10 y ago in patient words + buccal porcelain work">

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Another calcified and previously perforated - Courtesy ROOTS
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From: Nuria Campo
Sent: Saturday, July 26, 2008 1:26 PM
Subject: [roots] Fwd: 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?
- Nuria Campo

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