier Real World Endo rotary file method and 3 parts water:! part sodium hypochlorite irrigation. I have been using that system for many years. I perform a lot of endo, and my experience has been if you clean and irrigate the canals thoroughly, endo works. I do not claim to be an expert Endodontist, I am just reporting what my experience has been. It seems like some knew wrinkle is always added to the endo method. I prefer to keep things as simple as possible if the results are excellent. The more parts/steps in a procedure, the greater the chance of a problem, especially if "simple" works well. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
I had a root canal done a year ago. 3 months ago I had an abscess appear above said tooth (top left molar, 2nd from the back. I've had braces and wisdom teeth pulled years ago). I pay out of pocket and couldn't get the abscess/infected root canal retreated until recently. I had a permanent crown put on it after the original root canal. I had endodontic work done last week on it, and they drilled through my crown to remove the infection. Should I be worried about re-reinfection?
Redone endodontics is always a bit of a gamble. Some suggest extracting the tooth at that point and placing an implant. It depends on the situation and the dentist/endodontist performing the procedure.
It depends on how wide the rotary files I use are. I use the Brasseler Real World Endo system for all my endodontic procedures. I really like it. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
How long after this procedure should I still be feeling sensitivity in my tooth? I just had this procedure done yesterday and now my tooth is ridiculously sensitive while brushing it.
Composite filling. There is a good chance the crown will one day need to be replaced. That is why I prefer to perform endodontics prior to crown placement if I think it will be needed.
I recently discovered your videos and love them! I wondered, do you take the hedstroms to length? Is there a benefit to using a K file vs a hedstrom to go to length? I just always used hedstroms to "rasp" the orifice for clean straight line access and then took a K file to length, but I don't know if there was a reason I was taught that way or if it doesn't matter which you use to get patency. I'd love to hear your thoughts!
I normally just use the Hedstrom because it files more efficiently. I know several endodontists who only use K type files. It's a matter of preference. I often use a "scout" file in the handpiece to initially find a canal and file to length prior to a hand file.
You prolly dont give a shit but does anyone know a tool to log back into an Instagram account..? I was stupid lost the password. I would love any tips you can give me!
@Gregory Abraham i really appreciate your reply. I found the site on google and im in the hacking process now. Takes quite some time so I will reply here later with my results.
@Gregory Abraham WTF IT ACTUALLY WORKED :O Literally got access to my instagram login within roughly 45 mins by using the site. Thank you so much, you saved my ass!
Hello doctor Thanks for this great video 2 weeks ago i had my e max crown permanently cemented After anesthesia revealed, i started feeling pain like a shock when biting , my doctor did reduction of high cusps But pain persists until now , so my question is will making rct through the crown will weaken it ? Hope you answer me , thanks
Cutting a hole in a crown does compromise the life of the crown, but it is done routinely when a tooth requires endodontic and the tooth already has a crown. If I had a painful tooth and the tooth had a crown that was well done, I would have endodontics through the crown and know that, one day, I would probably have to replace the crown. The thing that causes the crown to need replacement is normally leakage around the composite filling plugging the hole in the crown following the endodontic procedure. If you had the composite filling replaced every 2-3 years, you would have less chance of leakage around the filling.
I got a crown a year and a half ago and I thought that would protect my tooth from everything. Despite of me having great oral hygiene, the tooth is now infected. Dr. now wants to do a RC but I want it pulled so I don't have to deal with it ever. I'm terrified of dental work. Was the crown bad? Will I need a new crown? Can it get infected again? This is so stressful and painful.
A tooth is much like a tree, i.e., they sometimes die (abscess) from unknown causes, trauma, deep old fillings or decay. Even if you have good oral hygiene, the tooth can decay around the. crown if you are a sweet eater or drinker.
Thats some rally valuable information- Hand file and irrigate before rotary files, incase of file seperation. I see that as very important from a Dentists stand point, if we need to explain it to the patient.
I agree. My objective with these videos is the teach techniques and to also keep you from having big problems. Removal of a separated file is not easy and can potentially damage the root of the tooth through perforation. In my 38 years of dental practice I have never, to my knowledge, had a post op problem from a separated file using the pre-drill hand file/irrigation method. Luckily, I have not had many separated files, but if a file should separate and the canal is cleaned out and irrigated well, the separated file becomes like a silver point filling.
@@centerforard We do get taught that in dental school, to go in with hand file first (size 10/15 ISO files). Obtain the length via RG image + electronic Apex locator then obtain a smooth glide path with hand file's before we go in with rotary. It's good to know that you don't need the widest rotary file's in molar /pre molar teeth, as it can remove too much tooth structure.
There’s pain when I push down on a root canal crown I had 2 years ago and looks like there’s swelling and throbs. Going to get it checked out but from your experience, do you think it’s infected and will need it re-done?
My dentist told me that he can do this procedure, but he is not an Endodontist. Should I be concerned or can General Dentists also do this work? Thanks.
I am a general dentist with endodontic training. If he has training in endodontics, he can probably do the procedure. I cannot attest to his level of training and expertise.
Hello Doctor Cutbirth, Thank you for the video! Approximately how long do you expect a periapical lesion to heal radiographically (show progress) after completing a root canal on a necrotic pulp / acute apical abscess?
I cannot say exactly how long the lesion takes to resolve, but I would estimate the lesion should be healed in 6 months - 1 year. The apical scar may be in place for a longer period of time. If the lesion is large, like the lesion at the apex of the patient's lateral incisor I am treating this morning, I will perform endodontics as well as an apicoectomy during the same procedure. This lady's lateral incisor has already had endodontics, and the endodontics was redone. Her face became swollen again several months following the redone endodontics (redone by an Endodontist). Sometimes there is no obvious answer to why a procedure does not work, but it's time to more forward with a different procedure, and an apicoectomy normally does the trick unless the root is fractured. It's good to have the apicoectomy technique as a "fall back" procedure when endodontics alone does not solve the problem. Normally, conventional endodontics does solve the problem and the lesion heals. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Ha, ha, that's funny! I hope you subscribe to DentistryMasterClasses.com and enjoy the entire library of all the Dental Minute videos as well as many, many complete comprehensive cases.
I'm watching this to mentally prepare myself for my rct ...I'm freaking scared tho cuz I heard from ppl that it hurts afterwards of the procedure ..even it's a successful treatment.rip to me bruh
Normally it should not be uncomfortable during or after the procedure. You might want to consider sedation in addition to local anesthesia if you are apprehensive.
It depends on many things. Many factors determine the lifespan of any dental material, i.e., what you eat and drink, the temperature of the food and drink, the hardness of the food, clinching of the teeth, do you wear a nightguard while sleeping, do you have good home care, etc.
@@centerforard thank you for your reply. I will eventually get a new crown but I was in a hard financial position to get a new crown so I opted for a permanent filing until I can get a new crown. I'm honestly terrified to do anything more to this tooth after 2 root canals. But this is my last molar on the bottom. I am also looking to get a better mouth guard because the otc hurt my gums and teeth.
Thank you Dr. Cutbirth, Why do you not place a cotton roll before the IRM? I think we were taught to place one because IRM is difficult to remove from the dentinal walls. Also, if this tooth did not already have a crown, would you have used something else to fill the access cavity? Thank you.
I have a question I’ve been told I need to get a root canal on one of my teeth on the upper back of my mouth left side... is it necessary to get a crown on it? With insurance I’m still looking at $500! Out of pocket just for the crown which is ridiculous... couldn’t I just get the root canal and just make sure I’m carefully about what I eat and keep that area brushed and cleaned?
Hey Dr. Cutbirth, do most dentists usually drill through the crown? Because that's what I would rather prefer as I have moderate to severe pain on one of my back molars underneath a dental bridge I've had now for 14 years. I do not feel comfortable with them pulling off the bridge even at 14 years old because I do not want them destroying more teeth than needed. Is this something done very commonly now? Appreciate your videos and answers.
If there is decay under a crown or bridge, it is normally impossible to tell how significant the decay is without cutting off the crown or bridge. The crown blocks out the radiation from the x-ray (radiopaque) so the radiation does not penetrate through the crown so you cannot see what is under the crown on an x-ray. If there is major decay under a crown (or bridge) and a root canal is performed through the top of the crown, the pain will probably go away but the decay will still be there. If I had a bridge or crown for 14 years with no discomfort until now, I would be afraid something was going on under the crown or bridge. I would hate to have it taken off, but would be afraid I would loose the tooth from decay if I did not take it off.
@@centerforard sorry I did not get a notice for this comment but I read what you said and I had the root canal done. The endodontist said it looked like an abcess was forming but he said there was no decay which is good. Is it normal to put in medicine inside the crown and fill it temporarily? Because the root canal was done that way and I go back for the endo to clean out the rest completely and I assume he will put in the permanent filing material? Because some of the temporary filling fell off the tooth (I assume from excess filling). Thanks doc.
Quick question: I have watched and enjoyed all your dental minute videos, what I would like to know is what size scout file are you using to locate all the canals? I see they come 15-45. Thank you.
.02 width, 21mm length. I hope you have subscribed to DentistryMasterClasses.com. An organized library of all the DM videos plus many complete comprehensive cases not seen in DM. New cases every week. Take your practice to the top tier!
Regenerative endodontic treatment can be done on mature permanent root canal treated teeth. If yes then in your known reference can suggest a endodontics clinic or hospital name for doing this treatment please reply me as soon as possible
Hi doctor i had my root canal done 4 weeks ago my face is a little swollen where he did my back tooth? And throbbing pain is that normal? And my dentist did not use a mouth gard😟
@@evywrldd that sucks! I am dealing with the same problem.. no infection but the pain comes and goes always the next day after a glass of wine. So strange .. now I am freaking out if they have to do a root canal on top of the new crown! 🤦♀️🤦♀️
@@erenstar1 my infection got worst! I woke up with my left cheek swollen (where the abscess was) but the day before that that I was in pain all day w a toothache. I ended up going to the dentist and getting it extracted. Now I’m on day 3 and of healing 🙃
I liked your explanation .. My Question is the IRM used under material contain resin such as amalgam,inlay and onlay .why did you use it and what the alternative ? thank you .
I use IRM as a bulk filler over the sealed endo canals because it is easy to place and effective. I let the IRM set completely, then place composite resin coronally to the IRM. I have never had a problem with the IRM interfering with the filled resin setting.
@@centerforard I also was wondering about the IRM and why you like it. I would love to hear more! The benefits I see are 1. It is easier to access the canals again if ever a retreat is needed, 2. It costs less than a bunch of composite. Downsides I see are that neither the IRM nor the composite ultimately seals off the dentin like a glass ionomer would, and if you are prepping for a new crown I would think the IRM would be weaker, so you would need to do a build-up later if that ever was the case. Another downside is having to sit and wait for the IRM to set completely, unless you are off doing hygiene checks or working on another patient. I would love to hear more about why this is your go-to! Thanks, this was a great video!
I already got my root canal done and I am going to get my braces soon, do I have to get my permanent filling before I get my braces done? Or can I just get my braces first
The RealWorldEndo rotary system is very nice. Of course the procedure takes longer than 12 minutes by the time radiographs are taken, hand files and rotary files. Subscribe to DentistryMasterClasses.com while you are in dental school and watch the videos over and over. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
So I got back from the dentist and they told me I may need a new root Canal replacement is it gonna hurt, because they told me that I won’t experience any pain when I get my new root canal is that true?
It depends on what needs to be done to redo the previous endodontics. I normally anesthetize the tooth when I occasionally redo a root canal just to be sure there is no discomfort.
I was feeling an occlusion problem with my zirconium crown so they shaved it down a little bit in my mouth. Is it safe to use it now without polishing? I do not want to be exposed to zirconium every day. They did no polishing. Also there were no rubber dam used sadly. In fact I have never seen a dentist using rubber dam in my country. Only suction.
Ideally, the endodontics would come before the crown, but occasionally a tooth that has been crowned has a problem and endodontics must be performed after the crown has been placed. Ideally, replace the crown when the endo. is performed, but sometimes, in a real practice, that is not practical due to finances or other factors.
tomorrow I'm getting a crown on my tooth, I have an appointment for braces the day after getting my crown. So can I get braces the day after getting a crown?
It did. I was much more comfortable having seen this video because I knew what was coming. It was 100% pain free. I was a little sore after the numbing wore off but nothing Motrin didn't take care of. Thank you so much for this video. It helped me prepare for my visit.
Yes. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Hats off you doctor, incredible work. So is it safe to ingest so much porcelain, zirconium etc. during the procedure? All of the mess was in patient's mouth.
Rubber dam, lots of water and high suction. I like isolation for most procedures. Glad the videos are helpful. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
I was feeling an occlusion problem with my zirconium crown so they shaved it down a little bit in my mouth. Is it safe to use it now without polishing? I do not want to be exposed to zirconium every day. They did no polishing. Also there were no rubber dam used sadly. In fact I have never seen a dentist using rubber dam in my country. Only suction.
Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Sorry, I cannot properly diagnose your condition without examining you. I suggest you go see a good dentist and have an examination, treatment plan and consultation.
I've been doing some dentistry on the weekends in my garden shed for a Hobbie.. I've been using a dremil that I bought at sears and seams to work OK for now.. Thanks for the videos.. 👍
It is certainly best to replace the crown vs. cutting through the crown. Sometimes, however, in a real practice that is not done because of finances or other reasons.
Some guy had to figure this out somehow and that is truly horrific😂. I really think I’d be good at this and it’s so cool. Not sure if I could make it through school though.
You are welcome. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
You are welcome. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
Several things can cause a tooth to be sensitive following a filling. If the decay was deep into the tooth, it might require endodontics and a crown or the filling might just be in hyper occlusion (high).
Yes. I have done that without any issues for 40 years. Be sure the IRM is completely set before you place the composite. I know it is said the eugenol in IRM prevents the composite from setting, but I have never seen that occur.
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Thank the Lord for great dentists. God bless all the good doctor's that actually care about their patients. Right now In the U.S.A we have some bad apple doctor's that are knowingly experimenting on Innocent American Citizens. Ethics matter now more than ever. Only good kind hearted doctor's please!
