Endodontic Case Discussions: Navigating MB2s and Complex Retreatments

Overview

Our first Livestream! Thank you to all our members who joined! In this video we're discussing some of the challenging cases provided by our premium subscribers. We focus particularly on the complexities of endodontic retreatment, sharing practical insights gained from our experience, including learning from failures. The discussion centres around managing difficult anatomy like MB2 canals and perio-endo lesions, emphasising the use of CBCT and specific instrumentation techniques.

Key Topics Covered

• Strategies for negotiating challenging MB2 canals, utilising CBCT imaging for diagnosis and planning.
• Instrumentation techniques for managing complex curvatures and calcification, including specific file sequences (e.g., C-Pilots, C+ Files) and the rationale for using variable taper systems (e.g., TruNatomy, Reciproc Blue).
• Assessment and treatment planning considerations for perio-endo lesions, exploring the diagnostic challenges and the decision-making process regarding root amputation versus full treatment.
• The significance of coronal flaring, balancing dentine preservation with achieving adequate access, especially when dealing with ledges or abrupt curvatures.
• Evaluating restorability, occlusion, periodontal factors (like cleanability and bone support around furcations), and the importance of clear patient communication for complex cases with uncertain prognoses
• Watch Reciproc Blue and the XP-Endo Shaper in action for endodontic retreatment and Gutta-Percha removal 

Clinical Relevance

This discussion offers highly relevant, practical advice for dentists facing more challenging endodontic scenarios. Understanding the our approach to navigating tricky anatomy, selecting appropriate instruments, interpreting CBCT scans in context, and considering long-term prognosis provides valuable tools to enhance clinical decision-making and treatment success in everyday practice.

Learning Outcomes

After watching this, dentists should be better able to:

• Apply systematic approaches to negotiating challenging MB2 canals.
• Understand appropriate instrument options and techniques (e.g., specific file sequences, variable taper systems) for managing complex root canal anatomy during treatment and retreatment.
• Critically evaluate the diagnostic factors and treatment options (including root amputation considerations) for teeth presenting with perio-endo lesions.
• Assess key prognostic factors more effectively and communicate the associated risks and potential outcomes for complex endodontic cases to patients.