Portfolio - Case of the Month

August 2021 | Dr.Jojo Kottoor


Dr Stephen Cohen appreciating Dr Jojo Kottoor's work

September 2020 | Dr.Frency Joseph

A case with one canal orifice noted clinically in the coronal and middle third aspect, three apical splits were negotiated apically

Mandibular premolars are called endodontic enigma as there are many anatomical variations. Vertucci et al found that 25.5% of 400 mandibular premolars had two apical openings and 0.5% of the teeth had three apical openings. Presenting a ReRct case of mandibular first premolar with three or possibly four POE, History of root canal treatment about 10 years back. The patient came with symptomatic apical periodontitis, Multiple visit Rct with CaOH as ICM for two weeks, Only one canal orifice noted clinically in the coronal and middle third aspect, three apical splits were negotiated apically, Final apical preparation till 4% 25, Sonic (Endoactivator), Ultrasonic( U files) and Manual Dynamic agitation of irrigation solutions(17% EDTA, 5% Na Hypo, 2% CHX), I was not successful in inserting the three mastercones simultaneously into the apical splits.So checked the master cone fit by inserting into two canals at a time. So placed two of master cones initially and ultrasonic spreder used to soften and remove the coronal gp till the apical splits, then again Mani flare spreaders used as spreader and inserted gp to the other split. Rdaiographs were taken in between the procedure to check the placement, Sealer used -Zno eugenol sealer, Zical ( prevest), Obturation technique - Ultrasonic aided Latetal compaction. Interestingly sealer flowed into one more accessory canal which i couldn't recognize earlier. Core build up done with composites. Hope the tooth will serve for many more years.

August 2020 | Dr.Frency Joseph

A case with very narrow and long root canals with severe curvature

Root canal treatment of 24 and 27, 27 with very narrow and Long root canals with severe curvature, WL -22mm(MB and DB), 23mm(P), Final apical preparation -4% 25, Instrumentation done in crown down manner, Coronal two third enlargement with Protaper S1 universal, 8, 10 K- files to full WL, Proglider used as glider rotary file to full WL followed by Herogold 4%20, 4%25 to full WL in sequence, Continuous irrigation and patency filing done inorder to prevent blockage.Irrigation- 5% Na hypo (20 ml ) and 17% EDTA (1 ml ), Manual and Sonic agitation of irrigation solutions, Final irrigation done with Truanatomy needle. Obturation technique- Ultrasonic aided lateral compaction, Sealer used- Zinc Oxide Eugenol sealer(Zical, Prevest), Orifices sealed with Blue flow composite(Anabond), Core build up with composites.

July 2020 | Dr.George Jacob, All For Roots, Cochin

A case for retreatment

Patients aged 14 years with periapical lesion of 1 to 1.5 cm

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