Beautiful video. I love how you're so candid with your viewers. I believe every single *social media* dentist now a days only wants us to learn how perfect their cases are and how they've never made a mistake. You're the complete opposite. You make us learn from your mistakes. God bless you.
Most FB posts are “look how great I am. This will not help or advance anybody except my ego. “. I try to limit my posts to “I stink at abc procedure. Any tips ?”
@@jsvlad Pride does not get us farther in any way. Yes document your cases so that you can show how great you are, but bragging on social media does not look well.
I really appreciate that you leave mistakes in or little things that don't go as planned. I think we learn more from presentations like these than ones where everything goes as scripted. For instance, we've all had material blow out of a too narrow of a tip. You could have edited that out, but leaving it in is real world approach. Super thankful for your awesome videos, lectures, humility. Very nice to see...literally!
Recently i had a similar bleed from a ML Canal in a Lower First Molar that just wouldn't stop. I even irrigated for more than 30 minutes. At the end i placed CaOH in the canal (was a hunch lol). I rewashed and did my irrigation and it had stopped. Sometimes we learn by accidents.
Such an important topic! Ive never had a problem getting a canal to stop bleeding until this week. Then, the next day, I had another one! Thanks for the video man!
Hey man. Thanks for the comment. You just have to make sure that there isn’t extra tissue in the canal - this is a huge reason why cases still bleed. Using this tech will mask it and the case may fail.
Have you tried hydrogen peroxide with paper points ? It stops like magic. Dip paper points in to h2o2. Keep in canal 1-2 min. Probably repeat 2-3 times and boom it will stop.
Check with EAL for perforation and recheck WL. Patients on blood thinners too can bleed noticeably. In such cases placement of astringent can quickly stop the bleeding. Place a piece of gelfoam instead of cotton pellet before placing temporary. A carefully placed gelfoam piece to the apex (especially in a wide canal) and BC sealer can make a good obturation.Ocassionally unidentified MB2 can also be a cause
Great video!! In cases like this, I usually put calcium hydroxide using a lentulo spiral. At the end of the procedure, rinse up all the medication and proceeded with sealing. Clearly, BC sealer works faster.
Hi Doctor, great tip. I have come across the same scenario few times. I have used Paper point dipped in aluminium chloride solution for a minute inside canal followed by irrigation with Saline and PATS and obturation with Bioceramic sealer if the bleeding doesn't happen again. Incase the bleeding resumes while using PATS, i used Calcium hydroxide intracanal paste and let them heal for few days.
BC sealer needs moisture to set. My theory is that when the BC sealer was extruded it set and formed a plug at the orifice which caused the bleeding to stop. Sometimes I use a little viscostat at the tip of a paper point at working length to stop my bleeding canals due to overextension of files
Thanks for the informative video Doc. Can I ask when we go for single-visit endodontics, or double-visit? I tend to do double visits for all my RCT patients regardless of the cause of necrosis/SIP/SAP. Thank you ☺️
I use alcohol on paper points to try to dilute and remove water molecules in the apical third - - the internal canal surfaces are porous and dentine itself is moist- ( so i see problem with oil based paste Or resin pastes-- the Capillary action at an inflamed apical foramen may also re wet your apical third after you think you have it completely dry - ( entombed bacteria may grow in moisture) - - as you said what you remove is more important than what you put in - The apical foramen ( the major point of leakage ) is usually Oval - so our circular gutta percha points cannot of themselves obturate any apical foramen - it is the paste coating the GP That makes the microscopic seal at the apical foramen - and that cannot be done without some degree of extrusion - we would hope that the biocompatible "puffs" have only a short term irritation
After put in the bc sealer with paper point, did you irrigated with saline solution or hypo? thanks for the video!I had a similar case in a young patient, I have a clearer idea of how to handle it a lot of thanks
I had a root canal 4 weeks ago and it just never stopped showing symptoms. I wish i had watched your videos before having it done. Ended up extracting the tooth. The tooth showed no infection on xrays. Is it safe to extract a tooth which may have bacteria from infected pulp leakage?
Hello Doc, I just wanted to ask you something, I had my teeth filled in my second molar area, after a week, it feels numb and somtimes hurts especially when I drink water. is this normal?
Great video. One of my colleagues recommends soaking a paper point in viscostat (clear) and placing it within the hemorrhaging canal. Let that paper point sit for a minute and see if that helps with the heme. What are your thoughts on that?
The puff may irritate the patient - absolutely. Depending on your training, a puff is either ideal or not. Dr. Ricucci has a great video here that talks about that. ua-cam.com/video/DH7oOOjt0eE/v-deo.html
At around 13:07, you say that the buccal canal of maxillary second molar commonly bifurcates. Are there any cues that you can use to see if the actual canal bifurcates or not? Im using 4.5x magnification, but I still dont know what I need to look for!
may i know in such symptomatic cases with bleeding issues, normally wait for how long prior for obturation or even cleaning shaping ? 3 days will it be sufficient? Or I have to wait for at least 1 week to recall patient to continue the treatment
I had once a canal that did not stopped bleeding - and it also was sooo painful - like the blood was pooling right between the end of the root and the bone...
You are not afraid of that over instrumentation that u did ? I mean from what I learned that even the sealers are not supposed to cross the apical foramen , i saw some cases with over instrumentations , I noticed that there is an apical resorption happened , i know it will take a long time to any preapical disease to happen if there anything wrong, just want to learn how to do the perfect decisions in case with over instrumentation
Does the patient feel pain at the bleeding canal? Got a patient, 9y/F, tooth 34. She was still bleeding even after an hour of irrigation and she also felt pain. Later I found out she never took the prescribed medication. But does that even affect the bleeding/pain?
Hi there. I just created a video for our private fb group associated with my endo course - but I think it may help you. I’ll upload it and send you the link through here.
Hello dr,ℹQuestion for youℹ,why there is differences in measurement of working lentgth while using same number rotary & hand files? (Ex : 25 red rotary file shows 20mm whereas 25 red hand file shows 17 mm of working length)
Hello pls i need help i saw your vid about class 3 and class 2 elastics fixing midlines for it to go to the left but my mindlines going to the right and my ortho did the same thing, class 2 on left & class 3 on right what do you think i should do? Can i just switch them?
Hello there, I have got a patient finished with Prep didn't bleed but after drying while reinserting GP noticed moisture..tried several paper points and the moisture would not stop just from that canal. Wondering if max sinus is the cause as it's from mesiobuccal canal.
I whish I could work with you together. After years of studying in Germany it is not allowed to me to work as a dentist. I passed 15 of 16 tests in the last exams. 8 years wasting time 😢
Great video! I do the same, but i close it temporarily and then reopen it after a coupe of weeks. Do you find you got better results if you do this in one sitting?
Hello. I have a question about my case. Maxillar right canine. During lateral condensation blood came from canal and I fill the canal that way. Now after 1 week patient saying he has a few ache on that tooth. Can the bleeding cause the pain?
Do you have any ideas on treating a hypersensitive tooth? I originally accessed and dressed with ledermix and left for 2 months. Then on reaccess tried to remove the nerve with a barbed broach but only got little pieces out, still with the tooth hypersensitive on filing. We put La down the canal to combat this and tried to spiral fill ledermix further down the canal, but ended up with ++ bleeding. We haven’t managed to get an apex reading yet due to the bleeding and hypersensitivity. Any tips to finish this RCT and remove the hypersensitive nerve?
I think it depends on where you live. I’m not 💯 sure what is permitted by Health Canada her (other than bc sealer) - hence-I don’t know of other products other than what it is marketed as elsewhere - iRoot. I think edge endo has a new ceramic sealer as well. You could ask on a dental fb page as well
Ive had this twice happen to me, maybe you can shed some light on it. Ive worked at 2 different offices with 2 different materials. After immense nonstop bleeding... i put Calcium Hydroxide in the bleeding canals (of course it didnt stop bleeding...) but the blood turns GREEN!! I am defeated... so i close up with as much CaOH as I can put into the canal while its still actively bleeding green goop, then I cotton pellet and cavit. From now on I am doing BC sealer, but any ideas why CaOH makes it green?
Beautiful video. I love how you're so candid with your viewers. I believe every single *social media* dentist now a days only wants us to learn how perfect their cases are and how they've never made a mistake.
You're the complete opposite. You make us learn from your mistakes. God bless you.
I absolutely agree
Most FB posts are “look how great I am. This will not help or advance anybody except my ego. “. I try to limit my posts to “I stink at abc procedure. Any tips ?”
@@jsvlad Pride does not get us farther in any way. Yes document your cases so that you can show how great you are, but bragging on social media does not look well.
I really appreciate that you leave mistakes in or little things that don't go as planned. I think we learn more from presentations like these than ones where everything goes as scripted. For instance, we've all had material blow out of a too narrow of a tip. You could have edited that out, but leaving it in is real world approach. Super thankful for your awesome videos, lectures, humility. Very nice to see...literally!
Agreed
One other tip I picked up somewhere is you can use endo ice on a paper point, insert it to the canal and it will stop the bleeding immediately.
Recently i had a similar bleed from a ML Canal in a Lower First Molar that just wouldn't stop. I even irrigated for more than 30 minutes. At the end i placed CaOH in the canal (was a hunch lol). I rewashed and did my irrigation and it had stopped. Sometimes we learn by accidents.
You mean in the next visit ,you rewashed the canal with sodium hypochlorite?
Such an important topic! Ive never had a problem getting a canal to stop bleeding until this week. Then, the next day, I had another one! Thanks for the video man!
Hey man. Thanks for the comment. You just have to make sure that there isn’t extra tissue in the canal - this is a huge reason why cases still bleed. Using this tech will mask it and the case may fail.
I love your work, please keep it posting. -dental student
Great video. I had this today, did not understand what was going on, but now after I saw your video I understand it much better.
you take paper point and freeze it with endo ice and place it for a minute, repeat until its dry.
Have you tried hydrogen peroxide with paper points ? It stops like magic. Dip paper points in to h2o2. Keep in canal 1-2 min. Probably repeat 2-3 times and boom it will stop.
Check with EAL for perforation and recheck WL. Patients on blood thinners too can bleed noticeably. In such cases placement of astringent can quickly stop the bleeding. Place a piece of gelfoam instead of cotton pellet before placing temporary. A carefully placed gelfoam piece to the apex (especially in a wide canal) and BC sealer can make a good obturation.Ocassionally unidentified MB2 can also be a cause
Great video!! In cases like this, I usually put calcium hydroxide using a lentulo spiral. At the end of the procedure, rinse up all the medication and proceeded with sealing. Clearly, BC sealer works faster.
Saludos doc, aquí en las mismas
👍
@ Buena!!
Your videos are just amazing ! Best solutions to our day to day ENDO problems
PDL bleeding. Happenes to me in vital cases. In such I put calcium hydroxide for a day or two. Next visit bleeding is gone.
What does calcium hydroxide do
Just happened to me today, I just put Calcium Hydroxide and hopefully next visit the bleeding is gone
Canada uses FDI tooth numbers! Thank heavens and all praise to Gob!
Hi Doctor, great tip. I have come across the same scenario few times. I have used Paper point dipped in aluminium chloride solution for a minute inside canal followed by irrigation with Saline and PATS and obturation with Bioceramic sealer if the bleeding doesn't happen again. Incase the bleeding resumes while using PATS, i used Calcium hydroxide intracanal paste and let them heal for few days.
This video was very interesting very successful good luck
BC sealer needs moisture to set.
My theory is that when the BC sealer was extruded it set and formed a plug at the orifice which caused the bleeding to stop.
Sometimes I use a little viscostat at the tip of a paper point at working length to stop my bleeding canals due to overextension of files
This was really helpful. Thank you!
Bleeding stops because bc sealer contain calcium. And calcium is part of coagulation factors cascade.
Omg. Is that it?!
@@AllThingsDentistry haha yes 😇! Not magnesium or smth else! Just calcium!
amazing job! i hope you keep making more videos like this one
someone please explain the obutration step I'm a little bit confused🤦🏻♀️
Hi there. I learned this tech from @realworldendo If you search bc sealer Allen Nasseh you will learn from the guru!
Thanks for the informative video Doc.
Can I ask when we go for single-visit endodontics, or double-visit?
I tend to do double visits for all my RCT patients regardless of the cause of necrosis/SIP/SAP.
Thank you ☺️
thanks :)
I use alcohol on paper points to try to dilute and remove water molecules in the apical third - - the internal canal surfaces are porous and dentine itself is moist- ( so i see problem with oil based paste Or resin pastes-- the Capillary action at an inflamed apical foramen may also re wet your apical third after you think you have it completely dry - ( entombed bacteria may grow in moisture) - - as you said what you remove is more important than what you put in -
The apical foramen ( the major point of leakage ) is usually Oval - so our circular gutta percha points cannot of themselves obturate any apical foramen - it is the paste coating the GP That makes the microscopic seal at the apical foramen - and that cannot be done without some degree of extrusion - we would hope that the biocompatible "puffs" have only a short term irritation
Your videos are helpful but too lengthy
After put in the bc sealer with paper point, did you irrigated with saline solution or hypo? thanks for the video!I had a similar case in a young patient, I have a clearer idea of how to handle it a lot of thanks
Hypochlorite 17:42
Thanks for sharing. Great stuff.
I use Ca(HO)2 all the time the same way instead of sealer to stop bleeding from over instrumentation
great work thanks for the info
I had a root canal 4 weeks ago and it just never stopped showing symptoms. I wish i had watched your videos before having it done. Ended up extracting the tooth. The tooth showed no infection on xrays. Is it safe to extract a tooth which may have bacteria from infected pulp leakage?
Hello Doc, I just wanted to ask you something, I had my teeth filled in my second molar area, after a week, it feels numb and somtimes hurts especially when I drink water. is this normal?
I usually irrigate with 3 % hydrogen peroxide or even with lidocaine with 1:100.000 epinephrine and bleeding stopped.
wait what ?! if you had a proper tugback how could that cone slip down ?! nice case tho , but drop this portrait mode :)
Great video. One of my colleagues recommends soaking a paper point in viscostat (clear) and placing it within the hemorrhaging canal. Let that paper point sit for a minute and see if that helps with the heme. What are your thoughts on that?
Puff doesn't irritate the patient? Is it necessary to make a puff ?
The puff may irritate the patient - absolutely. Depending on your training, a puff is either ideal or not. Dr. Ricucci has a great video here that talks about that. ua-cam.com/video/DH7oOOjt0eE/v-deo.html
At around 13:07, you say that the buccal canal of maxillary second molar commonly bifurcates. Are there any cues that you can use to see if the actual canal bifurcates or not? Im using 4.5x magnification, but I still dont know what I need to look for!
Hi there. Let me take a look at the cases I hav e recorded with a case like this and post it.
usualy I irigate with alustat
may i know in such symptomatic cases with bleeding issues, normally wait for how long prior for obturation or even cleaning shaping ? 3 days will it be sufficient? Or I have to wait for at least 1 week to recall patient to continue the treatment
I played calcium hydroxide intracanal medicament, leave it for 5 days and then go for bmp
Hello doctor
Did you restore this tooth with a full coverage crown or something else?
Good doctor but talking a lot we need short time videos
Hey Doc question, have you stopped using your endoactivator?
Do you refund the patient for your mistakes? I'm in terrible pain right now due to an inexperienced doctor.
I had once a canal that did not stopped bleeding - and it also was sooo painful - like the blood was pooling right between the end of the root and the bone...
You are not afraid of that over instrumentation that u did ? I mean from what I learned that even the sealers are not supposed to cross the apical foramen , i saw some cases with over instrumentations , I noticed that there is an apical resorption happened , i know it will take a long time to any preapical disease to happen if there anything wrong, just want to learn how to do the perfect decisions in case with over instrumentation
Just do 2 visit rct in such cases. Place syringe based calcium hydroxide paste from orikam . NEOCAL. Next visit canals will be dry
Can someone explain on a chemical level why sodium chloride is used and what it does?
Does the patient feel pain at the bleeding canal? Got a patient, 9y/F, tooth 34. She was still bleeding even after an hour of irrigation and she also felt pain. Later I found out she never took the prescribed medication. But does that even affect the bleeding/pain?
Hi there. I just created a video for our private fb group associated with my endo course - but I think it may help you. I’ll upload it and send you the link through here.
what s solution u have done hypochlorite de sodium
Hello dr,ℹQuestion for youℹ,why there is differences in measurement of working lentgth while using same number rotary & hand files? (Ex : 25 red rotary file shows 20mm whereas 25 red hand file shows 17 mm of working length)
just take a paper point with hydrogen peroxide 30 percent, put it in the kanal. After 10 sec repeat until is no bood anymore
Hello pls i need help i saw your vid about class 3 and class 2 elastics fixing midlines for it to go to the left but my mindlines going to the right and my ortho did the same thing, class 2 on left & class 3 on right what do you think i should do? Can i just switch them?
Can anyone tell me what exactly did he do to stop the bleeding canal, I didnt watched the whole video ?
how to anesthetize a Hot tooth?
Hello there, I have got a patient finished with Prep didn't bleed but after drying while reinserting GP noticed moisture..tried several paper points and the moisture would not stop just from that canal. Wondering if max sinus is the cause as it's from mesiobuccal canal.
I guess by now we now questions are not answered.
I whish I could work with you together. After years of studying in Germany it is not allowed to me to work as a dentist. I passed 15 of 16 tests in the last exams. 8 years wasting time 😢
Ur from which place?
Great video! I do the same, but i close it temporarily and then reopen it after a coupe of weeks. Do you find you got better results if you do this in one sitting?
do you place something in the cavity in between the two appointments?
Try an all tissue laser like Waterlase😊
Hello. I have a question about my case. Maxillar right canine. During lateral condensation blood came from canal and I fill the canal that way. Now after 1 week patient saying he has a few ache on that tooth. Can the bleeding cause the pain?
What scope iPhone adapter do you use?
nice
Do you have any ideas on treating a hypersensitive tooth? I originally accessed and dressed with ledermix and left for 2 months. Then on reaccess tried to remove the nerve with a barbed broach but only got little pieces out, still with the tooth hypersensitive on filing. We put La down the canal to combat this and tried to spiral fill ledermix further down the canal, but ended up with ++ bleeding. We haven’t managed to get an apex reading yet due to the bleeding and hypersensitivity. Any tips to finish this RCT and remove the hypersensitive nerve?
Sir your lectures are good , but kindly speak a little bit slower
But it's difficult to apprehend the different concepts in fast manner
irrigation with what (product)?
what is being said at 6:18? what kind of instrument is that? thanks!
Use endo ice
I do not know why is this becoming a trend again but vertical mode is terrible
Please suggest economical alternative to bc sealer
.
I think it depends on where you live. I’m not 💯 sure what is permitted by Health Canada her (other than bc sealer) - hence-I don’t know of other products other than what it is marketed as elsewhere - iRoot. I think edge endo has a new ceramic sealer as well. You could ask on a dental fb page as well
Ceraseal (metabiomed) 👌🏻
Hypo irrigation stops bleeding 🧐
It didnt for me, went full strength but still bleeding
Ive had this twice happen to me, maybe you can shed some light on it. Ive worked at 2 different offices with 2 different materials. After immense nonstop bleeding... i put Calcium Hydroxide in the bleeding canals (of course it didnt stop bleeding...) but the blood turns GREEN!! I am defeated... so i close up with as much CaOH as I can put into the canal while its still actively bleeding green goop, then I cotton pellet and cavit. From now on I am doing BC sealer, but any ideas why CaOH makes it green?
Iron in blood and hydroxide from the CaOH creates a greenish by product
Should have sent her to the hygienist before doing the restorations- biiiiig lump of calculus distal of 17
watching videos filmed like this gives a headache even the content is great or not
I wouldn’t let this guy no where near my teeth.
Someone please reply this comment when it starts!
Diri deginir un rappel tjik notification
Hello
@@burmeseodyssey476 thanks!!