My Casebook
This is a series of case reports I published last year, but I have now updated it with a new case. This case adds another interesting perspective to the debate. Read the old as well as the newly updated article.
Added: 2014-08-27 14:43
Medical aid societies are loathe to for more than three radiographs per single canal tooth. Is this fair and just?
Added: 2013-08-15 18:09
Added: 2014-08-27 14:43
Medical aid societies are loathe to for more than three radiographs per single canal tooth. Is this fair and just?
Added: 2013-08-15 18:09
Another example of successful "extreme" endodontics.
Added: 2013-08-09 17:26
Is it important to fill lateral canals?
Added: 2013-03-06 16:50
Added: 2013-08-09 17:26
Is it important to fill lateral canals?
Added: 2013-03-06 16:50
Every day patients are confronted with the dilemma of exercising their legal right in terms of their dental tretment. Dentists are obliged to inform their patients about the nature of their oral diseases, the various alternatives regarding treatment and the advantages, disadvantages, complications and costs of all treatment options. In particular patients are often faced with the difficult choice of having a tooth extracted as opposed to having it treated by means of a root canal treatment. This article presents a few guidelines for dentists and patients .
Added: 2008-12-27 11:39
Irrationality in Dentistry - 2016-08-23
Today I had the opportunity to view three dental fillings I did 33, 31 and 30 years ago. It gave me reason to reflect on a lifetime of work, my personal philosophy and the insanity that is currently the rage in the world of dentistry. I know that I am approaching my sell-by date. My painful left elbow and hand, over... more
Non-vital Bleaching: A Case Report - 2015-10-23
The patient, a 24 year old male, requested treatment for a severely discoloured anterior tooth (Figure 1) The treatment consisted of re-treatment of the root canal and non-vital bleaching. This was accomplished in three brief appointments. Non-vital bleaching is a tried and tested, non-invasive treatment. Gui... more
Case Report: Amalgam, the only choice that made sense. - 2015-10-22
Some professionals claim proudly that they “don’t do amalgam” anymore. Others even propound the untruth that “amalgam is dangerous.” Thirty seven years ago, at university I was told that amalgam restores “only” function, and not esthetics. This may be true, but it is equally true that amalgam is a... more
Extreme Endodontics, or Plain Common Sense? A Case Report - 2015-09-09
The patient, a senior female government official of an European country, was posted to Mozambique for an extended period. Prior to her departure for Africa she consulted her dentist in Europe for her complaint of vague discomfort in the right maxilla. Examination showed the presence of a fixed thr... more
Extreme Endodontics, or Plain Common Sense? A Case Report - 2015-09-09
The patient, a senior female government official of an European country, was posted to Mozambique for an extended period. Prior to her departure for Africa she consulted her dentist in Europe for her complaint of vague discomfort in the right maxilla. Examination showed the presence of a fixed three unit porcelain ve... more
Treating Chronic Orofacial Pain by Root Canal Treatment: Two Case Reports - 2014-03-12
Treating Chronic Orofacial Pain by Root Canal Treatment: Two Case Reports Introduction Chronic orofacial pain is a pernicious, debilitating condition affecting millions of people worldwide. It is often misdiagnosed and over- or under-treated. When over-treated, iatrogenic damage follows and resources are wasted, and whe... more
The challenge of removing material from root canals during root canal re-treatment - 2014-03-07
The challenge of removing material from root canals during root canal re-treatment Endodontics is an art as much as it is a science. It requires patience, skill, creativity, and contemplation as much as it requires knowledge, training, understanding and an analytic mind. Add the emotions of pain, empathy, fear, anxiety and the mutual s... more
Case report: Salvage procedure for five-unit fixed bridge - 2014-02-17
The patient, a 75 year-old cancer survivor, a retired university professor, was referred to the endodontic practice for the treatment of pain, swelling and discomfort in the left mandible. Examination showed a fixed bridge, with abutment anchors on the canine, first premolar and second molar and pontics on the second premolar and first molar. (F... more
Removal of fractured file. Is it necessary? - 2014-02-13
Removal of fractured root canal instruments from the confines of a root canal is technically one of the most difficult procedures in the entire array of medical and dental treatment modalities. It is no surprise that the success rate of removal is not very high. The instruments are just too small, and the canals too constricted, and diffi... more
In defense of amalgam: Case 2 - 2014-02-11
The patient, a 56 year-old businessman with a PhD in engineering and with vast global business interests, was referred by his oral hygienist for an opinion about the condition of his first upper left premolar tooth (24) (Figure 1). Figure 1. Note the amalgam restoration with "creeped" and ditched margins as well as buccal res... more
In defense of amalgam: A case report - 2014-02-10
In defense of amalgam: A case report Many colleagues take pride in practicing so-called "amalgam free dentistry," claiming the benefits of esthetics and the absence of mercury in resins and porcelain. By denying patients the benefit of a proper and well-designed amalgam restoration, they are actually causing patients harm and... more
Healing of peri-radicular area after treating fourth canal - 2013-12-12
A patient presented with pain and swelling on the first upper left molar tooth. Radiographic examination confirmed the presence of peri-radicular radiolucency, possibly caused by infection (Figure 1). The prosthetic crown was removed and the root canals re-treated. During the process the previously untreated mesiopalatal ("fourth") canal ... more
Resorption Revealed: Case Report - 2013-12-04
Resorption Revealed: A Case Report Root resorption is more common than widely believed. It can present as external or internal root resorption with some believing that internal resorption always exists together with external resorption, the one leading to the other. Resorption is not always visible on radiographs. A case of root can... more
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Open letter to Ms Maretha Smit, CEO of South African Dental Association - 2012-11-28
Ms M Smit CEO SADA Dear Maretha, In response to your communique in SADJ September 2012, Volume 67 no 8 page 442, I would like to raise a few points. Firstly I have been considering these issues, and publicly debating them, when I suspect you were still a teenager with stars in your eyes. You make a few va... more
Supervised Neglect or Intelligent Monitoring? - 2012-10-16
Introduction A case is presented illustrating nineteen years of observation before treatment was finally carried out. It raises the dilemma of early versus delayed intervention, in the endodontic context. Early history The patient, at the time twenty one years of age, and healthy, first attended the practice on 1 Septembe... more
A Zipping Perforation Revisited - 2012-10-13
The patient seeked a second opinion after being advised to have her second lower molar removed and replaced with another implant supported crown. The first molar had previously been replaced by just such a prosthesis. (Figure 1) The patient's history was non-contributory. Her main complaint was that of tenderness and occasional pain of the too... more
A Three Canal Premolar - 2012-10-12
Every now and then one encounters these almost bizarre mandibular premolars. This past week I filled one with three canals. ... more
The Endodontist’s Role in the Management of Chronic Orofacial Pain Published in SADJ October 2008 - 2009-11-04
The Endodontist’s Role in the Management of Chronic Orofacial Pain JT (Koos) Marais BChD (Pret) Endodontics Department of Restorative and Paediatric Dentistry School of Dentistry Faculty of Health Sciences University of the Witwatersrand PO Box 73004 Lynnwood Ridge 0040 koos@drkoosmarais.co.za kosie@... more
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The Essentials of Easy and Enjoyable Endodontics - 2009-11-04
As a service to all referring dentists I will publish the text of my textbook here. Please respect the copyright. The project will be completed over a period of three weeks, starting today, 4 November 2009. The process of editing is never ending and I welcome all criticism, even negative criticism. Printed copies of Part 1, The Essentials of ... more
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The Excellent and Effective Dentist - 2009-11-04
The Excellent and Effective Dentist CONTENTS Dedication Acknowledgements Introduction &nbs... more
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Are silver amalgam ("the infamous lead") fillings bad for my health? - 2009-11-04
Amalgam “toxicity” hits South Africa South Africa has recently been exposed to elevated levels of amalgam hype. Carte Blanche on MNet, Huisgenoot and You have reported on the suffering of patients from “amalgam disease” and their “miraculous recovery” after replacement of amalgam with tooth coloured material.&nb... more
Added: 2008-12-27 11:39
Irrationality in Dentistry - 2016-08-23Today I had the opportunity to view three dental fillings I did 33, 31 and 30 years ago. It gave me reason to reflect on a lifetime of work, my personal philosophy and the insanity that is currently the rage in the world of dentistry. I know that I am approaching my sell-by date. My painful left elbow and hand, over... more
Non-vital Bleaching: A Case Report - 2015-10-23The patient, a 24 year old male, requested treatment for a severely discoloured anterior tooth (Figure 1) The treatment consisted of re-treatment of the root canal and non-vital bleaching. This was accomplished in three brief appointments. Non-vital bleaching is a tried and tested, non-invasive treatment. Gui... more
Case Report: Amalgam, the only choice that made sense. - 2015-10-22Some professionals claim proudly that they “don’t do amalgam” anymore. Others even propound the untruth that “amalgam is dangerous.” Thirty seven years ago, at university I was told that amalgam restores “only” function, and not esthetics. This may be true, but it is equally true that amalgam is a... more
Extreme Endodontics, or Plain Common Sense? A Case Report - 2015-09-09The patient, a senior female government official of an European country, was posted to Mozambique for an extended period. Prior to her departure for Africa she consulted her dentist in Europe for her complaint of vague discomfort in the right maxilla. Examination showed the presence of a fixed thr... more
Extreme Endodontics, or Plain Common Sense? A Case Report - 2015-09-09The patient, a senior female government official of an European country, was posted to Mozambique for an extended period. Prior to her departure for Africa she consulted her dentist in Europe for her complaint of vague discomfort in the right maxilla. Examination showed the presence of a fixed three unit porcelain ve... more
Treating Chronic Orofacial Pain by Root Canal Treatment: Two Case Reports - 2014-03-12Treating Chronic Orofacial Pain by Root Canal Treatment: Two Case Reports Introduction Chronic orofacial pain is a pernicious, debilitating condition affecting millions of people worldwide. It is often misdiagnosed and over- or under-treated. When over-treated, iatrogenic damage follows and resources are wasted, and whe... more
The challenge of removing material from root canals during root canal re-treatment - 2014-03-07The challenge of removing material from root canals during root canal re-treatment Endodontics is an art as much as it is a science. It requires patience, skill, creativity, and contemplation as much as it requires knowledge, training, understanding and an analytic mind. Add the emotions of pain, empathy, fear, anxiety and the mutual s... more
Case report: Salvage procedure for five-unit fixed bridge - 2014-02-17The patient, a 75 year-old cancer survivor, a retired university professor, was referred to the endodontic practice for the treatment of pain, swelling and discomfort in the left mandible. Examination showed a fixed bridge, with abutment anchors on the canine, first premolar and second molar and pontics on the second premolar and first molar. (F... more
Removal of fractured file. Is it necessary? - 2014-02-13Removal of fractured root canal instruments from the confines of a root canal is technically one of the most difficult procedures in the entire array of medical and dental treatment modalities. It is no surprise that the success rate of removal is not very high. The instruments are just too small, and the canals too constricted, and diffi... more
In defense of amalgam: Case 2 - 2014-02-11The patient, a 56 year-old businessman with a PhD in engineering and with vast global business interests, was referred by his oral hygienist for an opinion about the condition of his first upper left premolar tooth (24) (Figure 1). Figure 1. Note the amalgam restoration with "creeped" and ditched margins as well as buccal res... more
In defense of amalgam: A case report - 2014-02-10In defense of amalgam: A case report Many colleagues take pride in practicing so-called "amalgam free dentistry," claiming the benefits of esthetics and the absence of mercury in resins and porcelain. By denying patients the benefit of a proper and well-designed amalgam restoration, they are actually causing patients harm and... more
Healing of peri-radicular area after treating fourth canal - 2013-12-12A patient presented with pain and swelling on the first upper left molar tooth. Radiographic examination confirmed the presence of peri-radicular radiolucency, possibly caused by infection (Figure 1). The prosthetic crown was removed and the root canals re-treated. During the process the previously untreated mesiopalatal ("fourth") canal ... more
Resorption Revealed: Case Report - 2013-12-04Resorption Revealed: A Case Report Root resorption is more common than widely believed. It can present as external or internal root resorption with some believing that internal resorption always exists together with external resorption, the one leading to the other. Resorption is not always visible on radiographs. A case of root can... more
Ms M Smit CEO SADA Dear Maretha, In response to your communique in SADJ September 2012, Volume 67 no 8 page 442, I would like to raise a few points. Firstly I have been considering these issues, and publicly debating them, when I suspect you were still a teenager with stars in your eyes. You make a few va... more
Supervised Neglect or Intelligent Monitoring? - 2012-10-16Introduction A case is presented illustrating nineteen years of observation before treatment was finally carried out. It raises the dilemma of early versus delayed intervention, in the endodontic context. Early history The patient, at the time twenty one years of age, and healthy, first attended the practice on 1 Septembe... more
A Zipping Perforation Revisited - 2012-10-13The patient seeked a second opinion after being advised to have her second lower molar removed and replaced with another implant supported crown. The first molar had previously been replaced by just such a prosthesis. (Figure 1) The patient's history was non-contributory. Her main complaint was that of tenderness and occasional pain of the too... more
A Three Canal Premolar - 2012-10-12Every now and then one encounters these almost bizarre mandibular premolars. This past week I filled one with three canals. ... more
The Endodontist’s Role in the Management of Chronic Orofacial Pain Published in SADJ October 2008 - 2009-11-04The Endodontist’s Role in the Management of Chronic Orofacial Pain JT (Koos) Marais BChD (Pret) Endodontics Department of Restorative and Paediatric Dentistry School of Dentistry Faculty of Health Sciences University of the Witwatersrand PO Box 73004 Lynnwood Ridge 0040 koos@drkoosmarais.co.za kosie@... more
As a service to all referring dentists I will publish the text of my textbook here. Please respect the copyright. The project will be completed over a period of three weeks, starting today, 4 November 2009. The process of editing is never ending and I welcome all criticism, even negative criticism. Printed copies of Part 1, The Essentials of ... more
The Excellent and Effective Dentist CONTENTS Dedication Acknowledgements Introduction &nbs... more
Amalgam “toxicity” hits South Africa South Africa has recently been exposed to elevated levels of amalgam hype. Carte Blanche on MNet, Huisgenoot and You have reported on the suffering of patients from “amalgam disease” and their “miraculous recovery” after replacement of amalgam with tooth coloured material.&nb... more
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