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Ca(OH)2 Extrusion - Courtesy ROOTS

The opinions and photographs within this web page are not ours. Authors have been
credited for the individual posts where they are - www.rxroots.com
From: cristescu roberto
To: ROOTS
Sent: Saturday, April 24, 2010 6:57 AM
Subject: [roots] Ca(OH)2 extrusion

This patient came in january with huge pain and an extremely mobile 26.
She wanted despite all the explanations to still give a try to save the tooth.

Having such a bad prognosis we choose a different approach, wanting to see some signs of
healing before we will fill the canals and charge the patient the full fee for an exteremly
questionable prognosis.

Unfortunately palatinal I made a huge Ca(OH)2 overfill. Which...was not painful...

After 3 weeks she came with a flare up (see the swellling in some of the clinical pictures).

After all , in 3 months, the pockets reduced, normal mobility, no pain on mastication,
signs of healing on the CBCT, so we decided to fill.

I am probably convinced the same result would have been with a single visit - Roberto

Excellent Work Roberto. It is amazing what NS-RCT can do...Henry Roberto, aside from posting terrific cases you set the documentation bar higher and higher :-)) - Dmitri Excellent documentation and nice end result. But Dr Roberto you are really convinced that you would have had similar results in a single sitting approach in such a case. I think the first challenge you would have faced would have been to get the canals dry. But that's just my loud thinking and want to add to my knowledge on these matters - Sanjay Jamdade Dear Roberto, superb treatment, documentation and result. Congratulations! - Liviu Hi Sanjay , Thank you for the nice comments. You are right about getting the canals dry. In this particular case , even with the pus starting in the P canal, at the end of 1st visit I was able to get all 3 root canal systems dry. I am more and more convinced reading the literature and seeing my cases (and others as well) that in regard with thorough desinfection of the root canal system probably Ca(OH)2 doesn't add any really benefit . I use it to temporise some guarded cases so that if it is really not getting better , than the patient just pays a small amount from the whole endo fee, plus he/she stays less in the chair. I am not convinced that waiting to see healing with empty canals is same as waiting with a temporary filling as CaOH... = Roberto Roberto, Great case & presentation, thanks for sharing! It seems the Kodak 3D is not just catching dust in your office ;-) Wonderful and impressive demonstration of the dynamics of healing...Maarten

Protaper flaring

6 yr old Empress

Cvek pulpotomy

Middle mesial

Endo misdiagnosis

MTA retrofill

Resin core

BW importance

Bicuspid tooth

Necrotic #8 treatment

Finding MB2 / MB3

Deep in a canal

Broken file retrieval

Molar cases

Pushed over apex

MB2 and palatal canal

Long lower third

Veneer cases

CT Implant surgury

Weird Anatomy

Apical trifurcation

Canal and Ultrasonics

Cotton stuffed chamber

Pulp floor sandblasting

Silver point removal

Difficult acute curve

Marked swelling

5 canaled premolar

Sealer overextension

Complex anatomy

Secondary caries

Zygomatic arch

Confluent mesials

LL 1st molar (#19)

Shaping vs Cleaning

First bicuspid

In Vivo mesial view

Inaccesible canals

Premolar 45

Ortho and implant

Radioluscency

Lateral incisor

Obturation

Churning irrigant

Cold lateral

Tipped to lingual

Acute pulpitis images

Middle distal canal

Silver point

Crown preparation

Epiphany healing

Weird anatomy

Dual Xenon

Looking for MB2

Upper molar resorption

Acute apical abcess

Finding MB2

Gingival inflammation

Irreversible pulpitis

AG BU ortho band

TF Files

using TF files

Broken bur

Warm technique

Restorative prognosis

Tooth # 20 and #30

Apical third

3 canal premolar

Severe curvature

Interesting anatomy

Chamber floor

Zirconia crown

Dycal matrix

Cracked tooth

Tooth structure loss

Multiplanar curves