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Difficult retreatment - Courtesy ROOTS |
| The opinions within this web page are not ours. Authors have been credited for the individual posts where they are. Photos courtesy Marga Ree - ROOTS |
From: Marga Ree To: ROOTS Sent: Wednesday, April 02, 2008 7:05 PM Subject: [roots] Difficult retreatment This was a difficult one, the dentist couldn't find the palatal canal. The root canal filling of the buccal was and extruded significantly, and the patient presented with a sinus tract. I suspected 3 canals, and indeed there was a deep split in the buccal. I could remove the main part of the extruded gp cone, but some remnants stayed behind in the peri-apical tissues. I had to extend the buccal canal orifice in a mesio- distal direction, in order to get access to both canals. Ca(OH)2 for 6 weeks, and today I finished treatment. Fiber post and BU of composite as usual. - MargaMarga, and i thougth that i am having the most complex cases in my practice. stunning as usual. extremely well done, as usual.- Sergiu Nicola Very,very nice Marga, as usual .How did you remove the GP cone ? - Paul Thanks Paul. Before using any solvents, I always try to engage the gutta-percha filling by screwing in a Hedstrom file, and remove it in one piece. Because the filing had been extruded in the peri-apical tissues, I didn't manage to remove it completely. - Marga Marga, I love the treatment, the presentation and of course the result. Can you please tell me how you place your Ca(OH)2 ? - Thomas Thanks Thomas. I bring a lentulo spiral to WL for application of the white stuff. - Marga Dear Marga, How thick is the white stuff ? Is it watery or solid or in between ? I am asking because lately I found out that sometimes it doesn't flow well inside the canal especially close to the apex. - Thomas Nice case Marga, Micholis hi marga , as others have already said, excellent treatment and documentation, we all look forward to your cases! In page 2 lower left is that CaOH extruded from the sinus tract? - Abdul Abdul, Thank you for the kind words. Yes, that's Ca(OH)2 extruded into the sinus tract. This happens once in a while when bringing CaOH to length after instrumentation. Some clinicians try to achieve this on purpose. When it happens, there is ususally a quick resolution of the sinus tract. Just my clinical experience, no scientific background - Marga Hi marga. Just as a footnote to that. Traditionally when treating ailing implant fixtures we have tried to detoxify the exposed surfaces with things like acetic acid , or tetracycline, another acidic medium. Recently, there have been reported some very positive results attained by flapping, thorough debridement, and the placement of caoh2 circumferentially around the ailing implant, and suturing closed. In essence an external version of what we do internally in endo. Are you and paul going to be home Tuesday aug 5. Connie and I are taking chrissy on a northern Europe cruise to celebrate her graduation and I believe the carnival splendor will be in port in Amsterdam that day for about 7 hours or so - Gary
