All Clinical Tips

In this long-term, three-year case journey, Dr. Bill Nudera shares one of the most fascinating and educational cases of his career—an evolving diagnostic and therapeutic puzzle involving a persistent osseous defect in the maxillary right premolar region.

A challenging anterior case in which a necrotic tooth (#9) with a chronic apical abscess failed to resolve after an otherwise straightforward root canal treatment. When both sinus tracts remained unchanged at the 4-week follow-up, the case shifted from routine to complex, prompting a critical reassessment of next steps.

This is one of the most fascinating cases I’ve seen to date—a 13-year follow-up that reveals how treatment outcomes evolve over time. You won’t want to miss what happened with this case. Watch the full clinical tip to see the long-term results and what made this case so unique.

Tooth #13 presented with symptomatic irreversible pulpitis but no periapical involvement. Despite appearing normal after a well-executed bridge restoration, CBCT revealed the premolar was significantly rotated, with roots canted in opposite directions. This hidden anatomy made access and canal location especially challenging.

Dr. Bill Nudera tackles a challenging maxillary canine with decay extending below the gingival tissue and close to the alveolar bone. See how he combined surgical, restorative, and endodontic strategies—plus managed a postoperative bleeding complication—to save a tooth many would consider hopeless.

I’ve learned that the diagnosis I make before treatment doesn’t always match what I find once I’m inside the tooth.

Dr. Nudera discusses the steps and protocols for vital pulp therapy, specifically apexogenesis on an 11y/o patient for a mandibular 2nd mola

Dr. Nudera presents endodontic revascularization, a root canal procedure designed for young patients with underdeveloped roots diagnosed wit

This patient is in pain with an unfavorable prognosis, and the tooth is in the esthetic zone, requiring more time to plan for the...

Dr. Nudera discusses his protocol for ensuring patient comfort during root canal treatment on tooth #30 with symptomatic irreversible pulpit

What does “success” mean to you? What does it mean for your patient? Dr. Nudera defines “success” in many different ways using case examples a

Dr. Nudera discusses the systematic approach he uses to determine the prognosis of a symptomatic mandibular second molar with a distal verti

An attempt to retain tooth #31— an abutment for and mandibular removable partial denture— using a selective root retreatment approach.

Management of a tooth with a history of prior silver point root canal treatment, prior apical surgery and symptomatic apical periodontitis.

Watch how Dr. Nudera takes a simple approach to stabilize this unscheduled emergency and get this young patient on the mend.

Dr. Nudera discusses the management of a sheer fracture extending on the palatal side on a 15 y/o patient related to trauma.

This exploratory retreatment goes to surgery. See Dr. Nudera's decision-making process as he tries to figure out what's going on in this str

Dr. Nudera follows a case he treated with persistent symptoms for 12 years, ultimately culminating in a retreatment.

A patient with asymptomatic findings needs clearance for upcoming joint replacement surgery. See how Dr. Nudera navigated his way through th

Teeth with abfraction lesions can present significant clinical challenges. See how Dr. Nudera maximized the integrity of the remaining...