POV clinical presentation of RCT of tooth 12 from A to Z.

Añadido: 2026-05-05

[00:00:00]This 71-year-old female patient was referred to me for endodontic treatment of tooth number 12. As you can see, there is a periodical radiolucency associated with the tooth and patient had symptoms. Porcelain crown that is a few years old. Tooth was very tender to percussion and palpation. Probings were 2 to 3 mm. And here's the bite wing.

[00:00:22]So, we discussed options with her and she wanted to try to save the tooth and that's what we did.

[00:00:27]So, let's go on and take a look at the POV clinical video of this tooth.

[00:00:32]From A to Z, how I did this root canal from A to Z under a surgical operating microscope Accu-Vision X.

[00:00:43]Thank you.

[00:00:44]All right. Okay, so rubber dam is on.

[00:00:49]And we can see what we're doing here. Number 12.

[00:00:55]Right there. All right, very good.

[00:00:58]Let's go ahead and get this going.

[00:01:03]All right, so I don't use H2O, but definitely you guys use H2O.

[00:01:12]I'm going through the porcelain crown.

[00:02:02]All right, those let me have the center diamond, please.

[00:02:06]All right, as you can see, I went through the porcelain crown. That's the build-up material. Now, I'm using a a thinner end cutting diamond bur and let's get inside of this tooth.

[00:03:09]You okay?

[00:03:10]You all right? You moved a little bit.

[00:03:11]You all right, though?

[00:03:13]Did you feel anything? Mhm. No, okay.

[00:03:15]All right.

[00:03:18]All right, there was just that little reaction.

[00:03:46]All right, those going in.

[00:03:49]Little bit of air.

[00:03:51]All right. Okay, those let me have the ultrasonic, please. All right, so we're going to switch to ultrasonic now and open these calcified canals up.

[00:04:06]First, locate them.

[00:04:09]What do you have it on, those? Four.

[00:04:11]Uh put it on two for now to begin with.

[00:04:15]Thank you.

[00:04:24]And then I'll put some air in there, those.

[00:04:30]And so All right, so looks like I got the palatal canal.

[00:06:09]Okay, all right.

[00:06:12]Thank you. All right, let's see.

[00:06:14]Let me have explorer, please.

[00:06:18]Let's clean it up.

[00:06:22]Get this all this debris out of there.

[00:06:53]Okay. Let me have hypo, please. Those have the orifice opener ready.

[00:07:00]Please. Okay.

[00:07:02]6% hypo.

[00:07:04]Let's get rid of all the debris and particles.

[00:07:12]Thank you.

[00:07:14]And we keep going.

[00:07:35]Perfect. Thank you. All right.

[00:07:38]Let's get the orifice opener in there.

[00:08:18]Okay, let me have the yellow, please.

[00:08:22]All right, thank you. All right, have 6% hypo again. Let's clean it up.

[00:08:30]And let's see where we stand.

[00:08:51]Those let me have air, please.

[00:09:02]Thank you. Let's go in here.

[00:09:05]And get that air in there.

[00:09:11]Okay, I definitely definitely I think there is another canal here. Those let me have a 10, please.

[00:09:23]So, that looks like the palatal canal right there.

[00:09:29]So, let's try.

[00:09:31]Let's see if we can get the buccal canal here with a number 10 C file.

[00:09:39]Yep, right there. All right. That's the buccal canal.

[00:09:45]Number 10 C file attached to the M4 reciprocating handpiece running at 1,000 1,000 rpm.

[00:09:57]All right.

[00:10:01]that's the palatal.

[00:10:04]That's the buccal.

[00:10:07]All right, those let me have Let me have the orifice opener again.

[00:10:11]Thank you. Back in with 6% hypo.

[00:10:38]Perfect. Thank you.

[00:10:40]All right, let's see if you can get that orifice opener in there.

[00:11:08]I'm not forcing it or anything. I just want to see if it if I can open it up a little bit.

[00:11:15]Uh I think it needs a little bit little bit more help.

[00:11:23]Close, let me have a 15.

[00:11:26]Uh This can't find it. All right, let's try a 15 C file in that buccal canal.

[00:11:48]Thank you.

[00:11:50]All right, let's try the 15 C file.

[00:12:05]There it goes.

[00:12:19]All right, now let me have the orifice opener again.

[00:12:23]Please.

[00:12:40]Perfect. Thank you.

[00:12:43]All right.

[00:13:03]All right, let me have the hypo again. Close, let me have the micro suction.

[00:13:12]All right, so this take a look here.

[00:13:47]Thank you. All right, let's put that micro suction in there.

[00:13:56]Yes, the one and two.

[00:14:01]Very good.

[00:14:06]Okay, two canals.

[00:14:08]>> [snorts] >> All right, let's measure those.

[00:14:39]All right, next is we're going to use our electronic electric electronic apex locator.

[00:14:49]We have it set for our estimated working length.

[00:14:54]Estimated working length of 22, so let's see. All right.

[00:15:03]It looks like they join, one and two, one and two. I mean uh buccal buccal and palatal.

[00:15:17]All right.

[00:15:19]Yeah, it is maybe 19.

[00:15:34]Yeah.

[00:15:35]Tell me what this is, nurse.

[00:15:38]It's 20 and 1/2. All right, I'm okay with 20.

[00:15:42]All right, so let's go back in with hypo one more time, 6% hypo.

[00:15:52]Close, let me have a 15, please.

[00:15:57]20.

[00:16:06]Thank you.

[00:16:08]All right, so that's 20.

[00:16:20]20 C file.

[00:16:37]Up and down, up and down, brushing brushing motion.

[00:16:48]So, we're not only instrumenting, but also activating the 6% hypo sonically with the with this motion.

[00:17:01]All right, those I'm going to take the S2.

[00:17:05]All right, let's let's go in with S2 now to our working length from the super flexy gold series of uh files.

[00:17:29]Super flexy gold.

[00:17:34]Thank you.

[00:17:36]All right, so that's S2 from super flexy gold.

[00:17:45]I'm using it in a brushing motion again.

[00:18:01]All right, let's clean it up.

[00:18:05]And let's go to the palatal canal. Yeah, it looks like buccal and palatal join.

[00:18:13]It became one.

[00:18:17]Yep.

[00:18:19]All right, very good. Next file, which is the F1.

[00:18:31]Irrigating with 6% hypo again.

[00:18:58]Perfect. Thank you.

[00:19:00]All right, let's go back in with the F1 file.

[00:19:21]All right, those next one.

[00:19:23]I didn't see any shavings in the flute in the flutes of the file.

[00:19:30]So, I'm going to go to the next file, which is the F2.

[00:19:52]Perfect. Thank you.

[00:19:54]All right, let's go to F2.

[00:20:00]F2 is red. 25 Okay.

[00:20:12]I'm going to inspect the flutes and I can see a little bit of shaving.

[00:20:18]Not not a whole lot, so let's go ahead and go to the next file.

[00:20:25]All right.

[00:20:28]Again, irrigating with 6% hypo.

[00:20:47]Perfect, thank you.

[00:20:50]Let's go ahead and go to the next file.

[00:21:00]If you can give me a 30, please.

[00:21:02]Actually, two 30s.

[00:21:11]All right, I can see some shavings.

[00:21:17]All right.

[00:21:19]>> [snorts] >> Okay.

[00:21:26]And a lot of debris coming out.

[00:21:31]Let me have the micro suction again, please.

[00:21:34]I'm going to inspect the tooth again.

[00:21:42]At this point, I don't like to put air in the in the tooth, in the canals.

[00:21:49]Because I opened up the canals pretty pretty nicely.

[00:21:56]Thank you. Let's see.

[00:21:59]Let's do an inspection.

[00:22:08]Make sure we're not missing anything.

[00:22:12]And it looks like one canal up and down now.

[00:22:20]I don't see anything on the buccal side.

[00:22:26]And based on the x-ray, it also looks like you seems like you have there's one canal.

[00:22:32]Let me have the explorer, please.

[00:22:36]Okay.

[00:22:56]All right. Okay.

[00:22:58]Hypo, please, and let's activate it.

[00:23:04]Thank you. We're going to use the the Surfy one.

[00:23:15]Sonic activator Thank you.

[00:23:21]Sonic activator by 8th teeth.

[00:23:24]Surfy one Sonic activator, you can purchase it from Flexi Bow Dental.

[00:23:31]Basically, everything I'm using you can purchase from Flexi Bow Dental.

[00:24:06]All right, very good. Thank you very much.

[00:24:09]All right, we're going to go back in with 6% hypo again.

[00:24:39]Excellent, thank you. All right, let's cone fit.

[00:24:43]So my ruler number 30 got a percha 04 was soaking in 6% hypo for the past few minutes.

[00:25:02]I also do this with the gutta-percha.

[00:25:04]That's another form of activating the 6% hypo. I got a pretty decent tug back.

[00:25:16]All right, let's measure this. See if we need to make make any adjustments.

[00:25:21]My working length was 20 and 1/2.

[00:25:26]And this is 20 This is 20 and 1/2. I wish you could see it 20 and 1/2 perfectly. All right, very good.

[00:25:34]Everything is going great.

[00:25:36]We're going to do a final rinse with 70% iso isopropyl.

[00:25:48]That's okay.

[00:26:09]Perfect, thank you very much.

[00:26:12]All right, micro suction.

[00:26:16]And next, we're going to use our sterile paper points.

[00:26:26]We're going to take the sterile paper point to working length.

[00:26:34]No more, no less.

[00:26:39]I'm going to measure measure it to 20 and 1/2.

[00:26:45]20 and 1/2 and let's get the canal nice and dry.

[00:26:56]Also, inspect the paper point.

[00:27:00]Just to make sure there is no oozing or anything like that.

[00:27:06]One more paper point.

[00:27:09]Sterile paper point to working length.

[00:27:13]Very good.

[00:27:14]Inspect it nice and dry.

[00:27:17]Next paper point again to working length.

[00:27:25]All right, I'm going to dip it in AH Plus.

[00:27:29]This is AH Plus again.

[00:27:32]Coat the walls of the canal with AH Plus.

[00:27:46]Very good.

[00:27:51]I'm going to measure uh let me measure this. Make sure.

[00:27:59]Coat the gutta-percha cone master gutta-percha to my working length.

[00:28:12]All right.

[00:28:14]Let's see if I need to use the other one, too.

[00:28:17]No, I'm okay.

[00:28:19]All right, very good.

[00:28:20]Next, I'm going to I take the 1 and 1/2.

[00:28:23]Next, I'm going to use System B to remove the coronal part of the gutta-percha and thermoplasticize the rest.

[00:28:37]All right, very good.

[00:28:40]B and un plugger to condense the thermoplasticized gutta-percha.

[00:28:49]I'm going to apply some apical pressure and hold for a few seconds.

[00:28:58]Very good.

[00:29:01]Apical pressure and hold.

[00:29:16]Excellent, very good.

[00:29:19]All right, and Obtura gun to backfill the rest of the canal.

[00:29:28]I'll take the two, please.

[00:29:30]All right, thank you very much.

[00:29:48]Next, I'm going to use 70% isopropyl alcohol on a cotton pellet to clean the pulp chamber and the walls nicely.

[00:30:34]All right, very good.

[00:30:38]Thank you, 70%.

[00:31:00]Mhm, then I'm going to air dry it.

[00:31:16]I'll fill them, very good. Sterile sponge goes in and then cavity.

[00:31:26]Sterile sponge goes in.

[00:31:30]We're going to use There you go.

[00:31:37]One of the girls will help me place the We usually use the all metal condenser for this purpose.

[00:31:48]All right.

[00:31:51]Cavity goes in with the all metal condenser.

[00:32:00]All metal condenser.

[00:32:03]Thank you very much.

[00:32:05]All right.

[00:32:16]All right, very good.

[00:32:25]And I'm going to activate it with some H2O on a cotton pellet.

[00:32:36]And that's it, we're all done.

[00:32:40]We're going to remove the rubber dam, take a couple of PAs, and go over some instructions, and patient's going back to her dentist with a permanent restoration. Excellent, great. Thank you all.

[00:32:54]Thank you, girls.

[00:32:57]Here's the post-op. As you can see, everything went beautifully. Look at that. Nice lateral right there with a little puff and puff right there.

[00:33:05]Everything went beautifully, as you saw in the POV clinical video, and you saw that we temporized it, temporized the tooth, and patient is going back to her dentist for the permanent restoration.

[00:33:15]If you like videos like like this, the POV clinical videos, make sure you subscribe to my channel.

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[00:33:58]So, TikTok's better than Instagram and Facebook, but YouTube is definitely the right platform for these types of videos. So, um very good. Excellent. See you guys next time. Bye-bye.