The Endodontic Practice: Dr. Gaurav Vasudeva in Perth, Western Australia | Dentist & dental surgery

The Endodontic Practice: Dr. Gaurav Vasudeva

Locality: Perth, Western Australia

Address: 322, Cannings Highway 6157 Perth, WA, Australia

Website: http://rootcanalspecialist.org.au

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• Endodontist

25.01.2022 #24 with SIP/SAP. Eccentric access through the restoration. Composite restoration was sound and done recently. Straightforward endo, 2 visits with focus on conserving healthy dentin. . . .... #endodontics #endodontist #rootcanalspecialist #rootcanal #dentist #dentistry #perthdentist #sydneydentist #melbournedentist #rootcanaltreatment #endodontia @ Perth, Western Australia See more

25.01.2022 Simple predictable everyday endo. #24 necrotic. Mild discomfort on chewing. Not ttP. No specific history of trauma. I couldnt find any cracks or any other specific reason for the pulp dying. What could be the possible cause? Two visits, conservative access, 25, 0.06. Eddy sonic activation. ... Should have kept it 0.04 on the hind-side. Got carried away as the coronal canal was quite wide already. Ive recently started taking a radiograph once I place the temp to visualize my access better. Gives me a chance to rectify/improve next visit. Composite core and ref back hoping it gets only a bonded overlay. . #endodontics #endodontist #endodontia #rootcanal #rootcanalspecialist #dental #dentistry #dentalstudent #endoaccess #endo #endodontistlife #rootcanaltreatment @ Perth, Western Australia See more

22.01.2022 One year follow-up #46 retreatment. Tooth was heavily restored with a history of multiple restorations in the past and endo about 5 years ago. Majority of past endodontic treatment fails due to missed canals apart from restorative breakdown/leakage. The challenge here was to try and retain whatever tooth structure possible as there wasnt much left anyway. A missed separate DL canal was the primary cause of failure. Follow-up after a year today with near resolution of the ...apical lucency. There is an onlay in place and it would be interesting to follow up this up long term. Original post on my IG https://www.instagram.com/p/CFMlk9lpt1C/ . . #endodontics #endodontist #rootcanalspecialist #rootcanals #retreatment #patientcanteredcare #dentist #dentistry #followupendodontics #savingyourteeth #saveyourtooth

22.01.2022 Keeping it tight! Curvy, 25mm long # 36 with a nice little 90 degree kink on the distal apical 3rd. SIP/SAP, leaking DO restoration. Retained the distal composite and only repaired to enable endo. 2 visits, 25 04. Sonic activation. ... New DO composite to finish of with flowable giomer and packable composite. . . #endodontist #endodontics #rootcanalspecialist #rootcanal #endodoncia #endodonti #rootcanaltreatment #dentist #dental #endolife #fullserviceendodontics #minimalinvasiveendodontics #perthdentist #sydneydentist #melbournedentist #australiandentist See more

22.01.2022 #36 with SIP. 27mm, S shaped long roots. Conservative access , single appointment with final composite restoration. Buccal amalgam is in place that will be restored with RD followed by an onlay hopefully. . .... . #endodontist #endodontics #rootcanalspecialist #rootcanaltreatment #rootcanal #rootcanals #dentist #dentistry #dentalstudent #dentistaustralia #dental #dentistlife #perthdentist #gaurav_vasudeva_endo See more

21.01.2022 Full service endo. Severe pain #37, extremely tender. As there was a large but shallow occlusal restoration, I initially suspected a crack. Couldnt find any after removing the existing restoration, no caries either. There was partial necrosis with hyperemic pulp tissue. SIP/SAP. 3 standard canals. Tried to keep it tight, limited mouth opening and didnt want the mouth prop. Could have kept my access smaller but happy with what we could achieve for them. Restored with com...posite. Back to her dentist for a conservative bonded onlay. 2 visits, 25 0.04, sonic activation. Permission to publish/post. Follow me on IG: gaurav_vasudeva_endo . . . #endodontist #endodontics #rootcanalspecialist #rootcanaltherapy #fullserviceendo #endodontia #rootcanal #dental #dentistry #australiandentist #perthdentist #sydneydentist #melbournedentist #endo #conservativeaccess #dentistlife #dentalstudent #rootcanaltreatment #endodonticsforgeneralhealth @ Perth, Western Australia

21.01.2022 Nothing exceptional. Minimal conservative access. #47 with SAP and ext inflammatory resorption. Minimal prep, 25 0.04, ultrasonic irrigation activation. Simple. . . #endodontist #endodontics #rootcanalspecialist #rootcanal #endodontia #dentistry #dentistlife #dentistaustralia #perthdentist #rootcanaltreatment #endodonticsforgeneralhealth #painlessendodontics @ Perth, Western Australia

20.01.2022 Life cycle of carious teeth. #reactionarydentistry 2 years ago, 45 and 46 were diagnosed with extensive caries, 45 with pulpal involvement. 1 year ago, both 45 and 46 with pulpal involvement and 45 pulp extirpated as it got symptomatic. 6 months ago, 46 also got symptomatic and an initial endo was done. Symptoms disappeared but the bacteria continued to do what they do best. Eventually, symptoms reappeared. ... 2 visits, 20-25 04. Full service with composite core ready for a bonded onlay for both. A bonded onlay in such teeth can work well as the composite can be repaired distally for 46 in a few years if needed. 47 is missing and there will be some further bone loss distal to 46 in time. I don’t know if this theory of mine will work but planning for the future nevertheless. . . #endodontist #endodontics #rootcanal #endodontia #endo #fullserviceendo #endoresto #dentistry #dentist #dental #tooth #dentalcaries #caries #cariesprogression #saveyourtooth #preventionisbetterthancure See more

20.01.2022 Retreatment of #16 over 2 visits with a diagnosis of SAP. Majority of endodontic treatments fail not because of poorly looking/condensed GP but mostly due to missed canals on initial treatment. This one had a missed MB2 and hence the apical lesion associated. Ive attached a recent study that determined the presence of an apical lesion in 82% cases due to missed canals and 62% of those missed canals were MB2. We can be almost certain that if one of the major canal is miss...ed during the initial treatment, the endo will fail in due course of time. . . . #retreatment #endodontics #endodontist #endotips #endostudents #endodontistlife #dentist #dentistry #dentistaustralia #rootcanal #endodontia #endo #dental #rootcanalspecialist #rootcanaltreatment #endofailure #gaurav_vasudeva_endo @ Perth, Western Australia See more

19.01.2022 Calcified canals? No worries. These are some of my favorite if all goes well. Easier said than done though as success cant be guaranteed. All we can do is focus and stick to our protocol. ... #11 with past history of trauma, now symptomatic and discolored. Certain important things to consider. . Can you see any evidence of the canal? CBCT always helps especially with orientation and assessing patency and depth. . Where should I make my access? The answer is always incisal or near incisal to not only get straight line access but also to conserve dentine and limit chances of perforations. Once the calcification can be visualized, a dye such as caries detection dye can be used to stain any vital/necrotic debris that suggests possible path to take. Careful troughing with ultrasonic tips in the correct direction with a darker floor. I found the canal further into the middle 3rd with file size 6. It was straightforward from there on. Composite core. 2 visits. Has been asymptomatic since. . . #endodontics #endodontist #rootcanalspecialist #rootcanal #roots #australiandentist #dental #dentistry #dentistlife #calcifiedcanals #endodontia #microscopeendodontics #microendo @ Perth, Western Australia

19.01.2022 Everyday endodontics, nothing special except an sealer base obturation here with BC #endosequenceBCsealer. Evidence suggests no difference in the treatment outcomes. I will try and follow up as long as possible. Advantages of a sealer based obturation? It is quick and slightly less technique sensitive. Disadvantages? Limited short to medium term evidence . ... #16 SIP/SAP, 4 canals, Full service endo, single visit, #VDWEDDY sonic activation and a final composite restoration. Distal amalgam is sound but it would be best to replace it before the onlay/crown. Any opinions or medium/ long term follow-ups with sealer based obturations? . . #Endodontics #endodontist #rootcanalspecialist #rootcanaltherapy #bcsealer #sealerbasedobturation #fullserviceendodontics #endodontistlife #dentistlife #dentistry

18.01.2022 Transverse/horizontal, oblique fracture of the #21 root approx from the junction of apical and middle 3rd. Not often we get to see such cases. The trauma occurred as the result of an accident while operating heavy machinery. There was also laceration of the surrounding soft tissue. I first saw the patient about 8 months ago and have followed up since. The treatment plan decided here was No treatment and monitor only.... There are no symptoms, almost no mobility, no signs of pathology on CBCT or root resorption yet, although no response to a cold and EPT test. The PA radiograph shows two fracture lines, this is a great sign that the fracture is oblique as you can see on the CBCT slice and not actually two separate fractures. Taking a CBCT for such dental trauma should be mandatory if not essential. This will not only affect the diagnosis but overall treatment plan/management. If you see carefully the fracture becomes more complex towards the palatal aspect with further micro fractures. Once the assessment is done, the question that needs to be asked here is, will any intervention improve the prognosis? Is there any compelling evidence of infection or symptoms present for you to intervene? I couldnt find any. Many teaching institution around the world and practitioners will choose to endo the coronal segment mostly but according to the #dentaltraumaguide and IADT and many publications on such cases, it has shown no benefit rather you risk the healing of the fracture site and also may cause further injury to the vitality of the apical pulp. The coronal pulp could also be vital as a matter of fact. Again, a negative vitality doesnt mean much here for now. I will continue to monitor this but will not intervene unless there is clear signs of infection, root resorption or IP causing severe symptoms. What would other endodontists do in a case like this? . #dentaltrauma #horizontalrootfracture #transverserootfracture #IADT #endodontics #endodontist #rootcanalspecialist #rootcanals #dentist #dentalstudent #dentistlife #newdentist #endodontia

18.01.2022 Last weeks emergency patient presented with severe pain. Tooth #36 with a furcation involvement root canal treated 2 years ago. There is no apical involvement as seen on PA. Although I had a good idea whats going on but there is nothing more important that getting your hands on patients previous endodontic treatment notes and radiographs. Never jump to conclusions on the current situation without investigating the history. I cannot stress this enough. The endo was done 2 ye...ars ago and although there was a small furcation involvement then there was no perio pocket associates. This tooth has been mildly symptomatic since a year or more and now there is swelling as well. Perio pocket more than 7mm on buccal furcation and all investigations leading to VFR or furcation fracture. I am sure this occurred more than a year ago and it is even possible that there was a furcation crack during the initial endodontic treatment undertaken 2 years ago. Would CBCT have helped in the crack detection? A small chance, Yes but probably not. There is no need for me to take the CBCT now as the diagnosis can be confirmed without it. Patient referred back to RD for extraction. The site can be assessed for an implant and it is important to extract a fractured tooth causing bone loss sooner than later to avoid future loss of bone. (Consent taken for sharing and dental education) . . . #endodontics #endodontist #rootcanal #rootcanaltreatment #dentist #dentistry #dentistsworkingduringpandemic #rct #perthdentist #endodontia #toothfracture #VFR @ Perth, Western Australia IG: gaurav_vasudeva_endo

17.01.2022 Truss Access. 89 years young patient with a great zest for life. #37 SIP/SAP, partially calcified chamber. It was a good case for Truss access. Takes a bit longer hence Im always appreciative for their patience. This was only my 2nd such case. 10 years ago I would have never tried it. Looking at it again I think I could have kept the distal access a bit more tighter. This shouldnt need a full crown rather a bonded onlay would suffice as there was a hairline shallow cra...ck to start with. Im hoping for a successful 10 year review and celebrate their 100th birthday . Follow my work on IG: gaurav_vasudeva_endo . . . #endodontics #endodontist #endo #endodoncia #endodonti #microendodontics #trussaccess #dental #dentistry #dentist #perthdentist #australiandentist #sydneydentist #melbournedentist #brisbanedentist #minimalinvasivedentistry #minimalinvasiveendodontics @ Endodontics and Beyond with Dr. Gaurav Vasudeva

17.01.2022 We had a fantastic day volunteering and seeing some endo patients who needed it the most. #savingyourteeth

16.01.2022 Distal crack 37 leading to SAP. Luckily not deep. Super long roots with 27.5 WL in mesials, S shaped. All restorations removed, crack explored and sealed, distal wall buildup. I used single cones, BC sealer here with partial WV condensation and back fill 2-3 mm with flowable composite followed by packable. 2 visits, asymptomatic and ready for a bonded onlay. . .... #endodontics #endodontist #longroots #endodontia #rootcanalspecialist #dentist #dental #crackedtooth #rootcanal See more

16.01.2022 Here we go again! Australian society of Endodontology ASE, Western Australia branch have moved to webinars for the next few months. There is nothing more important than diagnosis and referred odontogenic pain can be a difficult one. The focus of the presentation will be referred dental pain, getting the best out of sensibility testing, interpretation of 2d and use of 3D including others. I will finish with some pain management strategies and concepts with case difficulty ...assessment. This will be 2nd June 6pm AWST (Perth)and 8pm AEST(Sydney/Melbourne). Link in Bio and story for registration or below. https://asewa.org.au/event-3827196 It is free and open to all. You will have an opportunity post in your questions to a panel of Endodontists. . . . #endodontist #endodontics #rootcanalspecialist #rootcanals #perthdentist #australiandentist #adawa #ase #asewa #australiansocietyofendodontology

16.01.2022 Full service endodontics #17. Patient in mid 50’s. This one was almost unrestorable. Was advised extraction and implant replacement but wanted a 2nd opinion. A motivated patient is all we endodontists need to give teeth another chance . SAP with extensive caries 2mm plus subgingival. GIC placement to prepare the tooth for endo and replaced with composite post endo. ... Why did we choose to retain this tooth? Firstly, I am an endodontist? There is no better osteo-integration than already existing natural roots with perfectly functional periodontium associated with it. There is no better replacement of dentine and no implant material can match the resilience of it and finally if and when the tooth fails, we have a follow up treatment/replacement option. Referred back to my RD for a bonded onlay/crown. TGIF . #endodontist #endodontics #rootcanalspecialist #worthsaving #savingyourteeth #rootcanals #perthdentist #almostunrestorable #dental #dentistry #saveyourtooth

16.01.2022 Nothing more exciting for an endodontist to be able to work on such cool anatomies. Nice variation with this one. Super long roots with WL 27mm. Partial C shaped mesials with all merging at the apex confirmed with CBCT. #37 started with RD and also wanted to restore hence only placed a temp post op. .... . #endodontist #endodontics #rootcanalspecialist #rootcanals #rootcanal #dentist #dentistry #dentalstudent #dentalcases #dental #endodontia #rootcanalanatomy #australiandentist #perthdentist #sydneydentist #melbournedentist @ Perth, Western Australia See more

15.01.2022 #16 with SIP/SAP, calcified canals, hypercementosis, partially calcified pulp chamber. Moderately challenging especially because I wanted to keep my access tight and as small as possible without compromising my disinfection protocol. Was happy to achieve patency. MB2 merging with the main at the mid/apical 3rd. 2 visits, 20-25 0.04 taper. Restored with composite. #minimalinvasiveendodontics .... . . #endodontics #endodontist #rootcanalspecialist #rootcanal #endodontia #rootcanaltreatment #dentistry #perthdentist #australiandentist #dental #dentist #dentalstudent #conservativendo #microendodontics #microendodotia #calcifiedcanals #pulpstone #endodonticsforgeneralhealth #gaurav_vasudeva_endo @ Perth, Western Australia See more

15.01.2022 Calcifies canals! Bring it on. I call this the weird tooth due to its abnormal morphology. Nevertheless functional and now symptomless. Will keep an eye on apical healing. Prep to .04/20 and 25 With restriction down to level 1, I must say I feel so lucky to be living in this beautiful land and state of Western Australia. We never went into a full lock down and our COVID 19 is near elimination with almost all sick patients recovered and no new cases. Job well done .... . . #endodontics #endodontist #rootcanalspecialist #calcifiedcanals #dentistlife #dentistry #dentist #australiandentist #rootcanal #dentalworld #dentistryworld #saveyourtoothmonth #endodonticsforgeneralhealth #endodoncia #endodonti #minimalprep See more

15.01.2022 Hello everyone. We had a great turnout for the webinar Misdiagnosis and pain management in Endodontics by Dr. Gaurav Vasudeva for Australian Society of Endodontology WA Branch last night. Just in case you couldnt make it, here is the link. The first five minutes are not recorded. Thank you for all those who attended. ... #endodontics #paincontrol #diagnosis https://facebook.com/ASEWAInc/videos/269121511106917/

13.01.2022 #endoquiznight update. great participation, thank you. 14 year old with 2nd trauma to his max anterior dentition. 21 and 22 were previously root treated and I saw him only after the 2nd trauma 6 months ago with severe pain. Investigated the previous endo. No consent for CBCT and only wanted immediate pain relief. Large 1 cm ill-defined radiolucency associated with 21 and 22. Both teeth tender and discolored. Mild swelling assoc with both. ... 22 - had some signs of a large lateral canal. Did not look like a horizontal root fracture but I couldnt rule it out initially. 21 - possibly no 10-15 no.separated instrument at the apex about 4mm long. Less than satisfactory root filling. In cases where you dont have an option of CBCT and both teeth are equally symptomatic, it is usually wise to start with the tooth that has noticeable issues with previous endo even though the lucency was more prominent around 22. This is not standard protocol and each case is different. PAs can be deceptive and even though 22 could be involved, I somehow knew 21 was the tooth to start with. Excessive exudate discharge through 21. Retreatment carries out with removal of GP and a separated instrument. 2 appointment procedure with caoh2 places for 4 weeks in between. Monitored in 3 months and now in 6 months with near resolution of the apical lucency also because it was in an acute stage rather than chronic that would show more bone loss. 22 didnt require any treatment but I will watch it as long as I can. . . #endodontist#endodontics #rootcanalspecialist #rootcanal #dental #dentalstudent #dentistry #dentaltrauma #endodontia #retreatment #dentistlife #patientcenteredcare #endodiagnosis @ Perth, Western Australia

13.01.2022 #37 with the typical C shaped anatomy with separate mesial canal. Its very interesting to note variations in C shaped canals and its racial prevalence. They are the most common in East Asian population with 50% prevalence and mostly common in mandibular 7s. Ive attached some studies as well as variations in canal anatomies is one of my fav.... . . . . #endodontist #endodontics #endodoncia #rootcanalspecialist #rootcanal #rootcanals #rootcanaltreatment #dentistry #rootcanalanatomy #endodonticsforgeneralhealth #dentist #australiandentist #gaurav_vasudeva_endo @ Perth, Western Australia See more

12.01.2022 Life cycle of a tooth with caries and 5 canal system. Almost 6 actually . #36 with SIP/SAP restored to start with and eventually became symptomatic hence extirpated and referred to me for continuation. Interesting anatomy, 3 distal canals with the middle distal canal merging with the DL once enlarged to no25. 3 mesial canals. After a long time Ive seen a middle mesial canal not merging with either ML or MB. Incidence of middle mesial is very low and a separate stand alon...e MM is less than 1%. Full service endo over 2 visits. 25 04. MM 20 04. Old mesial restoration removed and replaced with a brand new composite. Ready for a conservative onlay/crown. I only wish I got the opportunity to access the tooth to start with. On a funny note, patient during consult wished he had only 3 canals, after the 1st visit I advised him he had 5, nearly 6 . Permission to post. Happy weekend. Follow me on IG gaurav _vasudeva_endo https://www.instagram.com/p/CE_b65_JKm8/ . . . #endodontist #endodontics #rootcanalspecialist #rootcanals #rootcanalanatomy #dentist #dentalstudent #dentistry #dentistlife #endolife #worthsaving #saveyourteeth #endodontia #saveyourtooth #fullserviceendo

11.01.2022 My fav reviews, apico reviews although this one only 3 months. Shows what a difference it came make in such a short time. #21, infected cyst as I could remove most of the lining. Infected with granulation tissue though. Apico with retrograde BC putty fast set. Nice soft tissue healing in 10 days with 3 month follow up. Happy they dont have to loose the existing crown. ... Sometimes apicoectomies are far more conservative and convenient both for the patient and the clinician opposed to retreatments. I will follow up as long as possible. Permission to post/publish. . . . #endodontist #endodontics #roootcanalspecialist #rootcanal #perthdentist #sydneydentist #melbournedentist #brisbanedentist #endodontia #endodontistlife #microsurgicalendodontics #apico #savingyourteeth #endo #rootcanaltreatment @ Perth, Western Australia See more

11.01.2022 Yesterday I put this case on my story #endoquiznight. Young man, 7 years old with newly erupted max incisors had a little bump. #11 suffered an intrusive injury/luxation approx 2-3mm intrusion. Unlike permanent teeth with closed apices, immature teeth with large open apex have a much better prognosis hence a different management pathway. The key is to assess and reassess and let the body do its job. Most of these should extrude/reerrupt by themselves, idealist in 4-6 weeks.... A negative vitality test means nothing here. The pathophysiology is complex in traumatic teeth especially in young immature teeth where A-delta fibers are not fully developed/present. I will assess it again in 2 weeks and then again in 4-6 weeks. If there is no progress, there could be a possible gentle ortho extrusion applied. Any endodontic intervention is contraindicated especially in these cases with super thin dentinal walls. Endo will not achieve much unless there is a clear sign of infection and the tooth becomes symptomatic and no other option is left. Regeneration can be one good option left on that case or the tooth is doomed for sure in medium to long term. IADT is doing a great job in keeping things real and uniform across the world but there are still some differences in teaching and learning in different countries. There are two rules I follow in dental trauma: 1. Timing is everything 2. Sometimes less is more (treatment) Assess, reassess and assess again as long as possible. More info on recently published IADT guidelines https://onlinelibrary.wiley.com/doi/full/10.1111/edt.12578 . Follow me on IG: gaurav_vasudeva_endo . #endodontist #endodontics #rootcanalspecialist #dentaltrauma #dentaltraumaspecialist #rootcanal #savingyourteeth #endodontia #dentistry #dental #dentalstudents #iadt

11.01.2022 Further details and registration via link https://asewa.org.au/event-3827196

09.01.2022 1 year follow up today and I was so pleased to see this healing so well. This was diagnosed with deflated infected cyst with partially calcified canal. Patient was referred to an oral surgeon for surgical removal of the cyst/periapical curettage and alternately removal of the associated tooth. Create the right environment and the body knows how to heal itself . . . #endodontics #endodontist #rootcanal#rootcanals #rootcanalspecialist #rootcanaltreatment #dentistaustralia #dentist #dentalradiology #dentistlife #dentalstudents #endodonticsforgeneralhealth #saveyourtooth #gaurav_vasudeva_endo #worthsaving

08.01.2022 Another C shape. #47 with SIP/SAP. Reviewed today after 6 months. The basis of a good access prep is not always straight line access but just enough prep that will help you disinfect the canals well without compromising healthy tooth structure. Minimal prep onlay would suffice. . .... #endodontics #endodontist #rootcanalspecialist #endodontia #endodontistlife #rootcanals #rootcanal #dentistry #dentistlife #dentist #australiandentist #perthdentist #rootcanaltreatment #gaurav_vasudeva_endo See more

08.01.2022 I drive past this beautiful beach every other day while driving back home. Spring is is my favorite season after autumn and usually at this time the sun is ready to dip into the ocean with a flare. Today I finished a little early and decided to watch the sun go down over this beautiful beach. Simple pleasures of life #endodontist #endolife #perthsunset #simplepleasuresoflife

07.01.2022 #35 with 90 degree rotation. What you see is the mesio-distal and not the bucco-lingual. Treating this one really played with my head not because it had a crazy anatomy but also because of the orientation under the microscope. You can see my struggle on the multiple PAs taken. Could have been better but Im happy with what I could achieve here. Amazing teeth and amazing anatomies. ... Referred back to their dentist for coronal restoration and crown. Happy Friday folks. . . . . #endodontist #endodontics #rootcanal #rootcanals #rootcanalspecialist #endodontia #dentistry #dentistlife #perthdentist #australiandentist #rootcanalanatomy #savethetooth #gaurav_vasudeva_endo @ Perth, Western Australia

07.01.2022 Symptomatic lower left 2nd molar with AP. Conservative/minimally invasive endo, both access and prep. The idea and rationale of the new age endodontics as I like to call it is minimal intervention and invasion of the root canal system preserving the dentine and keeping the tooth and root anatomy as close to the original. Are we ready to restore such teeth with more conservative overlays?... Mesials 20 04, distal 25 04. Two visits. Eddy sonic activation of irritants. Sealer Endosequence BC high flow with WVC. Patient plans to replace the 1st molar with an implant. Would you place a crown of this 2nd molar? Perhaps a conservative onlay? Or nothing? Original post from my IG. https://www.instagram.com/p/CFhKxhUpeHO/ Case series updated biweekly . . #endodontics #endodontist #endodoncia #minimallyinvasiveendodontics #rootcanalspecialist #rootcanal #dentistry #dentist #conservativeaccess

05.01.2022 Lifecycle of a carious tooth. #36. The initial bitewing and PA is from a year ago. Tooth diagnosed with SIP/SAP and initial endo/pulp extirpation with their dentist. The pain disappeared/life got busy and hence didnt follow-up. 2nd visit 7 months ago, re pulp extirpation with a different dentist. Advised possible crack and ortho band placed. Finally, temp restoration chipped off and the band wasnt fitting well. Ortho band removed, all previous temp restorations removed, n...o crack found under the scope. Full service endo with composite core, 2 visits. 25 04, WVC. Not a perfect margin as I would have liked to see on PA/BW but I couldnt find any catch or loss of marginal integrity clinically. Hopefully can be polished off during the bonded onlay prep by my RD. Composites used- flowable/ Giomers and Packable SDI. How many people take PA/BW following proximal restorations? Do you like placing ortho bands? . . #endodontics #endodontist #rootcanalspecialist #rootcanaltreatment #rootcanal #endodontia #fullserviceendo #endoresto See more

05.01.2022 Sunday evening reading. Management of cracked teeth remains a dilemma as there is limited evidence and its variability is high. A great systemic review that I enjoyed reading. It reinforces what Ive always believed. Dont fear the crack, assess it and form a realistic expectation for survival that your patient is well aware of. 1 year survival rate of 89% isnt bad if we are buying more time to plan the next stage. ... If the teeth are associated with perio pockets due to the crack and there is specific bone loss associated on PA or CBCT, the prognosis worsens. I hope to see more evidence of a 5 year survival rate for cracked teeth in the future. Bottom line for now: Cracked teeth can be root canal treated as long as the dentist and patients are okay with medium term success with a low risk of failure in short term. Worth reading and some of these teeth are #worthsaving. . . #saveyourteeth #endodontist #endodontics #rootcanal #rootcanals #dentist #crackedtooth #dentalstudent #journalofendodontics #endodoncia #dentistry #rootcanaltreatment #dentistaustralia

05.01.2022 Full service endodontics #17. Patient in mid 50s. This one was almost unrestorable. Was advised extraction and implant replacement but wanted a 2nd opinion. A motivated patient is all we endodontists need to give teeth another chance . SAP with extensive caries 2mm plus subgingival. GIC placement to prepare the tooth for endo and replaced with composite post endo. ... Why did we choose to retain this tooth? Firstly, I am an endodontist? There is no better osteo-integration than already existing natural roots with perfectly functional periodontium associated with it. There is no better replacement of dentine and no implant material can match the resilience of it and finally if and when the tooth fails, we have a follow up treatment/replacement option. Referred back to my RD for a bonded onlay/crown. TGIF . #endodontist #endodontics #rootcanalspecialist #worthsaving #savingyourteeth #rootcanals #perthdentist #almostunrestorable #dental #dentistry #saveyourtooth

05.01.2022 Lovely patient 80 years old, medically compromised, undergoing chemo for cancer and few other conditions. My work gets so much more rewarding when I can add value to not just saving someones tooth but my work will make a difference to a patients life in terms of overall systemic health and qualify of oral health. I could have planned removal of the crown, posts and redone all endo with new crown etc etc but its not always about us. This is patient centered care and what is... the best option for them and how comfortable they are with the plan. Single appointment, no dramas. Microapical surgery with apicoectomy and retrograde fill with Bioceramic root repair fast set putty. The handling of this material is so much better than MTA. Follow my work on Instagram gaurav_vasudeva_endo . . #endodontics #endodontist #rootcanal #rootcanalspecialist #dental #dentistry #dentist #dentistlife #dentalstudent #dentistaustralia #patientcenteredcare #endodonticsforgeneralhealth #microapicalsurgery #microdentistry #microscopedentistry #bioceramics @ Perth, Western Australia See more

05.01.2022 #26 with SAP. 5 canal molar with an additional DB canal. I dont always go looking for it like I would for the MB2 but floor of the chamber has all the clues hidden. The incidence of an additional DB canal or DB2 is less than 1.5% and in this case it fits the vertuccis classification of type 2, which has a common apex with incidence of 0.4% according to literature. All you need is good microscope and more importantly better illumination and some handy ultrasonic tips to w...ork with. Some interesting cases to keep me going during these restricted times. . . . #endodontist #endodontics #rootcanal #rootcanaltreatment #5canalmolar #rootcanalspecialist #dentist #dentistry #perthdentist #dentistworkingduringpandemic #endodontia #microendodontics #rootcanalanatomy #dentalpain #dentalemergencies @ Perth, Western Australia See more

03.01.2022 Cracked tooth! Everyones favourite topic to discuss and a nightmare to treat. Dont fear the crack unless it is extending onto the pulpal floor and/or causing deep periodontal pockets. These signs show the crack is large or deep enough to cause periodontal attachment breakdown hence poor prognosis. Warning signs to look out for? 1. Vertical isolated bone loss associated with that tooth. 2. Deep, isolated periodontal pockets associated when there is no sign of periodontal... disease. Consider a High resolution, small FOV CBCT but many times simple clinical findings, BW and PA radiographs will reveal a lot. I have attached a system review paper on survival of cracked teeth that provided a very good assessment guide for what to look for during treatment planning. A case I recently completed: #36 with typical symptoms of pain on chewing, with SIP/SAP. Mild alveolar bone loss, causing grade 1 furcation involvement independent of the crack. Removed the entire old restoration Access prepared and looked for cracks Methylene blue staining Multiple hairline cracks extending from ext buccal to the internal wall but just stopping short of the pulpalfloor. One on the distal wall too, not too deep. All 4 canals prepared and obturated 25 04. It is important not to enlarge the canals too much and compromise of the pericemental dentine. Cracks removed. Best outcome is with the use of a carbide bur to cut into dentine. Flowable and packable composite buildup with wraparound techniques over non-stress bearing areas. Apologies for my composite polishing capabilities . Asymptomatic and functional. Ready for a bonded onlay/crown with my referring dentist. clinical cases and tips on IG: gaurav_vasudeva_endo . . #endodontics #endodontist #rootcanalspecialist #rootcanals #dental #dentistry #endodontistlife #crackedtooth #endodontia #savingyourteeth #endodonticsforgeneralhealth #saveyourtooth #worthsaving #patientcenteredcare @ Perth, Western Australia

03.01.2022 Case of the week. #11 with internal resorption very deep, mid to apical 3rd. #21 and #11 both with SIP/SAP. Patient doesnt recall any history of trauma though mild discoloration evident. Incisal access for both with warm vertical obturation followed by composite restoration done over two visits. Master file 35 0.04. Eddy sonic activation. .... . . #endodontics #endodontist #rootcanalspecialist #rootcanal #endodontia #rootcanaltreatment #rootresorption #internalresorption #incisalaccess #endodonticsforgeneralhealth #endodontistlife #dental #dentist #dentistry #dentalstudent #dentistryworld #gaurav_vasudeva_endo #perthdentist #australiandentist #saveyourtooth @ Perth, Western Australia See more

03.01.2022 #47 SAP started at the RD office. Calcified mesial canals with long narrow roots. Referred for continuation. Had to work hard with my no 6 and 8 SS k files and C plus too. WL of 28mm. As the access was already large, canals didnt need to be. Prepared to .04, 20. 31 gauge irrigation needles used here and ultrasonic activation. Referred back for a new coronal restoration and onlay as it would conserve the remaining coronal tooth structure. Not to miss tooth #46 endo done 30... years ago, no signs and symptoms or songs of leakage. Would you retreat that? . . . #endodontist #endodontics #rootcanal #rootcanalspecialist #dentist #dentistry #endodontia #rootcanaltreatment #dentistlife #microendodontics #minimalprep @ Perth, Western Australia See more

02.01.2022 Friday follow-up . I retreated 41 with SAP/abscess about 6 months ago. Two separate canals with separate apices. Treated over two visits. 6 months follow-up today. The lesion has greatly reduced and healing well. It is interesting to note the lesion also seemed to be associated with 31 and possible 32 has also reduced thus showing the importance of accurate diagnosis. No guess works with CBCT. The only tooth that really needed the retreatment was 41. We will monitor both ...41 and 31 for another 1 year or more if possible. Follow me on IG: gaurav _vasudeva_endo Happy Friday . . . . #endodontics #endodontist #rootcanalspecialist #rootcanal #rootcanals #retreatment #perthdentist #sydneydentist #melbournedentist #endodontia #dentalstudent #dentist #dentistry #apicalhealing #endodonticsforgeneralhealth @ Perth, Western Australia See more

02.01.2022 Saving a tooth opposed to loosing a tooth! That is all what basic dentistry is about. There are plenty of replacement options but would you rather loose a part of you for an artificial replacement? Endodontics is not fancy because the work isn’t visible, isn’t cosmetic or smile enhancing work rather it’s the foundation work. We all know what happens to structures with poor foundations. ... Tooth 17. Large and deep carious lesion with defective restoration, symptomatic, all 3 roots going their own way and on top of that a disto-buccal angulation of the tooth. I find such upper 2nd molars hardest to treat right from placing the rubberdam clamp to final restoration. Completed in 2 visits with final core composite. 90mins each appointment. Asymptomatic now, fully functional besides a happy patient who didn’t want to loose this tooth. I wish my RD the best of luck with the onlay/crown prep though #saveyourteeth #endodontics #endodontist #rootcanalspecialist #rootcanals #endodontia #restorativeendodontics #curvedcanals #dentistry #dental #dentalstudent #australiandentist #worthsaving

01.01.2022 A case from few months ago, started with my RD and completed with me. #26 with SIP/SAP remained symptomatic for a few weeks. I completed it in 2 appointments 4-5 weeks apart. Severe 90 degree mesial root curvature with separate MB1 and MB2. My thoughts on the work I did many months ago? I rarely use tapers more than 0.04 anymore. This one was prepared with variable greater taper files, probably one of my last cases with the instrument. Nothing against the system but Ive mov...ed on to more conservative and minimally invasive endodontics. Theres still not much evidence comparing longevity and difference in success rates of minimal preps vs conventional but conserving healthy dentine both coronal and radicular cant be a bad thing. . . . #endodontics #endodontist #dentist #dentistry #severerootcanalcurvature #endodoncia #endodontictips #rootcanalspecialist #rootcanaltreatment #rootcanal #australiandentist #dentistaustralia #perthdentist #curvedcanals @ Perth, Western Australia See more

01.01.2022 https://instagram.com/p/CHNYAxIplQa/

01.01.2022 Interesting and deceptive! Emergency access opening with my RD as patient was in severe pain. Even though all the canals seem patent, the mesials had excessive calcification right from the orifice to the apex. A slow and tedious struggle negotiating with no 6-8 k files. Besides the mesials were necrotic and both distals were vital and bled excessively. Typical SIP/SAP showing different stages of disease and pathophysiology in mesial and distal canals. Completed over two v...isits 20-25 04. Final restoration with flowable and packable composites. . . #endodontics #endodontist #endodontia #rootcanalspecialist #rootcanals #endo #worthsaving #saveyourtooth #australiandentist #dentistaustralia #dental #dentalcaries #endodonticsforgeneralhealth #fullserviceendo See more