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Calcified Metamorphosis :buccal sinus tract
The opinions within this web page are not ours. Authors have been credited
for the individual posts where they are

From: Nuria Campo
Sent: Friday, July 25, 2008 3:02 AM
Subject: [roots] Another Calcified... and previously perforated

Female 50 yo.
Referral find out buccal sinus tract near #9 in routine yearly check up.
Previous "Root canal Fill" >10 y ago in patient words + buccal porcelain
work ( I donīt have the english word for "carilla") 3 y ago.

Diagnosis: Calcified Metamorphosis secondary to previous trauma + false
path with lateral perforation result + PAC and sinus tract.

I tried to recover the original root canal. At the time Iīm 4-5 mm to
the supossed POE. I removed gutta percha of the false path.

And I stopped. Dressed with CA(OH)2. Really i donīt know how to manage
the case if the sinus track donīt close.

Can you give any advice?
- CT Dental Scan can help in order to see if the apical 1/3 could be
  patent, or if Iīm in the right buccopalatal direction? I donīt have
  experience with that but I guess that it doesnīt worth.
- Do you follow deeping? I consider the perforation risk is hight.
- Rationale time dressing protocols.
- Next step options if the sinus tract donīt close.
  Seal with MTA the false path and gutta percha + sealer and follow up
  with delayed SRCT if the sinus tract donīt disapear.
  Or Surgycal access in the same visit and in any case, try to retroclean
  and shape the apical 1/3  if its patent and seal the apical POE and the
  perforation POE with MTA?

Any suggestions and criticisms will be welcomed - Nuria Campo

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