Clinical Cases

A large periapical lesion was present on the mesial root of tooth 4.6, which had been previously treated and restored with a fiber post and crown many years ago. Despite being informed that retreatment through the crown was not the ideal approach, the patient insisted on proceeding with this method.

After removing the fiber post using an ultrasonic tip, the tooth was desobturated with rotary files, shaped, cleaned, and obturated in the same session. CeraSeal bioceramic sealer was applied using the Cold Hydraulic Condensation (CHC) technique, as the tooth was asymptomatic and no exudate was present.

At the 7-year recall, complete healing of the large lesion was observed, confirming the long-term success of the treatment.

In this case of a Lower Left Second Premolar with a large periapical lesion and discontinuation of the lamina dura, the bioactivity of bioceramic sealers played a key role in promoting healing within a short period of time. After biomechanical preparation, the canal was obturated using CeraSeal bioceramic sealer with the Continuous Wave of Compaction (CWC) technique, designed to create a post space for a later post and core restoration.

At the 3.5-month follow-up, the case showed significant healing, with evident bone formation around the root and continuous healthy lamina dura. The CeraSeal sealer puff demonstrated excellent integrity and stability over this period. The bioactivity of CeraSeal contributed to rapid healing and shorter follow-up periods, allowing for precise monitoring of the case.

A patient was referred for the treatment of a necrotic tooth 3.5 with an associated periapical lesion, presenting with acute abscess, pain, and lip paresthesia due to compression of the mental nerve. Despite initial antibiotic therapy and dressing by the referring dentist, symptoms persisted. Endodontic treatment was initiated, but the working length could not be determined due to a ledge formed in the apical third of the canal.

After managing the ledge, the canal was medicated with calcium hydroxide, and two weeks later, symptoms had completely resolved. The tooth was obturated using CeraSeal bioceramic sealer with the Cold Hydraulic Condensation technique, and post-treatment radiographs showed the ledge was fully filled by the sealer.

At the 4-year recall, complete healing of the lesion was observed, confirming the effectiveness and stability of this treatment.

This case involved a Lower Left First Molar with poor obturation and a large periapical lesion. The gutta-percha was removed, and after biomechanical preparation, the canals were obturated using CeraSeal bioceramic sealer. CeraSeal was applied in the Continuous Wave of Compaction (CWC) technique for the distal root and the Hydraulic Condensation (Single Matched Cone) technique for the mesial canals.

After 2 years, the case showed complete healing, with noticeable bone formation around the distal root and healthy lamina dura for both roots. The extruded CeraSeal demonstrated excellent stability and integrity over time, highlighting the success of this treatment approach.

In this retreatment case of the Upper Left Lateral Incisor, which had poor obturation and a fiber post, the gutta-percha was removed using rotary files, and the fiber post was removed with ultrasonics. An evident periapical lesion was present, and after proper disinfection, CeraSeal bioceramic sealer was applied using the Continuous Wave of Compaction (CWC) technique. CeraSeal was limited to the apical half of the canal to prevent heat from affecting it.

After 33 days, there was a noticeable reduction in the periapical lesion, with bone formation above the apex and improved radiopacity in the periapical area. The extruded CeraSeal showed excellent integrity and stability over time, demonstrating the success of the treatment.

The use of bioceramics is leading to faster healing and shorter follow-up periods, although longer follow-up is recommended for continued success.

A patient was referred for the treatment of a necrotic 3.6 with a lesion. The tooth was tender to percussion and palpation and exhibited typical signs of “Cracked Tooth Syndrome,” with no probing and a favorable prognosis. The treatment was completed in two visits. During the first visit, the canals were shaped, cleaned, and dressed with calcium hydroxide. In the second visit, the canals were obturated using the Cold Hydraulic Condensation Technique with a single cone and CeraSeal bioceramic sealer.

The referral dentist placed a long-term temporary crown immediately after treatment and followed up with a permanent crown after the 2-year recall. After 5 years, the case showed complete healing, highlighting the success of this approach.

This retreatment case involved a missed MB canal/root and poor obturation of the DB and Palatal canals. After removing the gutta-percha with rotary files and shaping with reciprocation files, CeraSeal was used for obturation. The flowability of CeraSeal allowed me to efficiently obturate the MB and DB canals, despite constricted entrances. For the Palatal canal, I applied CeraSeal to the apical half, as I planned to remove gutta-percha from the middle half for post and core restoration. CeraSeal’s biocompatibility prevented any flare-ups despite large sealer puffs. It can be safely used in all cases and obturation techniques when applied correctly.

A patient was referred for the treatment of a symptomatic 3.6 with a large lesion. After four weeks of dressing with Calcium Hydroxide, the symptoms resolved, and the canals were obturated using the Cold Hydraulic Condensation Technique with a single cone and CeraSeal bioceramic sealer. Postoperative radiographs revealed significant overfilling, which, although unexpected, is a common occurrence. According to literature, overfilling is observed in 66% of cases involving lesions when using bioceramic sealers, and it does not negatively impact the treatment outcome if it is unintentional and follows proper shaping, cleaning, and filling.

Follow-up evaluations at 1, 3, and 6 years showed complete healing of the large lesion, demonstrating the effectiveness of the proper filling technique and the biocompatibility of CeraSeal.

n this retreatment case of the lower right second premolar, which had poor obturation and an evident ledge, the gutta-percha was removed using rotary files, and the ledge was successfully bypassed. After disinfection, CeraSeal bioceramic sealer was used for obturation with the Continuous Wave of Compaction (CWC) technique to create a post space for future restoration.

When applying CeraSeal with the CWC technique, it is essential to limit its use to the apical half of the canal and avoid pressure to prevent apical extrusion. When applied correctly, CeraSeal remains unaffected by CWC heat.

At the 3 month follow-up, complete tissue healing and bone repair were observed, with CeraSeal maintaining its integrity and stability. This successful outcome highlights the effectiveness of the treatment approach, and further follow-up is advised as tooth preservation remains a priority.

A patient was referred with a history of acute abscess and internal resorption detected on tooth 4.5. The treatment was completed in a single visit using the Cold Hydraulic Condensation Technique with CeraSeal bioceramic sealer. CeraSeal’s flowability allowed it to fill the internal resorption and extend beyond the apex.

A follow-up at 18 months showed good healing and complete reabsorption of the sealer, which is uncommon. Despite this, the long-term outcome remained positive, demonstrating the sealer’s unique ability to maintain its stability over time. After 5 years, the technique showed consistent stability and successful results.

Bioceramic sealers, such as CeraSeal, have revolutionized endodontic treatment by enabling faster healing and improved tissue repair. In this case, a patient with significant bone loss due to periapical infection was treated with CeraSeal using the Single Cone Hydraulic Condensation technique.

Unexpectedly, the patient returned for a follow-up after 10 weeks, revealing excellent healing progress. X-rays showed significant bone formation, a reduction in the periapical lesion, and the start of tissue repair. The patient was advised to replace the crown restoration and scheduled for another follow-up visit.

Lateral canals are often not evident in preoperative radiographs, but the presence of a lateral lesion should raise suspicion for their involvement. In this case, a male patient presented with continuous pain associated with his recently restored Upper Left Central and Lateral Incisors. To preserve the newly placed crowns, an access cavity was created through the crowns.

By carefully adhering to disinfection protocols and utilizing the flowability of CeraSeal bioceramic sealer, the lateral canals were effectively filled in a simple and efficient manner. The 1-year follow-up demonstrated excellent tissue healing, bone repair, and the integrity and stability of CeraSeal over time, confirming the success of this approach.

This clinical case involves a patient with periodontal disease referred for the failure of indirect pulp capping on tooth 1.4, performed eight months prior. The patient presented with pain and swelling in the right upper quadrant, and after draining the pus, the tooth was shaped, cleaned, and dressed with Calcium Hydroxide.

Two weeks later, the canals were obturated using the Cold Hydraulic Condensation Technique with a single cone and CeraSeal bioceramic sealer. The hydraulic pressure generated by the technique resulted in the injection of a lateral canal. Follow-up evaluations at 1 year and 4 years showed the stability of the sealer-based technique and confirmed the healing of the lesion.

Dr. Filippo Cardinali shares this clinical case involving a symptomatic tooth 2.7, which presented with a large lesion and a sinus tract. After four weeks of dressing with Calcium Hydroxide, the sinus tract healed, symptoms disappeared, and the canals were obturated using the Cold Hydraulic Condensation Technique with CeraSeal bioceramic sealer.

Though the post-operative radiograph revealed a significant overfilling, which was less than ideal, such occurrences can happen in complex cases. The tooth was secured with a temporary crown, and following a 1 year healing period confirmed by a CBCT scan, the tooth was restored with a Zirconia crown. A 4 year recall from the referring dentist showed successful healing, further demonstrating the effectiveness of this treatment approach.

We appreciate Dr. Filippo Cardinali for providing this insightful clinical case, which demonstrates the application of CeraSeal. The case involved the retreatment of tooth 36 and the treatment of symptomatic tooth 37, successfully completed in just two visits. During the procedure, calcium hydroxide was utilized in conjunction with CeraSeal to ensure optimal results.

A follow-up evaluation after 4 years demonstrated excellent recovery, with no reported complications. This case highlights the effectiveness of CeraSeal in endodontic treatment and emphasizes the importance of proper procedural protocols in achieving successful outcomes. We appreciate Dr. Cardinali’s contribution to advancing knowledge in the field of endodontics.

We are pleased to present a clinical case from Dr. Mostafa Anwar involving a male patient with symptomatic apical periodontitis in the upper left lateral incisor. The patient underwent a single-visit root canal treatment (RCT) following a thorough disinfection protocol, utilizing the Hydraulic Condensation Obturation Technique with CeraSeal bioceramic sealer.

Despite unintentional sealer puff periapically, the biocompatibility and bioactivity of CeraSeal supported rapid healing. A follow-up after 5 months showed significant healing, including tissue repair, bone formation, intact lamina dura, and the material’s stability over time. This case highlights the effectiveness of CeraSeal in managing apical periodontitis and underscores the importance of proper treatment protocols.

Vital pulp therapy (VPT) has become a preferred approach for managing reversible pulpitis. In a recent case, a patient with a necrotic tooth (#16) was treated using CeraPutty, a calcium silicate-based bioceramic material from Meta Biomed. After careful isolation and disinfection, CeraPutty was applied for direct pulp capping, followed by a light-polymerizing calcium hydroxide layer for added protection.

Post-treatment evaluations showed the patient remained asymptomatic, with normal pulp responses after two years. This successful outcome underscores the importance of accurate diagnosis and effective materials in dental treatment. With a success rate exceeding 85% over ten years, CeraPutty demonstrates its role as a reliable option in preserving pulp vitality and enhancing patient care.

We are pleased to present a remarkable clinical case by Dr. Mohamed Zaafarani, showcasing the successful repair of a lateral root perforation using CeraPutty from Meta Biomed. This case involved the retrieval of a well-engaged separated file in the buccal cortical bone, which occurred due to difficulties in locating the main canal. Dr. Zaafarani’s meticulous approach to the perforation repair illustrates the effectiveness of CeraPutty in managing complex endodontic challenges. The successful outcome not only emphasizes the importance of precision in treatment but also highlights the innovative solutions available for dental professionals. We extend our gratitude to Dr. Zaafarani for sharing this insightful case, contributing to the advancement of endodontic practice.

We are pleased to showcase a compelling case by Dr. Anwar, involving the treatment of a lower left canine with a missed root and periapical lesion. Utilizing CeraSeal and the single cone technique, Dr. Anwar achieved outstanding results. Follow-up X-rays demonstrate complete healing of the lesion after 11 months, illustrating the effectiveness of this approach. The meticulous application and successful outcome underscore the reliability of CeraSeal in managing challenging endodontic conditions. This case serves as an excellent example of how advanced techniques can significantly enhance treatment success and patient outcomes. We extend our gratitude to Dr. Anwar for sharing this valuable case, which highlights the efficacy of CeraSeal in complex endodontic treatments.

We are pleased to present an exceptional 5-year follow-up case shared by Dr. Filippo Cardinali. The patient, presenting with a necrotic and discolored tooth (2.2), was treated using the Cold Hydraulic Condensation Technique with CeraSeal bioceramic sealer. Following two visits, which included calcium hydroxide dressing and internal bleaching, the tooth demonstrated excellent healing and stability. Follow-up reviews at 1 year and 5 years further validate the effectiveness of this technique in managing large lesions and preserving tooth health. We extend our sincere thanks to Dr. Filippo Cardinali for contributing this remarkable case to our collection.

We are pleased to present a noteworthy clinical case shared by Dr. Filippo Cardinali. This case involves the successful treatment of a pulpitis condition in tooth 4.7 with complex anatomy using CeraSeal bioceramic sealer. The tooth was initially shaped, cleaned, and dressed during the first visit, followed by obturation using the Cold Hydraulic Condensation Technique in the second visit. A 6-year follow-up reveals stability and partial resorption beyond the apex, highlighting the long-term effectiveness of CeraSeal in managing intricate endodontic cases. We extend our sincere gratitude to Dr. Filippo Cardinali for contributing this valuable case to our knowledge base.

We are pleased to present a remarkable clinical case by Dr. Mostafa Anwar. Utilizing CeraSeal Bioceramic Sealer, Dr. Anwar achieved outstanding results in the obturation of a lower second premolar with complex anatomy. The precise application and successful outcome highlight CeraSeal’s efficacy in managing intricate endodontic cases. This case not only demonstrates the superior performance of CeraSeal but also serves as an exemplary model for handling challenging anatomical conditions. We extend our sincere gratitude to Dr. Mostafa Anwar for sharing this impressive case and contributing to the advancement of endodontic treatment.

We invite you to review this outstanding clinical case shared by Dr. Filippo Cardinali. Dr. Cardinali effectively treated a necrotic 1.6 tooth with a significant periapical lesion using the Cold Hydraulic Condensation Technique and CeraSeal bioceramic sealer. Follow-up evaluations at 1 year and 5 years have confirmed complete healing of the lesion. This case not only demonstrates the superior performance of CeraSeal but also provides valuable insights into its application in challenging endodontic scenarios. The successful outcome underscores the importance of precision and advanced techniques in achieving long-term success. We extend our gratitude to Dr. Filippo Cardinali for his contribution and for sharing this exemplary case.

We extend our sincere gratitude to Dr. Filippo Cardinali for sharing this exceptional clinical case. Dr. Cardinali successfully treated a lateral canal connecting an empty canal space to an infection area using Cold Hydraulic Condensation and CeraSeal bioceramic sealer. The case presented with bone loss manifesting as a sinus tract within the gingival sulcus. Follow-up evaluations at 1 year and 6 years demonstrate complete healing of the large lesion, highlighting the long-term efficacy of CeraSeal in complex endodontic situations. This case exemplifies the advanced capabilities of modern endodontic techniques and reinforces the value of innovative treatments in achieving optimal patient outcomes. We appreciate Dr. Cardinali’s contribution to advancing our understanding and application of these critical procedures.

We are pleased to present a notable clinical case by Dr. Filippo Cardinali, featuring a two-year follow-up utilizing the Cold Hydraulic Condensation Technique with CeraSeal. The case involved the retreatment of a 1.6 with a lesion, a plastic core in the maxillary sinus, and large foramina. Dr. Cardinali’s successful application of CeraSeal in this complex scenario underscores its effectiveness and versatility. The comprehensive approach and meticulous technique used have led to significant improvements and successful outcomes. This case not only demonstrates the reliability of CeraSeal but also provides valuable insights into managing challenging endodontic conditions. We extend our gratitude to Dr. Filippo Cardinali for sharing this exemplary case, which highlights the benefits of CeraSeal in advanced endodontic procedures.

We are pleased to share an exceptional clinical case presented by Dr. Filippo Cardinali, which highlights the remarkable performance of CeraSeal bioceramic root canal sealer over a four-year period. The case involved a 1.5 cm lesion, a deep apical split, and large foramina. Despite the foramina being larger than 70, the canals were effectively obturated using the Cold Hydraulic Condensation Technique with CeraSeal. This method is noted for its ergonomic and time-efficient application. Follow-up reviews conducted at 1 year and 4 years post-treatment have shown complete healing of the lesion. We extend our sincere gratitude to Dr. Filippo Cardinali for allowing us to feature this outstanding clinical case, which demonstrates both his expertise and the efficacy of CeraSeal in advancing endodontic treatment.