Challenging Maxillary Canine Case

A severely carious maxillary canine with decay extending below the gingival tissue and dangerously close to the alveolar bone. Managing both the restorative and endodontic challenges took careful planning, advanced imaging, and innovative technique. From flap design and isolation strategies to a caries-directed endodontic access, Dr. Nudera balances tissue management, root canal therapy, and restorative repair to preserve a tooth many would consider hopeless — with practical pearls on achieving isolation, controlling heme in anticoagulated patients, and using the gutta-percha projection technique for predictable access and restoration. The case also covers a postoperative complication: persistent bleeding from the patient's Warfarin use, and how to identify and manage a liver clot without compromising healing.