Contents at a Glance

A. Direct composite restorations

B. Tooth Bleaching
C. Minimally invasive preparation using air abrasion
D. Endodontic cases
E. Surgical cases
F. Esthetic cases treated with fixed prosthesis
G. Interdisciplinary cases
 Dr. Kanika Yadav
Dept. of Conservative Dentistry and Endodontics
Goa Dental College and Hospital

Under the guidance of

Dr. Ida de Noronha de Ataide
Professor and Head of Dept.
Dept. of Conservative Dentistry and Endodontics
Goa Dental College and Hospital
A. Esthetic cases treated with direct composite
1. Case 1: Peg shaped lateral incisor treated with direct composite
2. Case 2: Anterior teeth diastema treated with direct composite on #11, 12,21,22
3. Case 3: Direct composite laminates on # 12,13,23,33,34
4. Case 4: Class III, IV, V carious lesions treated with direct composite on # 11, 12,
21,22,23
5. Case 5: Class V carious lesion on # 11,12,21,22,23 treated with indirect pulp
capping with Biodentine and direct composite restorations

B. Tooth bleaching
6. Case 1: Discolored tooth treated by root canal treatment and
intracoronal bleaching
7. Case 2: Discolored teeth treated by intracoronal bleaching of #11 and
extracoronal bleaching of anterior teeth.

C. Minimally invasive preparation using air abrasion

8. Case 1
D. Endodontic cases

Direct pulp capping with Biodentine

9: Case 1

Avulsion
10: Case 1

Apexification using Biodentine

11: Case 1

Apexogenesis using PRF

12: Case 1

Management of discolored calcified tooth

13: Case 1

Endodontic management of different configurations of C shaped canals

14: Case 1
15: Case 2
16: Case 3
Endodontic management of second molar with pulpal floor perforation and C
shaped canal
17. Case 1

Endodontic management of teeth with extra canals

18. Case 1 : Mandibular first molar with middle mesial canal
19. Case 2 : Mandibular first premolar

Management of complicated crown fracture using fragment reattachment

20. Case 1

Management of radix entomolaris and bilateral conservative post endodontic

restoration with fiber reinforced composite and CAD – CAM onlay
21. Case 1
E. Surgical cases

Management of periapical cyst using PRF

22. Case 1

Management of Endodontic – Periodontal lesion

23. Case 1

Management of vertical root fracture

24. Case 1

F. Esthetic cases treated with fixed prosthesis

25. Case 1: Grossly carious anterior tooth treated by root canal treatment, cast post core
and zirconia crown on # 21
26. Case 2: Ellis class III fracture treated by root canal treatment, fiber post core and
zirconia crowns on # 11, 21, 22
27. Case 4: Ellis Class III fracture treated with zirconia crowns on # 11, 12 and
complicated crown fracture of # 22 treated with reattachment of fractured
fragment
G. Interdisciplinary Cases

28. Case 1: Ellis III fracture and caries treated with orthodontic extrusion of #22, cast
post core and metal ceramic crowns on # 21, 22
29. Case 3: Caries, protrusion and diastema treated with fiber post core and
metal ceramic crowns on #11, 21
Esthetic cases treated with direct composite
Case 1: Peg shaped lateral incisor treated with direct composite
Case 2: Anterior teeth diastema treated with direct composite on #11,
12,21,22
Case 3: Direct composite laminates on # 12,13,23,33,34
Case 4: Class III, IV, V carious lesions treated with direct composite on # 11,
12,21,22,23
Case 5: Class V carious lesion on # 11,12,21,22,23 treated with indirect pulp
capping with Biodentine and direct composite restorations
 Peg shaped
Direct Composite lateral
Restorations : Case 1

Peg shaped lateral incisor treated with direct composite

Preoperative intraoral view

Postoperative intraoral view

Preoperative and Postoperative anterior view

Preoperative Postoperative
smile view smile view
 Diastema Closure
Direct Composite Restorations : Case 2
Diastema closure with direct composite on # 11, 12, 21, 22

Preoperative intraoral view

Postoperative intraoral view

Preoperative and Postoperative anterior view

Preoperative Postoperative
smile view smile view
 CDirect Composite Restorations : Case 3

Direct Composite laminates on # 13, 12, 23,33,34 ositelaminate

Preoperative intraoral view

Postoperative intraoral view

Preoperative and Postoperative anterior view

 Direct Composite Restorations : Case 4

Preoperative intraoral view

Postoperative intraoral view

Preoperative and Postoperative anterior view

Preoperative Postoperative
smile view smile view
 Direct Composite Restorations : Case 5
Class V carious lesions treated with diet modification followed by caries excavation,
Biodentine placement and direct composite restorations

Preoperative intraoral view

Caries excavation Biodentin placement Composite restoration

Preoperative and Postoperative anterior view

Preoperative Postoperative
smile view smile view
Tooth Bleaching

Case 1: Discolored tooth treated by root canal treatment and

intracoronal bleaching
Case 2: Discolored teeth treated by intracoronal bleaching of #11 and
extracoronal bleaching of anterior teeth.
 Tooth Bleaching : Case 1
31 year old female patient reported with tooth discoloration in # 11 and history of trauma 5 years
prior . History of previous root canal treatment in #11 6 months prior. Treatment plan comprised
of intracoronal bleaching of #11 and extracoronal bleaching of anterior teeth.

Preoperative viewview Preoperative radiograph

Intracoronal bleaching Extracoronal bleaching Postoperative view

Preoperative anterior view Immediate Postoperative anterior view

Preoperative shade Postoperative shade

 Tooth Bleaching : Case 2
26 year old female patient reported with discoloration in # 21 and previous history of trauma
and root canal treatment 6 years prior. Treatment plan included intracoronal bleaching

Preoperative viewview Preoperative radiograph

Intracoronal GIC barrier Bleaching agent in pulp chamber Postoperative view

Preoperative shade Postoperative shade

Minimally invasive preparation using air abrasion
Case 1
 Minimally invasive preparation using air abrasion

Preoperative intraoral view Highlighted hypoplastic area

Hypoplastic enamel exposed Cavity preparation Air abrasion unit

for cavity preparation completed

Composite restoration Preoperative and Postoperative smile views

Endodontic cases
Direct pulp capping with Biodentine
Case 1

Avulsion
Case 1

Apexification using Biodentine

Case 1

Apexogenesis using PRF

Case 1

Management of discolored calcified tooth

Case 1

Endodontic management of different configurations of C shaped canals

Case 1
Case 2
Case 3

Endodontic management of second molar with pulpal floor perforation and C shaped canal
Case 1

Endodontic management of teeth with extra canals

Case 1
Case 2

Management of complicated crown fracture using fragment reattachment

Case 1

Management of radix entomolaris and bilateral conservative post endodontic restoration with fiber reinforced composite
and CAD – CAM onlay
Case 1
 Direct Pulp Capping with Biodentine
21 year old male patient reported with Ellis class III fracture in # 21 following trauma. Treatment
plan involved direct pulp capping with Biodentine followed by composite restoration.

Preoperative intraoral view Pin point pulpal exposure

Biodentine placed Postoperative intraoral view

Preoperative radiograph Biodentine placed Post operative radiograph 1 year follow up

 Avulsion
13 year old male patient reported with avulsed tooth # 11 and lost tooth # 21. Extraoral dry
time was more than 24 hrs. Treatment plan included extraoral root canal treatment followed
by reimplantation and splinting for 3 weeks.

Preoperative intraoral and radiographic view Avulsed tooth

Immmediate
Incomplete closure Apical 3mm plug of Root canal treatment reimplantation view
of the apex Biodentine placed completed extraorally
Post splinting radiograph 3 months follow up photograph and radiograph

RPD fabrication and try in Post operative view

Preoperative anterior view Post operative anterior view 8 months follow up

 Apexification with Biodentine
19 year old male patient reported with discolored and fractured #21 with a history of trauma 10
years prior. Incomplete closure of the apex was seen radiographically. Treatment plan involved
apexification with Biodentine followed by fiber post core and zirconia crown placement.

Preoperative intraoral view Preoperative intraoral radiograph

4mm apical plug of Fiber post try in Fiber post cementation

Biodentine
 Tooth preparation Zirconia coping try in Crown cementation

Preoperative intraoral view Postoperative intraoral view

9 months follow up
radiograph

Preoperative Postoperative
smile view smile view
 Apexogenesis with Platelet Rich Fibrin (PRF)
14 year old female patient reported with extraoral swelling on right side of the face. Radiograph revealed periapical
radiolucency and open apex in # 11, 21. Patient reported history of trauma 4 years prior. Treatment plan involved
PRF placement in the root canals after canal disinfection.

Preoperative extraoral view Preoperative intraoral view Preoperative radiograph

PRF packed inside the MTA placement

Root canal debridement, PRF preparation
canals 3mm below CEJ upto CEJ
Triple antibiotic paste
placement PRF ac
 Radiograph showing MTA
Post operative radiograph Post operative extraoral view
plug placement

Preoperative
Postoperative
view
view

Preoperative radiograph 3 months follow up 6 months follow up

 Endodontic management of a discolored calcified tooth
Patient reported with pain and discoloration in #21 and history of trauma 2 years prior.
Reported history of previous dental treatment of #21 three months prior.

Preoperative intraoral view Preoperative radiograph

Access opening Canal located using Munce bur Located canal

Munce bur
 Working length radiograph Master cone radiograph Postobturation radiograph

Intracoronal GIC barrier Intracoronal bleaching Fiber reinforced composite

Preoperative intraoral view Postoperative intraoral view 1 year follow up

Endodontic management of different configurations of C shaped canals
Preoperative Working length Master cone Postoperative
radiograph radiograph radiograph radiograph
Case 1

Case 2

Case 3
Management of second molar with pulpal floor perforation and C shaped canal
41 year old male patient reported with pain in # 37. Patient also reported previous dental
treatment 3 months prior.

Preoperative photograph and radiograph Perforation repair with Bodentine

Working length Master cone Postoperative

radiograph radiograph radiograph

Post endodontic restoration with fiber reinforced composite

 Endodontic management of teeth with extra canals
Case 1: Mandibular first molar with middle mesial canal

Preoperative
Access opening Working length

Master cone Post obturation Postoperative

Case 2: Mandibular first premolar

Preoperative Working length Master cone Postobturation

 Management of complicated crown fracture using tooth fragment reattachment

30 year old male patient reported with complicated crown fracture in #11,21,22. Treatment
plan included reattachment of fractured fragment #11 , zirconia crowns on #21, 22.

Preoperative intraoral view After removal of fractured fragment

Fractured fragment Fiber post trial Etching of fractured fragment

stored in saline
Reattachment of fractured #21, 22 crown preparation
fragment Zirconia crown cementation

Preoperative view Postoperative view

Preoperative Postobturation Post space Post operative 15 months

radiograph radiograph preparation radiograph follow up
 Management of ONLAY
Endodontic management of radix entomolaris and bilateral conservative postobturation
restoration with CAD CAM onlay
Patient reported with undermined caries involving pulp with intact occlusal enamel in #36
and #46 . # 46 had radix entomolaris. Treatment plan involved recording occlusal anatomy
prior to root canal treatment followed by CAD CAM onlay .

#36 and 46 preoperative radiographs Preoperative intraoral view

Casts to record intact Access cavity preparation of #33 and # 34

occlusal anatomy
Root canal treatment of #36 and #46 Fiber reinforced composite placement
inside the cavity

Onlay cavity preparation of #36 and #46 Crown lengthening of #46

CAD CAM onlay fabrication

 Post operative intraoral views of # 36

Post operative intraoral views of # 46

1 year follow up radiographs and photograph

Surgical cases

Case 1
Management of periapical cyst using PRF

Case 2
Management of Endodontic – Periodontal lesion

Case 3
Management of vertical root fracture
 Surgical management of periapical cyst using PRF : Case 1
21 year old male patient reported with extraoral swelling on right side of the face and intraoral
palatal swelling on right side. Patient also reported history of trauma 1 year prior and previous
dental treatment 3 months prior. Radiograph revealed large periapical radiolucent lesion in
relation to # 11,12, 13 and multiple perforations in # 11

Preoperative extraoral view Preoperative intraoral view

Preoperative radiograph Preoperative CBCT views

Intraoperative radiographs showing perforations Working length and master cone radiograph

Perforation repair with Biodentine Fiber reinforced post and core

 Flap reflection Surgical enucleation Retrograde filling
of cyst with MTA PRF preparation

PRF placement inside Immediate post Crown preparation

the bony defect 8 months follow up
surgery radiograph

Crown cementation 14 months follow up

 Management of Endodontic- Periodontal lesion : Case 2
35 year old male patient reported with pain on food lodgement in #46 and generalised bleeding
from the gums. Clinical and radiographic examination revealed a 6mm deep periodontal pocket
Root canal treatment was completed and 3 months later a periodontal open flap debridement
and bone graft placement was done

Preoperative view Preoperative radiograph Working length radiograph Master Cone radiograph

Postoperative radiograph Flap refection and debridement Intraoral sutures placed

6 months follow up 6 months follow

radiograph up photograph
 Management of vertical root fracture : Case 3
Patient reported with recurrent pain and gradual increase in mobility over a period of 6 months
in # 11. History of previous treatment of the same tooth 1 year prior.

Root canal treatment

Preoperative radiograph Guttapercha tracing of sinus

2 months follow up-

unresolved sign and symptoms CBCT views showing no fracture 7mm deep periodontal
or extra canal pocket, vertical crown- root
fracture seen on removing
composite restoration

Fiber reinforced composite Exploratory periodontal surgery

build up
Methylene blue dye stained Vertical fracture line on
vertical fracture line Tooth extraction
mesial and distal aspect

Sealing of the fracture

Reimplantation of tooth and splinting
with light cure GIC

Splint removal after 3 weeks 4 months follow up

Esthetic cases treated with fixed prosthesis
Case 1: Grossly carious anterior tooth treated by root canal
treatment, cast post core and zirconia crown on # 21
Case 2: Ellis class III fracture treated with root canal treatment,
fiber post core and zirconia crown on # 11, 21, 22
Case 3: Ellis Class III fracture treated with zirconia crowns on #
11, 12 and complicated crown root fracture treated with
reattachment of fractured fragment
 Esthetic restoration of anterior teeth : Case 1

31 year old female patient reported with grossly carious #21. Treatment plan involved root
canal treatment, followed by cast post core and zirconia crown placement

Preoperative photographs
Preoperative radiograph

Cast post cementation

Post space preparation Post pattern fabrication
Zirconia coping try-in Bisque try-in Crown cementation

Preoperative anterior view Postoperative anterior view

Preoperative smile view Postoperative smile view

 Esthetic restoration of anterior teeth : Case 2

19 year old male patient reported with Ellis class III fracture in # 11,21,22. Treatment
plan involved fiber post core and zirconia crown cementation.

Preoperative intraoral view

Fiber post core and Polyvinyl siloxane Zirconia crowns mounted

crown preparation impression on stone cast

Zirconia coping try in Zirconia crown cementation

Postobturation Post space preparation Fiber post cementation Post operative

Preoperative intraoral view Postoperative intraoral view

Preoperative smile view Postoperative smile view

 Esthetic restoration of anterior teeth : Case 3
20 year old female patient reported with Ellis class II fracture in # 21. Ellis class III fracture in
# 11, #12, #22. Patient preserved fractured fragment of #22. Treatment plan involved
reattachment of # 22, zirconia crowns on #11, #12. Composite restoration # 21.

Fractured fragment Fiber post cementation

Preoperative intraoral view stored in saline

Composite build up of #21,

Reattachment of fractured fragment Crown preparation of # 11,
#11, #21,
#12

Preoperative and postoperative

Bisque try in Crown cementation anterior view
Interdisciplinary Cases

Case 1: Ellis III fracture and caries treated with orthodontic extrusion
of #22, cast post core and metal ceramic crowns on # 21, 22
Case 2: Caries, protrusion and diastema treated with fiber post
core and metal ceramic crowns on #11, 21
Case 3: Management of diastema, peg shaped laterals and gummy
smile with orthodontic treatment, crown lengthening and composite
build up
 Interdisciplinary Case: 1

Patient reported with Ellis class III fracture in #21 , 22 and grossly carious 22. Treatment plan
involved was orthodontic extrusion of #22 followed by cast post core and crown placement on
#21, #22

Preoperative intraoral view

Composite build up of #22

Slow orthodontic extrusion 2mm extrusion in 2 months Gingivectomy

Post and core pattern fabricated Metal post cementation

PFM crown cementation
Preoperative Post orthodontic Intraoperative Postoperative
radiograph Extrusion radiograph radiograph radiograph

Postoperative anterior view

Preoperative anterior view

Preoperative Smile view Post operative Smile view

 Interdisciplinary Case: 2
21 year old female patient reported with carious, discolored and proclined upper anteriors.
Treatment plan involved fixed orthodontic treatment followed by fiber post core and metal
ceramic crown placement on #11, 21.

Preoperative intraoral view

Post orthodontic treatment views

Fiber post try in Core build up and crown preparation PFM crown cementatopn
 Lateral view
Lateral view

Smile view

Preoperative Intraoperative Postoperative

radiograph radiograph radiograph 6 months follow up
 Interdisciplinary Case: 3

Crown lengthening

Post ortho frontal view Post ortho lateral views

Diastema closure and peg shaped laterals build up