Marlborough Clinic Belfast - Referrals

Endo somatic Referrals with . Complimentary CBCT scan when clinically necessary and IV Sedation available for nervous patients.

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Not the most challenging case but, when a lower molar presents with a 6mm buccal furcation pocket, you tend to worry.

In this case, it turned out to be a crevicular sinus.

Pass no remark on my misaligned access 🤫

44-y-o M
Dx: PN and CAP
6mm buccal furcation pocket

Treatment was carried out over 2 visits, 6 weeks apart, with calcium hydroxide medication.
At the second visit, the buccal furcation pocket had resolved.

Zarc SlimShaper ZS1 & ZS2
AUI 5.25% NaOCl and DualRinse
Hydraulic Condensation

Note the lateral POE that likely caused the crevicular sinus.

Callum McCandless & Tim Harris are presenting 'Oral Surgery – tips, tricks and making your day more predictable' here at Marlborough Clinic Belfast on Friday and Saturday 18th/19th October.

This is an interactive course to address and support the individual needs for each delegate. By the end of the course the delegates will be more experienced and comfortable in providing oral surgery treatments for their patients.

The event is CPD accredited and costs £250 to attend.

Spaces on the course are limited. To register visit:
https://mailchi.mp/marlboroughclinicbelfast/f6isugscr4

We wish Stephanie, our marketing intern from Queens University Belfast, every success with her onward academic journey to France.

Bon voyage from all the Marlborough team – it was great having you as part of our team.

We would like to thank New Vision for updating our signage to include dermatology.

Private dermatology consultations are available with our consultant dermatologists. Please contact Chloe from our Welcome Team at [email protected] or 028 9002 2000 to arrange an appointment.

Andrew Wallace is presenting a ClearCorrect Provider Study club here at Marlborough Clinic.

The event is free to attend on 11th September.

Registration link:

https://mailchi.mp/marlboroughclinicbelfast/otqioni6y8

Endodontic Referrals with . Complimentary CBCT scan when clinically necessary and IV Sedation available@for nervous patients.

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53-y-o F
Pulp necrosis and CAP following deep restoration.
Unable to chew on right side for past 2 months.
Mesial canals very narrow.
Mesial canals negotiated to patency with #8 D-Finders and 14.03
EdgeEndo X7 Utopia 17.04, 20.04, & 25.04

AUI 5.25% NaOCl with DualRinse
Hydraulic Condensation and composite core.

Nice Friday case. D-Finders and 14.03 turning a big job into a little job.

Endodontic Referral at with . Complimentary CBCT scan when required and IV Sedation for nervous patients.

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I got sidetracked today, ensuring that a referring dentist didn’t have to take out a marginal ridge.

This 39-y-o F has changed dentists, and her new dentist identified an issue with her 2.6.

She had had, for some time, intermittent pain from the 2.6.
On examination, the 2.6 had an amorphous DO composite restoration, was negative to sensibility testing, and was TTP.

Dx: PN and CAP.

Removal of the restoration from the 2.6 revealed:
⚪ Gross caries in the 2.6
⚪ Significant iatrogenic damage to the mesial enamel of the 2.7
⚪ Caries at the gingival level in the 2.7

I opted, prior to carrying out the 2.6 pre-Endo buildup (SDR and Tofflemire), to use the direct access I had, to remove the caries from the 2.7 and restore the mesial contact point of the 2.7.
Caries was removed, etch and bond, and free-hand flowable composite restoration.
This way, the RD doesn’t have to destroy the mesial marginal ridge to access the caries in the 2.7.

The 2.6 was managed with Zarc Slimshaper.
ZS1
ZS2
ZS3

The MB2 took a lot of work with D-Finders and the Toothsaver 14.03, but it eventually merged with the MB.

5.25% NaOCl and DualRinse
Irriflex
AUI Irrisafe
Hydraulic Condensation with TotalFill and 25.04 GPP
Grandio Core filling.

The Slimshaper seems to leave a much deeper prep than X7 Utopia. 25.04 GP cones seated easily with BCS, and that’s a ZS3 prep around that nice apical curvature in the Palatal root; nice files. I’m looking forward to trying the Slimshaper Pro.

David Nelson is delivering the comprehensive Restoring Dental Implants incorporating Digital Technology full day complimentary course on Friday 6th September.

If you are interested in becoming involved in implant dentistry and would like to learn about restoring implants this one-day practical course is suitable for you.

The course has a practical hands-on element with access to intra oral scanners and our digital dental laboratory. The hands-on exercises are based around Straumann® Dental Implant System.

Marlborough Academy events are complimentary and CPD accredited.

Spaces on the course are limited. To register visit:

https://mailchi.mp/marlboroughclinicbelfast/84zmkcvoy4


straumannclearcorrect

He may not have won the Open but Callum did win the Portstewart Senior Men’s Scratch cup yesterday. Back to earth with a bump today in his Oral Surgery Clinic.
Congratulations to Callum from everyone at Marlborough ⛳️🏌️‍♂️🍾👏👏👏👏👏

Endodontic Referrals with . Complimentary CBCT scan when clinically necessary and IV Sedation available for nervous patients.

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calls these Schwartz Failures. I suppose this is a Stewart Failure. (Dare I be so presumptuous?)

I treated this, now 54-y-o M, in 2016. The 6-month review radiograph showed excellent healing, and he has since had the 4.6 crowned.
I saw him in late 2023 to assess his, unfortunately root-fractured, 2.2 and seized the opportunity for an 8-year review.

He had no complaints about the 4.6 but my radiograph showed some loss of bone density; enough to prompt a CBCT…
As you can see, there was a significant radiolucency at the Mesial root apex.

I feared a root fracture, but the cervical bone looked intact on CBCT, so I offered a selective re-treatment to ascertain if there was any hope for the tooth.

Treatment was carried out today. Tracking the groove between the mesial canals, I was able to engage, with a #8 C+, the tiniest catch of a Mid-Mesial or***ce. There was moisture and a foul odour from the mesial isthmus. A bit of work with the C+ and D-Finders led to the ML apex.
GP was removed with Eucalyptus oil and Reciproc Blue R25, and the Mid-Mesial was prepared with an EdgeEndo X7 Utopia 17.04 and the R25.

AUI with 5.25% NaOCl with DualRinse.
Hydraulic Condensation with TotalFill and 25.04 GPP.

A few points from this case:
1. The GP was the devil’s own job to remove (WVC GP with Kerr’s PCS). I suppose I wasn’t planning on removing it 🤷‍♂️
2. It’s always worth investigating before pronouncing a root fracture, and the demise of the tooth.
3. The MM did not show on CBCT, but I hope I wouldn’t miss it now. I habitually track the mesial groove after completion, to check for a missed MM.
4. Failures, like file separations, are part of the game. If you treat enough teeth, you’re going to lose the odd match. It’s just a bonus if you can win the return match.

An Argentinian Malbec is currently soothing my bruised ego 🍷

Endodontic referrals with . Complimentary CBCT when clinically nescessary and IV Sedation available for nervous patients.

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Interesting anatomy in this strategic 3.8, showcasing the abilities of EdgeEndo X7 Utopia.

66-y-o M
Pulp Necrosis and CAP 3.8
3.7 extracted
3.8 strategic for retention of proposed -/P CoCr

Glad I didn’t see a CBCT prior to treatment, as I might have felt a bit more pressure 😂
Knowing your files well helps with the understanding of the tactile feedback.

EdgeEndo X7 Utopia 14.04, 20.04 & 25.04.
AUI with 5.25% NaOCl with DualRinse.
30G needles were not penetrating as well I would have liked, so switched to Irriflex for the last 5mL of irrigation.
AUI with Irrisafe.
Hydraulic Condensation with Totalfill BCS and gauged MF cones.
Grandio core to fill the access.
Now, off to the restoring dentist for crown.

We are closed tomorrow Friday 12th July and Monday 15th July.

We will reopen at 8.30am on Tuesday 16th July.

We wish everyone an enjoyable bank holiday.

In the case of an emergency, contact us on 028 9002 2000 where further details are provided about out of hours.

Marlborough Clinic Belfast are seeking a highly motivated Dental Hygienist / Therapist with a commitment to further education interested in joining our expanding multi-disciplinary specialist and referral clinic in South Belfast.

This is an exciting opportunity to be part of a dedicated hygiene and periodontal team with a focus on delivering personalised solutions for patients using a collaborative approach.

About the role:
- Part time role, one day per week
- Flexible to work evenings
- Qualified Hygienist or Therapist - valid GDC registration
- Working alongside dedicated periodontal team
- Leading remuneration.

To apply for this position, please request an application by emailing [email protected]

For more info please visit the link below:
https://acrobat.adobe.com/id/urn:aaid:sc:EU:469445cc-c608-46d9-b3a8-5f5e5bf79a25

Closing date for applications is 24th July.

𝗗𝗢 𝗬𝗢𝗨 𝗦𝗨𝗙𝗙𝗘𝗥 𝗙𝗥𝗢𝗠 𝗥𝗢𝗦𝗔𝗖𝗘𝗔?
is a skin condition that causes inflamed red skin characterised by flushing, red bumps and sensitivity, usually on the face. Incorrect treatment can aggravate the skin further, resulting in flare-ups. At Marlborough Clinic Belfast, our Consultant Dermatologists provide personalised treatment and skin care. No waiting list for private self-funding or insured patients.

Arrange your appointment today on 📞028 9002 2000 or ✉️ [email protected]

James Nelson is presenting his Restorative Mini Series of events here at Marlborough Clinic Belfast in Autumn 2024.

The mini series events are complimentary and CPD accredited.

Register for events at:

'Periodontal Management and Occlusion' on Wednesday 18th September: https://mailchi.mp/marlboroughclinicbelfast/c57aw65emc

'Determining the Restorability of Teeth' on Wednesday 2nd October: https://mailchi.mp/marlboroughclinicbelfast/tr6uo1k37l

'The impact of medical conditions on restorative dentistry' on Wednesday 16th October: https://mailchi.mp/marlboroughclinicbelfast/mkgxoi7giu

Endodontic Referrals with . Complimentary CBCT scan when clinically necessary and IV sedation available for nervous patients.

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Hard yards in this 3.6

41-y-o nurse referred for RCT of 3.6.
The tooth had extensive caries, and appeared to be completely sclerosed. I suspected a crack, so split treatment over two visits.

Visit 1
Caries removal
Crown lengthening with Diamond bur and Ceramic Tissue Trimmer
DME with SDR, using Tor VM Saddle Matrix.
Locate the canals and negotiate with beaucoup #8 D-finders and Toothsaver 14.03 file.

At the return visit today, the gingiva appeared healthy and the tooth was no longer painful.

Visit 2
Preparation with EdgeEndo X7 Utopia to 25.04.

Krasner and Rankow kept nagging me that the canal layout did not look symmetrical. A bit more searching with LN burs, and I was able to pick up the tiniest DL canal. Negotiation once more with D-Finders and the TS 14.03, and the DL transpired to have it’s own apical foramen.

Four canals with four apical foramina; all hard sledging. 🥵

AUI with 5.25% NaOCl and DualRinse
Hydraulic Condensation with TotalFill and gauged MF cones.
Grandio Core composite filling.

Review in 6 months, and I’ve recommended leaving the DME untouched and placing an EMax onlay.

Still loving how conservative of PCD is the X7 Utopia file.
Nothing easy about this one, and now, prompted by .endo, I’m ready for a Hazy Jane (IPA).

Dr Andrew McCleery was delighted to present Fiona Morrow of with the prize for winning the Women's Doubles Tournament at the Ulster Open and Masters 2024 last weekend at .

Congratulations to Fiona and her doubles partner Kerri Russell!

Andrew Birnie, Callum McCandless and Louise O'Hare accept referrals for oral surgery and can see patients promptly.

IV sedation is available for nervous and anxious patients.

For convenience we have a dedicated oral surgery referral form on our website, together with the option for you to book an appointment for your patient online when they are with you in practice.

If you would like further details on our online booking facility for oral surgery, a user guide is on the website. Alternatively, please feel free to call our Welcome Team on 028 9002 2000.

Link to book appointment:

https://www.marlboroughclinicbelfast.com/treatment/oral-surgery/?_gl=1*y95451*_up*MQ..*_ga*MTYzMjEwODM1LjE3MTg2OTk0NTU.*_ga_77CJWKDJ3Q*MTcxODY5OTQ1NS4xLjEuMTcxODY5OTQ3Mi4wLjAuMA..

Endodontic Referral with . Complimentary CBCT when clinically necessary and IV Sedation available for nervous patients.

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OK, bear with me. This is an interesting one.

56-y-o F with H/C sensitivity from a root treated tooth

The 4.6 had had a metal crown placed in 2013.
RCT had been carried out through the crown in 2023.
The patient still felt pain from the LR6 region.

IOPA showed the mesial canals were filled short of working length but there was no clear sign of apical pathology.
I was sceptical about the chances of the temperature sensitivity coming from the 4.6; however…

The beauty of Kerr Soft Clamps is that they can be applied without LA, if you’re careful.
I placed Rubber Dam on the 4.6 and applied temperature challenge in complete isolation.
💧Hot water — Pain
❄ Endo Frost: +ve ++ and lingering

Treatment was carried out today and relevant findings were:-
• The pulp chamber had not been de-roofed.
• The pulp chamber was filled with reactionary dentine.
• There was an un-instrumented Mid-Mesial canal, which contained pus.
• There was a, previously undiscovered, Disto-Buccal canal, which contained vital tissue.

D-finders
ToothSaver 14.03
Zarc SlimShaper ZS1 & ZS2
AUI 3% NaOCl and DualRinse.
Hydraulic Condensation of TotalFill BCS
Grandio Core Flow composite.

😊

Endodontic referrals with . Complimentary CBCT scan when required and IV Sedation for nervous patients.

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A note on case difficulty assessment.

This 20-y-o F was referred due to the inflammatory root resorption and open apex in the distal root of her 3.6.
There was a sinus on the buccal mucosa, adjacent to the apex of the 3.6.
Dx: Pulp Necrosis and Chronic Abscess.

From a case assessment point of view, referral was absolutely the correct management pathway, given the open apex of the distal root.

What had not been noticed, was the loss of definition of the mesial canals, in the mid-root. Inability to trace the canals on radiograph is a complicating factor in case difficulty assessment.

The pulp chamber, and particularly the distal canal, were filled with necrotic material. On attempting to negotiate the mesial canals, there was resistance in the mid-root.

The mesial canals were negotiated to patency with #8 D-Finders, revealing vital tissue beyond the mid-root barrier. The patient felt some slight discomfort, and a lingual infiltration of 4% Articaine with Adrenaline was administered. Another reminder that, just because there’s a sinus, it doesn’t mean you can skimp on the local anaesthetic.

EAL gave a working length, consistently shorter than expected in the mesial roots. There appears to have been some IRR here as well.

Preparation: Zarc Slimshaper to ZS2
AUI with 5.25% NaOCl and DualRinse
Distal apex gauged to #45
Hydraulic Condensation TotalFill BCS
Composite core filling

A nice, interesting case, and the patient was interested in it as well; she’s a Physiotherapy student. A pleasure to treat someone who is interested in the minutiae. 😂

We were delighted to welcome QUB final-year dentistry students Hannah-Rose and Niamh to the clinic today.

We wish them all a wonderful evening on Saturday for their Graduation Ball.

Marlborough Clinic Belfast are delighted to be sponsoring the Queens University Belfast 2024 Dentistry Graduation Ball. We wish the students an enjoyable night!

Endodontic referrals with . Complimentary CBCT when required clinically and IV Sedation available for nervous patients.

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EdgeEndo X7 Utopia for this S-shaped canal system.

37-y-o F referred as her dentist could not get to working length in the 2.5.
Dx: Previously initiated treatment.
Complicating factors:
Limited opening
Gag reflex - Radiography was a major challenge.

The 2.5 canal was not negotiable beyond 16mm; however, a bit of investigation revealed a, previously uninstrumented, Palatal canal.
#8 D-Finders to patency in the Palatal canal at 20mm
16mm was the maximum extent of the Buccal canal.

X7 Utopia 17.04, 20.04, 25.04.
AUI 5.25% NaOCl & DualRinse, with Irrisafe.
Irriflex Canula
Hydraulic Condensation of TotalFill and gauged MF cones.
The final radiographs show both canals cleaned and filled to working length. The apical 4mm of the buccal canal did not see a file.

Young Dentist Study Club Reminder

Stephen Quinn is hosting 'Dental Implants - Your A-Z Guide for General Practice' here at Marlborough Clinic Belfast on Thursday the 13th of June 7pm-8pm

Spaces on the course are limited. To register visit:

https://mailchi.mp/marlboroughclinicbelfast/vcgnm3nbgi

A cancer charity is warning people to do more to protect themselves from the sun as the number of melanoma skin-cancer cases in the UK continues to rise.

At Marlborough Clinic Belfast our Consultant Dermatologists are experienced in all types of skin diseases including melanoma.

You can access a private dermatology consultation appointment promptly with our team if you have any concerns.

Read a recent BBC article to learn about Melanoma skin cancer cases rising in the UK:

https://www.bbc.co.uk/news/articles/c2ll0eywz37o

We appreciated the support of all our sponsors who were with us throughout our Innovations and Future Trends in Dentistry event – and M&D Financial Management Ltd.

With special thanks to our engaged and informed speakers who shared a comprehensive overview of insights to trends and innovations –

For further added value the delegates received complimentary access to a module from The Dental Entrepreneurial Bootcamp courtesy of the Campbell Academy valued at £450.

Please follow the link if you are interested to find out more about upcoming Campbell Academy events:

https://www.campbellacademy.co.uk/