A 55-year-old woman presented to my office for root canal treatment on tooth No. 19. She had been experiencing generalized discomfort throughout this region intermittently for the past 2 years. About one year ago, her general dentist noticed a crown fracture in tooth No. 19 and recommended a full-coverage crown in an attempt to alleviate the patient’s symptoms. However, the symptoms persisted. She was then referred to my office for endodontic evaluation and treatment. After evaluation, her chief complaint was isolated and reproduced in tooth No. 19. The endodontic diagnosis was pulp necrosis with symptomatic apical periodontitis (Figure 1).

A Perfect Match

Root canal treatment was initiated and the access was completed through the existing lithium disilicate crown. Crown replacement was not recommended because the crown was relatively new and the margins were well sealed. Endodontic treatment was completed over 2 visits with an intracanal medicament of calcium hydroxide for 2 weeks. The canals were sealed with a bioceramic sealer and gutta percha (Figures 2 and 3). The deepest portion of the access was restored with Visalys Fill. To provide the best esthetic result with her new crown, Visalys Flow was used for the occlusal 3 mm of restoration, along with adjunctive use of hydrofluoric acid etch and a silane coupler (Figure 4).

Written by Ryan M. Walsh, DDS

It’s a common saying that nonetheless bears repeating, especially when it comes to the wealth of dental materials available, and it’s this: not all

materials perform equally. This is especially noticeable when we compare color-matching technology, a claim many products make but that is not always equal across the board.

In my experience, the Visalys line of restoratives from Kettenbach offers very effective color-matching capabilities. In particular, Visalys Flow truly has a chameleon effect. Its formulation allows it to blend seamlessly into existing porcelain, zirconia, and ceramic materials, providing me with highly esthetic restorations. It’s made the Visalys line of materials a frequent go-to in my restorative armamentarium.

In My First Case

A 55-year-old woman presented to my office for root canal treatment on tooth No. 19. She had been experiencing generalized discomfort throughout this region intermittently for the past 2 years. About one year ago, her general dentist noticed a crown fracture in tooth No. 19 and recommended a full-coverage crown in an attempt to alleviate the patient’s symptoms. However, the symptoms persisted. She was then referred to my office for endodontic evaluation and treatment. After evaluation, her chief complaint was isolated and reproduced in tooth No. 19. The endodontic diagnosis was pulp necrosis with symptomatic apical periodontitis (Figure 1).

A Perfect Match

Root canal treatment was initiated and the access was completed through the existing lithium disilicate crown. Crown replacement was not recommended because the crown was relatively new and the margins were well sealed. Endodontic treatment was completed over 2 visits with an intracanal medicament of calcium hydroxide for 2 weeks. 

The canals were sealed with a bioceramic sealer and gutta percha (Figures 2 and 3). The deepest portion of the access was restored with Visalys Fill. To provide the best esthetic result with her new crown, Visalys Flow was used for the occlusal 3 mm of restoration, along with adjunctive use of hydrofluoric acid etch and a silane coupler (Figure 4).

Visalys Core + Flow = Case Success

My second case concerns a 37-year-old man who was referred for endodontic evaluation with pain in tooth No. 13 from biting ever since the crown was seated 2 weeks prior. After clinical testing, the endodontic diagnosis was symptomatic irreversible pulpitis with symptomatic apical periodontitis. Root canal treatment was recommended (Figure 5).

Again, because of the new restoration, replacing the crown was not recommended. A conservative endodontic access was completed through the crown. Root canal treatment was performed with rotary instrumentation and obturated with gutta percha using a bioceramic sealer (Figure 6).

A fiber post was anticipated for the final restoration. The post was bonded into the canal space using Visalys Core. The occlusal-most portion of the restoration was restored with Visalys Flow with the aid of a zirconia primer (Figure 7).

An Amazing Trio

In my experience, the combination of Visalys Flow, Visalys Fill, and Visalys Core provides an amazing restorative complement for any endodontic treatment. Visalys Flow is particularly well suited to seal endodontic accesses through crowns and bridges because of its amazing Flex Shade System. This shade matching effortlessly blends into the adjacent restoration and camouflages the endo access.The result is a highly esthetic restoration which leads to a happy patient and a happy dental team.

About the Author:

Dr. Ryan M. Walsh attended the University of Iowa where he completed both his biology and dental degrees. He continued his education at Texas A&M College of Dentistry where he received his specialty certificate in endodontics and Master of Science degree in oral biology. Dr. Walsh is a board-certified diplomate of the American Board of Endodontics and an adjunct clinical professor at Texas A&M College of Dentistry.

The Go-To Products Used in These Cases

Leave a Reply

Your email address will not be published. Required fields are marked *

  • Archives

  • Categories

  • Recent Posts

  • Newsletter sign up

     


  • Spam Blocked

  • Upcoming Events

    March 2024
    M T W T F S S
     123
    45678910
    11121314151617
    18192021222324
    25262728293031
  • Categories

  • Archives

  • Categories

  • Recent Posts