We take the time to carefully identify the problem. This includes taking a detailed history, examination, radiography, relevant tests and frequently high resolution Cone Beam CT imaging. When all the facts are gathered together, it is then possible to make a diagnosis and determine what is the appropriate treatment.

If you are a dental care professional, you know what we do! Wherever possible, our approach is conservative, high-precision, minimally invasive treatment to preserve as much tooth structure as possible. If the tooth has a well-fitting crown, we do everything possible to preserve it by conservative minimally invasive work. With re-treatment it may be feasible to work selectively on one or two infected roots to preserve the crown and tooth structure.

If conservative re-treatment is not possible, and the root apex is anatomically accessible, it may be feasible to retain the tooth by apical microsurgery. The entire procedure from local anaesthesia, incision, apicectomy, retro-seal, flap closure through to suturing is performed with high accuracy using the operating microscope.

A critical first step is to identify the type, location and extent of root resorption. Conventional radiography has many limitations for accurate diagnosis, whereas high resolution Cone Beam CT provides exceptional diagnostic clarity. Treatment may include an internal or external approach, or a combination, occasionally monitoring. With internal root resorption, laser activated irrigation (Fotona Lightwalker with SWEEPS®) provides for enhanced cleaning and removal of resorption tissue.

In advanced cases of root resorption with extensive damage or inaccessible sites, extraction may be warranted. High resolution Cone Beam CT is crucial for defining any factors that may impact on prognosis.

Most dentists are comfortable with initial post-trauma management. If need be, contact us for advice. High resolution Cone Beam CT can provide valuable data regarding the presence of undisclosed root fractures. Generally, trauma cases require close monitoring; sometimes, intervention (e.g. Cvek pulpotomy, root canal treatment, apexification) is necessary following a dental traumatic injury.

When viewed under high magnification with the operating microscope, most teeth have cracks. Whether treatment is necessary depends on the location and depth of the crack, symptoms and radiographic findings. Whilst cracks are typically beyond the resolution of what can be seen on a CT scan, high resolution Cone Beam CT imaging can provide invaluable data of the adjacent bone. For example, a V-shape radiolucency at the adjacent alveolar crest is a strong indicator of a deeper crack. Sometimes, dismantling previous restorations and direct visual inspection with the operating microscope is the best way to assess crack depth and restorability.

Most dentists are comfortable with whitening vital teeth using a bleaching tray. For non-vital and root filled teeth, internal bleaching offers a conservative option to lighten a discoloured tooth. Before commencing bleaching on a previously root filled tooth, high resolution Cone Beam CT is useful to exclude periapical pathology. Accurate diagnosis is essential because some discoloured teeth are much more responsive to bleaching and have a more favourable outcome.