Check Page Ranking

Home
Dental tourism
Conferences
New additions
Dental books
FREE journals
Bad breath
Kids caries
Smoking effects
Patient info
Dental Videos
Latest news
ROOTS cases
Wisdom tooth
Diabetes
Drugs of choice

Endo tips    Better Endo    Endo abstracts    Endo discussions

The opinions within this web page are not ours. Authors have been credited
for the individual posts and photographs where they are. - www.rxroots.com

14 year recall: retreat the retreat?

From: Terry Pannkuk To: ROOTS Sent: Wednesday, April 28, 2010 10:56 AM Subject: [roots] Ugly-working, Radiographic Fake job-failing- 14 year recall Puzzle: what next? This case is a perfect demonstration of how apical cleanliness, maintaining asepsis during treatment, and understanding sound endodontic principles leads to success. I was referred this patient in 1996 for retreatment of the first molar which had been previously ledged blocked and filled with Sargenti paste. I cleaned and shaped it to the blocks, manicuring a controlled lateral perf under meticulous isolation with a rubber dam, maintaining an aseptic field; I.e. I didnít use an IsoLite. When I recalled this patient in 1998 at two years, I noted that she had seen someone else to have #31 treated. Maybe she was told my radiographic result didnít look appealing so she went to a white line lover radiographic showman. :) I found out later it was treated with Thermafilth. She was referred back yesterday as her crown had fallen off. Her new dentist was dismayed that the cotton pellet I had left in the distal post space in 1996 was still intact and looked as ripe as month old guacamole (another example why I donít leave spacers, either cotton pellet or sponge, when I send them back to their dentist for a core these days ,below is a case I treated today and placed solid Cavit without a space letting the dentist dig out as much as he needs for retention). I took a CT and predictably the Thermafilth case was growing a mesial lesion and my retreated tooth showed no lesions on either root. Sure this is just another single anecdote, but is it really a small wonder that an unclean, poorly shaped apical third filled with a CrapnCone will eventually break down and fail? This radiographically ugly retreatment endo success next to a radiographically pretty Thermafilth failure is a nice side by side contrast of endodontic long-term outcomes. Puzzle Question: What do you do with #30 now that the crown fell off? Retreat the retreat again? Clean out the post space, place a core, have a new crown made and cross your fingers? Extract and implant? What do you think Iím planning on doing? - Terry If you pack the Cavit deep you donít get rotten guacamole like this case today (2nd molar today, I treated the first molar in 2005)
K 3 lightspeed
Crown replacement
Root reinforcement
Vertical root fracture
Periodontal pocket
Cox crapification
Cold sensitivity
Buccal sinus
Nikon 995
Distal canals
Second mesial canal
Narrow escape
Membrane
Severe curvatures
Unusual resorption
Huge pulpstone
Molar access
Perforation repair
Maxillary molars
Protaper shaping
Pulsing pain
Apical periodontitis
Mesial middle
Isthmus protocol
Fragment beyond apex
Apical trifurcation
Jammed K file
Mesial canals
Irreversible pulpitis
Bicuspid abscess
Sideways molar
Red Dye allergy
Small mirrors
Calcified molar
Extraction and implants
Calcificated central
Internal resorption
Bone lucency
Porcelain inlay
Bone allograft