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dens case ,tx options
From: Sashi Nallapati
Sent: Tuesday, January 30, 2007 7:34 PM
To: ROOTS
Subject: [roots] dens case ,tx options
This is how I managed it
please read the attached case report I published in JOE for the
exact tx sequence. if I were to treat it today, I will do the
the same exact way but in one visit. good luck
prognosis is excellent if the tx is done well. ;-)) - Sashi
Sashi: I had not seen that article before. Well documented and
written. I saved a copy for future reference.
Excellent as always - gary
HI Sashi, Excellent case report, very well detailed tx secuence.
Some questions: - Nuria Campo
1. When you say "if I were to treat it today, I will do the same
exact way but in one visit", are you saying the 1st option
would be: NSRCT + Endodontic Surgery in one sesion? - Nuria
Yes - Sashi
2. Why not CHX 2% for flushing the canal vs 0.12 % during
the surgery? - Nuria
you can do that...Sashi
3. About hemostasis during surgery:
- If you didnīt control bleeding very well, would you choose
filled flowable composite or would you prefer another
retroobturation material less wet-sensitive like MTA or
others? - Nuria
YES, But remember, if you use MTA, then you have to do
orthograde obturation first and then the retrograde. if you
do it the way i did, (retro first and ortho next) then the
retrofill my pop out during the ortho fill. You can consider
using super EBA as well where you can do the retro first and
then the ortho fill - Sashi
- What is the pharmaceutical form of calcium sulfate? Powder,
liquid, paste? Do you obtain at the drugstore or is a
registered trademark? - Nuria
I used calcium sulfate USP powder from Schein. its cheap and
can be microwaved to sterilise.- Sashi
- Is usually under control the bleeding using calcium sulfate
during apical surgery?
calcium sulfate helps with hemostasis. You fill the crypt and
after it sets, you can carve it back to expose the root end.
4. Is Suture removal 48h later the standart for 6-0 microsutures?
you can do it upto 4-5 days.
I prefer to get rid of them in 2 days. - Sashi
5. Obviosuly 4 moths recall shows bone regeneration, but did you
have long term recall of the case?
yes, 18 months recall which i posted in the same post.
i also attached it in this mail.complete bony healing,
pdl regeneration around the root end and vitality of the pulp
maintained. i spoke to the patient last month (3.5 Y ) and he
still has vitality in tooth and doing fine. i will get him
down for another radiograph.- Sashi
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