Endo Retreatment with CBCT Showing Transported Canal with a Perforation

Craig Berry

Endodontist, Diplomate



Introduction to the case

Fun retreatment. Patient had RCT on 9, which was retreated by another endodontist 5 years ago. Patient developed pain and swelling in the area. CBCT revealed a transported canal with a perforation. I was able to locate the canal and hopefully save the tooth!


Composite Full Mouth Rehab Using Activa Bioactive Restorative

Introduction to the case

This is one of my most MacGyver cases to date. This patient has extensive damage from wear and erosion and was ready to restore his mouth before it gets any worse. He is now a faithful nightguard wearer but nonetheless, those masseters made me really nervous.

I like to test drive big cases in composite before committing to porcelain because if they’re going to be breaking stuff, it sure helps to figure out why and correct it before proceeding to finals. You can certainly do it with just a bisacryl overlay but it tends to pop off and you can’t really leave it on as a buildup. Doing the mockup in a real composite allows you to break the teeth up individually for flossing and allow them to wear it longer. It also serves as a buildup by filling in deficient areas of tooth.

In this case, I generated a template from a waxup and used it to injection mold the intraoral mockup. The contacts were broken by inserting mylar strips interproximally.

I chose to use Activa here for a variety of reasons. It is injectable, it’s dual cure, it doesn’t have to have a bonding agent, and it is very resistant to wear and chipping. The bioactive aspect is icing on the cake making it far less likely to have secondary decay.


16yo Non-Compliant Ortho Patient with Large Anterior Carious Lesions

Jonathan Held

General Dentist

Sioux Falls, SD


Introduction to the case

16 year old female presented with full ortho maxilla and Mandible. Patient had been in ortho for 2 years. Patient had very poor oral hygiene and presented with generalized decay in posterior and anterior, as well as deep carious lesions around ortho brackets. I called referring orthodontist to discuss case and patient’s hygiene regimen. Orthodontist stated that patient’s ortho treatment plan would last at minimum another year if we continued treatment. We made the decision to discontinue orthodontic treatment to address deep decay and improve oral hygiene. A few posterior teeth with deeper decay were addressed first and then we addressed anterior teeth following prophylaxis and a few weeks of healing. Full extent of decay was visualized following removal of brackets. Treatment plan included restoring anterior teeth with composite restorations with future need for full coverage crowns once patient’s homecare improves. Patient was seen in one visit to remove maxillary anterior decay and restore with Filtec Supreme Ultra composite. Greater curve bands were used for all restorations. Pictures show pre-treatment and post treatment, with a 2 week follow-up.