Access as key to success - Courtesy ROOTS
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From: Jörg Schröder
Sent: Saturday, December 16, 2006 3:05 AM
Subject: [roots] Access as key to success
this one showed me that access can only be substituted by better access.
# 18 (# 1 US). AAP, MB2 was located under a lip of dentin. I had a hard
time to get the rubberdam on. After removal of the filling I built up
the mesial wall. Then I struggled for a good access to all canals.
Nice mixture: tooth location, angulation in the arch and nice curvatures.
MB1 and MB2 merged about 6-7 mm below orifices. Did not get behind the
merging point in first session, when entering the mesial systems from
At the second visit the prebended!! handfile just slipped into the MB2.
Shaping with M2 and ProFile. To bad I created that $!!§!&%void ! But Pt.
and me had been both quite exhausted - Jörg Schröder
Jorg, Oh man, I'm sweating just reading about this case ----
fantastic work and images as always! - Kendel
Jorg a good dentist only will be substitutued with a better one like
your self. Great case and documentation - Carlos Murgel
Jörg , Excellent documentation and managment of a very hard tooth !
How did you build the mesial wall after the removal of the filling ?
Always nice to see your post, those collages are so nice - Thomas
Thank you Thomas,
after placing ruberdam, clamp is wingless (W8A) I first try to get the
rubberdam as apiccaly as possible. If the tooth is still covered by
rubberdam I use cords to push it down. When I can see the tooth margin
I use a highspeed diamond coated bur to prepare this area. As it is hard
to fix a matrix in these cases I use a low flow composite
(Estelite Lowflow) and build up the margin only. This may need 3 or 4
thin layers of composite to create a small wall mesial. If you didi
it ight you don't have to do anything but placing the matrix. If you
spoiled some composite just use a finishing strip to smooth the outline,
bond it again and place the matrix now. The proceed as if you were doing
a composite filling - Jörg
Really nice case. When I have a Type II or merging canals, I place both
master cones, sear off at the orifices, and then downpack one at a time.
Terry has shown his technic where he uses two pluggers while obturating.
Or, just "squirt"...right Joey? - Fred
Thank you Fred. I was not able to get more than a ProTaper S2 into the MB2.
As the distance from the orifice of MB2 to the merging point was not more
than 6-7 mm I did not use a mastercone in MB2. I used the heat carrier to
reduce the extruding GP and then squirted the MB2 - Jörg
in addition to marga's comments, i have found a well trimmed good old
copper tube to be an excellent matrix to do a pre core buildup - gary