A specialist endodontic partner for general dentists across the South Bay
Dr. Jason Kung's practice is limited entirely to endodontics — no implants, no crowns, no general dentistry. The structural commitment that protects your relationship with your patient, and the case-acceptance philosophy, scheduling, and communication standards we build around it.
Our case-acceptance philosophy
We treat your patient, then send them back to you
Dr. Kung's practice is limited entirely to endodontics. That means we do not place implants, do not place crowns, and do not provide general dentistry. Once endodontic treatment is complete the patient returns to your office for the restoration. This is not a fence the office happens to sit on — it is the structural reason a referral to us protects the relationship between you and your patient.
Prognosis is communicated honestly, in your patient's language
Every treatment plan uses the AAE Treatment Options for the Compromised Tooth (2014) framework: favorable / questionable / unfavorable. We tell patients directly when a tooth is borderline, and we do not pressure patients into treatment we cannot stand behind. If a tooth should not be saved, we say so and refer back to you for extraction planning.
Specialty-grade equipment on every case, not just complex ones
Every endodontic procedure is performed under the Zeiss OPMI surgical microscope. Every complex diagnostic case is scanned on the J. Morita Veraview X800 in Endo Mode (80 µm voxel, 40 × 40 mm limited FOV) per the AAE/AAOMR Joint Position Statement on the Use of CBCT in Endodontics. Bioceramic obturation, ultrasonic activation, and electronic apex location are standard, not upgrades.
Communication is a clinical deliverable, not an afterthought
The single most common complaint general dentists raise about specialty referrals is communication. We treat that as a quality-of-care issue: same-day written report, CBCT export, direct phone call within 24 hours on complex cases, and a copy of the patient-facing explanation we provided so you can reinforce the same message at the restorative appointment.
Cases we see most often
A non-exhaustive list — when in doubt, call. We would rather hear about a borderline case early than have the patient circle back six months later in worse shape.
- Complex first-time root canal — calcified canals, severe curvature, suspected MB2/MB3 on a maxillary molar, or any maxillary posterior tooth where the sinus floor is at risk
- Endodontic retreatment — failed prior RCT, post-and-core in place, missed canal suspected on CBCT, or persistent apical periodontitis 1–2 years post-treatment
- Endodontic microsurgery (apicoectomy) — when retreatment is blocked by a tall post or screw-retained restoration, or when prior retreatment has already failed
- Cracked tooth diagnosis — when the cuspal bite test is positive but the location of the crack is uncertain, or when CBCT is needed to stage the fracture
- Dental trauma — avulsion (call immediately, time-critical), luxation, root fracture, complicated crown fracture; same-day evaluation
- Suspected non-odontogenic pain — when sinus, neuralgic, or referred pain is on the differential and a specialist endodontic exam can rule the tooth in or out
- Resorption — internal vs. external, with CBCT staging and AAE 2014 prognosis communication
- Maxillary sinusitis of endodontic origin (MSEO) — see the condition-specific referral guide
When root resection should be on the table before extraction
A furcation-involved or single-root-failing multi-rooted molar is the textbook case for the "save vs. replace" conversation. The decision usually comes down to candidacy, not philosophy — the long-term outcome literature on root resection and hemisection is consistent enough to give you concrete criteria. The bullets below distill the six most useful papers; the full references are listed at the end of this section.
- Periodontal indication beats non-periodontal indication. Park 2009 found root resections done for periodontal reasons (isolated furcation breakdown, isolated single-root bone loss) had significantly better long-term survival than resections done for caries, vertical root fracture, or endodontic failure on a single root. The non-periodontal indications tend to drag the average down. [1]
- Bone support on the remaining root(s) should exceed roughly 50%. Park 2009's only statistically significant site-related factor was the bone level around the retained roots — cases with greater than half the original support had materially better 10-year survival. If the CBCT shows generalized bone loss on the roots you'd be keeping, the case is borderline at best. [1]
- Avoid isolated mandibular terminal abutments under long bridges. Langer 1981's dominant failure mode at the 10-year mark was root fracture with cement washout on resected teeth serving as the distal abutment of a long-span fixed bridge. If a hemisected lower molar would be the terminal abutment of a 3+ unit bridge, the prognosis drops sharply — reconsider, or plan the case as a single crown instead. [2]
- Parafunction is either absent or managed. Langer 1981 and subsequent series consistently identify bruxism / heavy occlusal load as a leading reason resected roots fracture. If the patient grinds, the case is only realistic when an occlusal appliance is part of the treatment plan and the patient will actually wear it. Document this in the referral. [2]
- Maxillary molars with two large remaining roots tolerate force better than mandibular molars with one small remaining root. The biomechanics here favor upper resections of a single buccal root with the palatal root retained. Lower hemisections that leave a slender distal or mesial root carrying full occlusal load fail earlier — Klavan 1975 and Bühler 1988 both flag this as the predictable inferior outcome. [3,4]
- Combined endo-perio lesions on a single root of a maxillary molar can be salvaged with resection plus GTR. Oh 2012 documents the interdisciplinary workflow — endodontic treatment of the retained roots first, then resection of the affected root combined with guided tissue regeneration of the resulting defect. The right case here is a maxillary molar with localized endo-perio breakdown on one root and otherwise healthy support. [5]
- Set the survival expectation honestly: roughly 62%–97% over 10–15 years, driven almost entirely by case selection. Langer 1981 reported ~62% survival at 10 years across an unselected cohort; Bühler 1988 reported ~68% at 10 years; Fugazzotto 2001 reported ~96% cumulative survival at up to 15+ years in carefully selected resected molars — comparable to molar implants in the same practice (~97%). The takeaway for the referral conversation: a well-selected resection candidate has implant-comparable longevity. A poorly selected one does not. [2,4,6]
How to refer for evaluation
For a candidate resection or hemisection case, the most useful packet to send is:
- •Periapical of the tooth in question, plus a recent bitewing if available.
- •CBCT (limited FOV) if you have one — it's the single most useful piece of information for resection planning. If you don't, we'll capture one on the Veraview X800 in Endo Mode (80 µm voxel, 40 × 40 mm) at the consult.
- •Recent perio chart (or just the pocket depths on the tooth in question, with mobility class and bleeding-on-probing notes).
- •A line on occlusion: bruxism history, existing appliance, planned restorative end-state (single crown vs. abutment for a bridge).
Submit via the online referral form, or send the packet through the case assessment page. For a same-day phone discussion on a borderline case, call (669) 234-2354.
Related deep-dives: the patient-facing root resection & hemisection guide — useful to send a patient who wants to read the same evidence in plain language; and the apicoectomy page for the related decision when the apex of one root — rather than the whole root — is the problem.
References
- Park SY, Shin SY, Yang SM, Kye SB. Factors influencing the outcome of root-resection therapy in molars: a 10-year retrospective study. J Periodontal Implant Sci. 2009;39(2):55–60.
- Langer B, Stein SD, Wagenberg B. An evaluation of root resections. A ten-year study. J Periodontol. 1981;52(5):719–722.
- Klavan B. Clinical observations following root amputation in maxillary molar teeth. J Periodontol. 1975;46(1):1–5.
- Bühler H. Evaluation of root-resected teeth. Results after 10 years. J Periodontol. 1988;59(12):805–810.
- Oh SL. An interdisciplinary approach to a combined endodontic-periodontal lesion involving a maxillary molar treated with hemisection. J Endod. 2012;38(7):1009–1011.
- Fugazzotto PA. A comparison of the success of root resected molars and molar position implants in function in a private practice: results of up to 15-plus years. J Periodontol. 2001;72(8):1113–1123.
What you get back, and when
Same-day written diagnostic report
Endodontic diagnosis, CBCT findings on the affected tooth and adjacent structures, treatment performed, materials used, prognosis category (favorable / questionable / unfavorable), and any follow-up recommendations for the restorative appointment.
CBCT export and intraoral imaging
Annotated JPEG slices by default, DICOM on request. Pre-op and post-op periapical radiographs. All imaging stays with your patient's chart, not locked in a specialist portal.
Copy of the patient-facing explanation
You receive the same plain-language explanation we gave the patient, so the message stays consistent across both offices and you can reinforce next-step expectations at the crown appointment.
24-hour direct call on complex cases
Not a portal message — an actual phone call from Dr. Kung within one business day on any complex, borderline, or unexpected case. For urgent cases, same-day.
Scheduling
Seen within the same calendar week. Online referral form is the fastest path — auto-routed to scheduling within business hours.
Same-day or next-business-day. Call (669) 234-2354 directly; you can also reach Dr. Kung's mobile through the office for true time-critical cases (avulsion, severe facial swelling).
Saturday and Sunday, 9 AM – 3 PM. One of the only Bay Area endodontic offices with regular weekend availability. Same-day weekend emergency root canal treatment for your patients who can't wait until Monday.
Not sure if a case is worth referring? Score it first.
The AAE Endodontic Case Difficulty Assessment Form (CDAF) is a one-page worksheet that scores any case across patient, diagnostic, and treatment considerations and lands on a Low / Moderate / High difficulty rating. Moderate and High cases are exactly the ones that benefit most from a specialist referral. Print it, keep it chairside, and use it to make the treat-versus-refer call objectively.
Pre-edentulous risk minimal — predictable for most GPs to treat in-house.
Complicating factors present — consider referral, especially without a microscope and CBCT.
Exceptional complexity — referral to a specialist is generally the standard of care.
Ready to refer?
Submit through the secure online referral form, download the printable referral pad, or call Dr. Kung directly for same-day discussion of a complex case.