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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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