From: Fred Barnett
To: ROOTS
Sent: Sunday, April 24, 2005 1:20 AM
Subject: [roots] 4th case du jour--Ag point retreat

AG point retreament.
I troughed around the Ag points with ultrasonics, and they came out very easily....thank goodness.-  Fred

 



My odds with silver points aren't so good.  I've had some jump out,
others have gotten the best of me.

Is my experience similar to others?  or am I particulary weak in this area,
I don't know. - Kendel

Same as mine.....these were easy..others that were done correctly
(wedged in tight) can be a bear.- Fred

Hello Fred,  Same experience here as Kendel.
Do you use ultrasonics for all retrievals? My worst nightmares are the ones in which the tips of the silver points are
cut and then placed with the ends below the orifice level. Any suggestions on how to handle these? - Samir

Hopefully there is some space around them and a Hedstrom file can be worked along side the Ag point...1/4 turn...
then pull.  On occasion, I will trough around the point with a thin U/S tip.- Fred

Fred, But my fear with U/S is that the silver point being so malleable may "give" with the resultant further
fracturing of the coronal part. Anyway... sounds good. Will give it a try although I hope I do not have an opportunity
soon! ;-)) -  Samir.

I have some very old but very useful narrow bore trephine burs that were made by s.s. white which are great for freeing
up the heads on a silver point or a small post.  Does anyone know of a manufacturer who might still be making these.
We use the same concept often for removal of failing implants.  I’m worried sick I’ll snap this thing one day and that
will be that.- gary

When troughing around a silver point, only trough 3/4 of the circumfrence.
That way there is remaining support for the soft metal point, and you are more likely to expose sufficient length to
allow getting a purchase on the point.  And you can use low u.s. power to vibrate the point against the remaining wall
of support while loosening it.  Otherwise you are likely to end up only shortening hte silver point to hte level where
you cannot get it out.

But if you are in a great big hurry, go find something else to do for humanity.- wes

Great tip wes.  I have always troughed circumferentially, but your explanation makes sense to me and also conserves
more tooth structure, which may have the added benefit of less chance to perf.- gary

Thanks Wes, I'll keep this in mind.   The troughing tips that is, in service to humanity.  ;-)  - Kendel

That is a great tip Wes.  I have had very good success removing silver points, but have busted them off before and made
my life more difficult. - John A Khademy

Your comments please