Deep margin management

Managing deep margins in endodontics: A clinical case walkthrough

Overview

This video presents a clinical case demonstrating how to manage deep margins in teeth requiring endodontic treatment. It emphasises practical techniques for addressing subgingival caries and ensuring good coronal seal for long-term success, simplifying complex procedures to get great results.

Key topics covered

• Assessment of teeth with caries extending below the gingival level
• Complete removal of old restorations and caries
• The importance of soft tissue management (papilla) for proper isolation
• Explore how to manage the papilla in deep margin cases
• Using a thermocut bur to remove the papilla in the posterior region effectively and safely
• Matrix band adaptation techniques, including saddle matrices and customised wedges with PTFE tape

Clinical relevance

This video directly addresses a common challenge in endodontic and restorative dentistry – managing deep margins. It provides dentists with actionable strategies to improve isolation, achieve better coronal seals, and ultimately enhance the long-term prognosis of root canal-treated teeth with compromised coronal structure. It also highlights the importance of a good contact point to reduce postoperative pain.  Without optimal management of all these aspects on a complex sceanrio like this, the prognosis of the tooth will be worsened

Learning outcomes

After watching this video, dentists will be able to:

• Implement different techniques to manage soft tissues and improve access to deep margins
• Select and understand how to adapt an appropriate matrix band system and modify a wedge for optimal coronal seal
• Understand and utilise the thermocut bur safely and effectively for papilla removal in posterior teeth