Clinical cases
 Carlos Bóveda Z.


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  The invited case # 19 : Dr. Yosef Nahmias

Our nineteenth guest was Dr. Yosef Nahmias, founder of the Endoweb, in Oakville, Ontario, Canada.

 (click on the images to enlarge) 

As commented by Dr. Nahmias: " This is a cool one! Patient came to the office with swelling at the level of the apex of 1.4 (5 in the U.S.). Took pa and this is what we saw.


Three options were given : Extraction, Retreatment and Surgery

Upon reviewing the case, it was decided that the best alternative was a surgical exposure in order to seal the apices and check for cracks, perforatins etc.

Here are the pics

This was probably a perforation created when the DDS tried to do the RCT.

We decided to clean up the area,

and seal the defect with geristore.

Then came the fun! Buccal root was esposed, no canal could be detected (no catch at all!). But the difficult part was locating the palatal root, I had to drill about 1 inch of bone b4 I found it. The problem was to also mantain as much of the buccal root as possible with out exposing the buccal defect! Fun fun fun.

Finally, the palatal root was located (no catch at the apex either!). Small retropes were made , and sealed with optibond!

optibond being applied to seal Buccal apex

View of palatal root

View of buccal root

Final pa,

I think that the surgical approach for this case was the right one! Time will tell!

The patient was seen two days after the surg to have stiches removed, and then a week later to assess healing!

So far, so good! "

Clinical cases by prior guests

# 1 - Dr. Gary Carrccc# 2 - Dr. Yosef Nahmiasccc# 3 - Dr. Peter Cancellierccc# 4 - Dr. Gary Carr

# 5 - Dr. Yosef Nahmiasccc# 6 - Dr. Uziel Blumenkranzccc# 7 - Dr. Joaquín Pérez Seguraccc# 8 - Dr. Uziel Blumenkranz

# 9 - Dr. Yosef Nahmiasccc#10 - Dr. Yosef Nahmiasccc#11 - Dra. Andreína Avendañoccc#12 - Dr. Yosef Nahmias

#13 - Dr. Giorgio Uccelliccc#14 - Dr. Ken Serotaccc#15 - Dr. Jerry Avillionccc# 16 - Dr. Gary Carrccc# 17 - Dr. Gary Carr

# 18 - Dr. Rick Schwartz

¿Do you have an interesting clinical case that you would like to share with all of us ? Please send us an e-mail to

 Carlos Bóveda Z. March 2002