https://ma-endo.co.uk/blog daily 0.75 2025-10-19 https://ma-endo.co.uk/blog/an-extra-dimension monthly 0.5 2022-08-29 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/47345a1b-67ff-44ae-97d4-7fe593becd71/CBCT+3.jpg Blog - An extra dimension - Make it stand out Further apically more pathology and anatomy can be seen, the apical radiolucency and the mental foramen. https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/e22d6947-6c32-4cb7-bfb8-a1ec113668cb/Post+op+PA+LR5.jpg Blog - An extra dimension - Make it stand out Post-op periapical radiograph shows well condensed obturation. https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/a52c5ca8-bad5-4209-adcd-ece586343dc6/CBCT+2.jpg Blog - An extra dimension - Make it stand out CBCT scan revealing the missed canal. https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/197e0721-1881-45d5-bfe0-c6b79bae772f/Pre+op+PA+LR5.jpg Blog - An extra dimension - Make it stand out This pre-op radiograph shows a root filled LR5 with an apical radiolucency and a radiolucent line running down the centre of the root. https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/190f16ed-0562-4dc7-ac6c-60da4a8ad1fd/Master+cone+PA+LR5.jpg Blog - An extra dimension - Make it stand out Intra-operative periapical radiograph confirming preparation of the missed canal to a good length. https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/22f378c7-bba1-44dd-878b-b45dd75bdc3a/CBCT+1.jpg Blog - An extra dimension - Make it stand out This CBCT view shows the DO restoration in the crown of the LR5. https://ma-endo.co.uk/blog/i-wrote-my-name-on-it monthly 0.5 2022-07-13 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/5b04ab86-2ada-4f15-9ea6-3b8a525fc10a/Screenshot+2021-11-08+at+22.07.08.png Blog - I wrote my name on it! - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://ma-endo.co.uk/blog/i-found-you monthly 0.5 2021-12-05 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1631722222858-NSZW3QY9JQMEEA92HAXL/WL+LR3.JPG Blog - I found you! - Make it stand out A radiograph is taken with a file in the canal to confirm correct location was achieved. https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1631721574192-KY5P951SIF4YXEM81Q4Y/PA+LR3.JPG Blog - I found you! - Make it stand out The root canal of the LR3 is just about visible on this radiograph. https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1631722865582-C2VS3QIZQB81M58ZSIHE/Post+op+LR3.JPG Blog - I found you! - Make it stand out Postoperative radiograph showing the canal successfully filled to the apex. https://ma-endo.co.uk/blog/its-just-a-flesh-wound monthly 0.5 2021-09-15 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1615050804259-5GAWO2RO333I6XEOLBL2/Pre+op+PA+LR7.JPG Blog - It’s just a flesh wound! - A fourteen year old was referred to me as they were experiencing pain from the lower right side. The periapical radiograph shows a deep carious lesion on the mandibular second molar that has breached the mesial pulp horn. It is also clear that there is incomplete root development. When I saw the patient I did a vitality test for this tooth which confirmed my suspicion that the tooth was still vital. This information decided the treatment, a vital pulp therapy. https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1615051429327-0OP65OZUJ9US6S3V1LG6/2+year+follow+up+LR7.JPG Blog - It’s just a flesh wound! - Two years and no symptoms later a review radiograph shows continued root development on the mandibular second molar. Great result! https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1615051132464-4VIO6GC3SUBM1FGPYOMD/Post+op+PA+LR7.JPG Blog - It’s just a flesh wound! - All the caries was removed under rubber dam isolation and the pulp was accessed. Inflamed pulp tissue to a depth of a couple of millimetres was removed with sterile instruments and the bleeding was stopped by applying pressure with cotton soaked in sodium hypochlorite. Mineral trioxide aggregate (MTA) was placed as a direct pulp cap. This has excellent biocompatibility and will allow the pulp to heal. I used white MTA as it does not discolour the tooth. This was given 10 minutes to set then a composite restoration was placed on top. https://ma-endo.co.uk/blog/let-me-c monthly 0.5 2021-03-06 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1615049197722-S6Q90OP9DJZNFKJNK0V7/LL7%2B%253D.jpg Blog - Let me ‘C’! - Once accessed I could see the the canals of this tooth it was clear that it was in a C-shape configuration. There was one clear canal in the mesial root and one clear canal in the distal root. The third canal was positioned just buccal to the distal canal. All three canals were prepared and irrigated thoroughly ready for obturation. https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1615048906633-6R73HNJ8ZP3WRAMLTADP/Pre+op+LL7.JPG Blog - Let me ‘C’! - This pulp chamber of this second mandibular molar was accessed by the referring dentist which helped in removing the pain that was troubling the patient. There is a radiolucency mesially which suggests there may still be some decayed tooth that needs to be removed. Otherwise, there seems to be nothing out of the normal with the root morphology. https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1615049653231-BN15I2RCJS8LYLC9VXVN/Post+op+LL7.JPG Blog - Let me ‘C’! - Once the canals were dried they were obturated with gutta percha using a warm condensation technique, and a GIC restoration placed to give a good coronal seal. All canals have a well condensed root filling and both canals are visible in the distal root. A really interesting case to treat! https://ma-endo.co.uk/blog/one-good-two-great-three-im-getting-excited-now monthly 0.5 2021-03-06 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1615047846398-RL0PRJ8W3H7HLE42DNQ3/Post+op+PA+UR6.JPG Blog - One, good. Two, great. Three, I’m getting excited now! - After preparing and irrigating all the canals, they were dried and obturated with gutta percha using a warm condensation technique. I need to take an angled radiographic view at the review appointment to really show up the three canals in the MB root. https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1615047021256-7YS73LHJEZUPYLV4U4MO/-%2BUR6.jpg Blog - One, good. Two, great. Three, I’m getting excited now! - After accessing the the pulp chamber I noticed the existing restoration had a well-sealed distal margin and decided to keep this in place as it will help keep the irrigant within the tooth. After accessing and preparing the main MB canal, I carefully removed dentine to locate the second MB canal. To my surprise I unearthed two extra canal orifices, the second and third MB canals. I mechanically prepared these canals and it became apparent that they both joined the main MB canal towards the apex. You can see all three MB canal orifices in a line and also the disto-buccal canal orifice above. https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1615046735173-B5JPIPUBMRBF4LYEA1TF/PA+UR6.jpg Blog - One, good. Two, great. Three, I’m getting excited now! - This patient was in pain due to an infected non-vital maxillary right first molar. He went to see an emergency dentist who got the patient out of pain by accessing the root canal system and dressing the canals with an antibacterial medicament. https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1615046460505-63LUBLHHODR74QAQJNQZ/MB2.jpg Blog - One, good. Two, great. Three, I’m getting excited now! - This second MB canal is located in a position mesial to a line drawn between the MB and palatal canal orifices. There is a characteristic lip of dentine covering the orifice which will prevent a handfile from negotiating the full length of the canal. Removing this lip of dentine with ultrasonic tips or goose-neck rose head burs is needed in order to prepare the canal. https://ma-endo.co.uk/blog/separated-instrument-removal monthly 0.5 2021-03-04 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614893480873-IE2O260JFL432TKFBZVX/Post+OP.JPG Blog - Separated Instrument Removal - Both the LL6 and LL7 were irrigated thoroughly, dried and obturated with gutta percha using a warm condensation technique. A zinc oxide eugenol seal was placed in the canal orifices and the access cavities were sealed with GIC. Ready for cuspal coverages. https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614893359181-L76A3CNTA4DBG0Y9KBBF/IMG_3452.jpg Blog - Separated Instrument Removal - A platform was created around the head of the broken file using a modified Gates Gliden bur (I removed he non-cutting tip with a bur and a fast handpiece). This allowed me to place an ultrasonic tip close to the head of the broken file and carefully remove dentine circumferentially. Once a sufficient amount of the broken file was exposed the ultrasonic tips was used in an anti-clockwise motion to unwind and remove the file. After much patience - success!!! https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614893422226-TVEIC0LWJMOGZKMKG3RZ/Broken+file+D+LR6.JPG Blog - Separated Instrument Removal - What I thought was success was only halfway there. I was able to fully prepared the mesio-lingual canal after removing the separated instrument from that canal - great! Unfortunately the file broke during the removal and a small piece found its way into the distal canal. Luckily this canal was already prepared and only needed irrigating the remove the final piece. https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614635076259-1URSM99Q5UCLWTF0VBXU/IMG_3067.jpg Blog - Separated Instrument Removal The offending instrument. https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614893165236-4OL3ZF2POVRGMPGE8MTD/Broken+file+LR6.JPG Blog - Separated Instrument Removal - Essential factors for the removal of a separated instrument are direct visualisation and unimpeded pathway of exit. The head of this broken file was visible in the mesio-lingual canal using high magnification and illumination. https://ma-endo.co.uk/fees daily 0.75 2025-10-19 https://ma-endo.co.uk/home daily 1.0 2025-10-19 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614516529274-M3U8RTU5SPNZW8GM0VZX/Protrait.jpg https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/f0bf083f-2c15-404b-baae-5565359b895d/post+op+PA+LL6.JPG https://ma-endo.co.uk/about-me daily 0.75 2021-12-24 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1616605789924-FI1AQL9LI9GIPNMIE6FC/IMG_2716%2B2.jpg About Me BDS (Lond.) 2013 MSc (Endo) 2019 GDC 245007 https://ma-endo.co.uk/how-to-refer daily 0.75 2021-12-24 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1615069159678-9ZT144KTD7N05NDJA1H6/unsplash-image-hjwKMkehBco.jpg How To Refer https://ma-endo.co.uk/contact-me daily 0.75 2021-03-13 https://ma-endo.co.uk/for-patients daily 0.75 2024-01-04 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614723087790-869XN9DXZDE0ZE75AM13/IMG_3061.jpg For Patients - We will make sure your treatment is pain free by numbing the tooth using local anaesthetic and a rubber sheet will be placed over your tooth ensuring an oral bacteria free working environment. Then, with the aid of magnification and illumination, an access cavity entry into the dental pulp area will be made. https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614724417128-8UWQX1GFLS33RJM91HRK/image.jpg For Patients - Slight discomfort after treatment is common and normally lasts a few days. Painkillers can be taken to ease the discomfort during this healing phase. Do not exceed the dosage advised on the packaging. If you would like to talk to us please find our contact information here. https://ma-endo.co.uk/testimonials daily 0.75 2021-04-11 https://ma-endo.co.uk/404 daily 0.75 2021-03-07 https://ma-endo.co.uk/privacy-policy daily 0.75 2021-03-13 https://ma-endo.co.uk/cases daily 0.75 2025-10-19 https://ma-endo.co.uk/cases/case-nine monthly 0.5 2021-03-06 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1615068739662-FECIHM0TBM6SCN9WOB91/Pre+op+PA+LR7.JPG Cases - Case Nine An occlusal carious lesion breaching the pulp horn of the second molar, the apices are not fully developed https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1615068739659-NAMSODUKKIZUWRMZERRA/Post+op+PA+LR7.JPG Cases - Case Nine Inflamed pulp tissue was removed with sterile instruments and bleeding was arrested, a biocompatible mineral trioxide aggregate direct pulp cap was placed followed by a composite restoration https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1615068739562-64TDDHY3XHI70F1X1G6N/2+year+follow+up+LR7.JPG Cases - Case Nine Two years and no symptoms later this PA shows continued root development of the second molar https://ma-endo.co.uk/cases/case-eight monthly 0.5 2021-03-02 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614725342430-4L6GJ8QDN7HHMUUJVLD2/44098428122RX-400ade36-1cca-481d-9449-3eb417d8015b-09102020-0.JPG Cases - Case Eight An apical radiolucency on the UL6 is one of the signs of apical periodontitis for this tooth https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614725342627-9WIW03WXJ1NDG7EAUYSO/PA+UL6.JPG Cases - Case Eight All four canals have well condensed root fillings with good apical-coronal seals https://ma-endo.co.uk/cases/case-seven monthly 0.5 2021-04-09 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614546165954-ZSQJEXW8PABFFDL7MEAK/Broken+file+LR6.JPG Cases - Case Seven A separated file can be seen in one of the mesial canals (turned out to be the mesio-lingual canal), luckily it was visible with the use of high magnification and illumination https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614546165662-BKFPWXIEP1B3FK9YU4HA/Broken+file+D+LR6.JPG Cases - Case Seven After removal of the separated instrument and full preparation of the canals an X-ray was taken and showed part of the file managed to enter the distal canal https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614546166815-LIUUJQJSG6UG527GW5TL/Post+OP.JPG Cases - Case Seven The last piece of the separated instrument was removed and all canals were filled with a good apical-coronal seal https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614546489911-J3L1AZKDL4BK3ZAHMH68/IMG_3067.jpg Cases - Case Seven The offending instrument https://ma-endo.co.uk/cases/case-six monthly 0.5 2021-02-28 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614528268650-89URGCHE6VM422CAQ2YU/pre+op+37.jpg Cases - Case Six Pre-op PA, the UR1 abutment has a sclerosed canal, there seems to be a radiolucency halfway down the root on the mesial side, maybe there is a lateral canal? https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614528268634-0WT5U1FK427TQGNWXTAN/post+op+37.jpg Cases - Case Six Post-op PA, well sealed canal from apex to root orifice, root canal sealer has revealed the suspected lateral canal https://ma-endo.co.uk/cases/case-five monthly 0.5 2021-02-28 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614527843990-9B081HHIZULI15PY6LA6/preop+UL6.jpg Cases - Case Five Pre-op PA reveals caries breaching the mesio-buccal pulp horn, both buccal roots are curving toward each other https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614527844380-0VGVTAF0NESJZ4PSCZKV/postop+UL6.jpg Cases - Case Five Post-op PA showing all four canals well filled with a good apical-coronal seal https://ma-endo.co.uk/cases/case-four monthly 0.5 2021-02-28 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614527001741-53BFM24UDVCGR0DWU7ZS/LR6+Pre+op.JPG Cases - Case Four Pre-op PA of the LR6 shows a mesial cavity opening into the pulp, the mesial canals seem sclerosed towards the apex, this is further complicated by an acute curvature https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614527001748-R30EII078WZQ2RLOU4BD/Post+op+LR6.JPG Cases - Case Four Post-op PA shows all canals well prepared to the apex https://ma-endo.co.uk/cases/case-three monthly 0.5 2021-02-28 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614526307475-3W3L9O1NGBF40HDVWVYQ/preop+LL6.jpg Cases - Case Three Pre-op PA of LL6 reveals a crown with a poor distal margin, poorly filled root canals and large periapical radiolucencies https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614526307480-RW1Z3BFDIO849TBCUCDW/postop+LL6.jpg Cases - Case Three Immediate post-op PA, the crown was removed to prevent re-entry of bacteria distally and allowed for better visualisation of the pulp floor https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614526308317-4II09ELY53ZKPXER80RH/12+month+LL6.jpg Cases - Case Three One year post treatment review, good bony healing is evident and a new crown with good margins is preventing re-entry of bacteria https://ma-endo.co.uk/cases/case-two monthly 0.5 2021-02-28 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614518745340-HYSCYN05UJJQ41E6HTUS/preop+UR5.jpg Cases - Case Two Pre-op PA of the UR5 shows the secondary carious lesion entering the pulp https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614518745362-4MK7T01BUUUEF7ID53ND/postop+UR5.jpg Cases - Case Two All three canals (not usual) were found and cleaned thoroughly, the two buccal canals were extremely close to each other and difficult to obturate https://ma-endo.co.uk/cases/case-one monthly 0.5 2021-02-28 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614518009440-OX1YTO5THI2L50AE2GUI/preop+LR7.jpg Cases - Case one Pre-op PA LR7 shows a large apical radiolucency (it was decided to remove the LR6) https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614518009464-GE9WPRV7BIAG00XGG1GG/postop+LR7.jpg Cases - Case one Immediate post op PA of LR7 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1614518009346-S3CMSDASBTQFY6EV6JL3/12+month+LR7.jpg Cases - Case one One year review PA shows complete healing of the bone https://ma-endo.co.uk/cases/case-ten monthly 0.5 2021-03-11 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1615496569255-FETAF3H3SV2SHZAPM2K4/UR6.JPG Cases - Case Ten The angle of this PA hid the true nature of the canal curvature https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1615496569254-12IVXVG9M85BLDWPLVO6/Post+op+PA+UR6.JPG Cases - Case Ten The fully obturated canals reveal the true nature of that extreme curvature in the mesio-buccal canal https://ma-endo.co.uk/cases/case-eleven monthly 0.5 2021-03-17 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1616013751712-3TX5L7BZ0UU58F6G5NKQ/ur6.JPG Cases - Case Eleven A suboptimal root filling on the UR6 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/1616013751219-IJS28ZPOY9H4SYGRV9TI/RX.JPG Cases - Case Eleven Post treatment with all canals filled with a good coronal-apical seal https://ma-endo.co.uk/cases/case-twelve monthly 0.5 2021-03-23 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/d0684941-68d0-45fd-a655-0668d319bb65/UL7.JPG Cases - Case Twelve UL7 with recently placed occlusal restoration, pulp calcifications can be seen https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/76fda245-aaa5-4d04-a176-c14ddc1251f4/post+op+UL7.JPG Cases - Case Twelve All canals are well obturated to length with a good apical-coronal seal https://ma-endo.co.uk/cases/case-thirteen monthly 0.5 2021-12-05 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/c235503b-07cd-41cd-b75a-d45d3019fbed/Pre+op.JPG Cases - Case Thirteen Pre-op PA revealing sclerosed canals on the UR6 and an apical radiolucency on the curved MB root https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/ba353817-5df0-4b69-bf3a-a8a89c45ebda/Post+op+2.png Cases - Case Thirteen Post-op PA showing a good apical-coronal seal in all four canals https://ma-endo.co.uk/cases/case-fourteen monthly 0.5 2022-02-20 https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/66a60032-b1c5-44c6-aa95-d8e1e66cc56f/PA+LL6.JPG Cases - Case Fourteen Pre-op PA of LL6 showing a deep DO restoration with secondary caries and apical radiolucencies. https://images.squarespace-cdn.com/content/v1/603b8b527b5f487d2f7852bb/54f0d377-078f-499f-aff5-03758f547220/post+op+PA+LL6.JPG Cases - Case Fourteen Post-op PA showing a good coronal-apical seal of all canals.