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Full mouth rehabilitation
From: "Winfried Zeppenfeld"
To: "ROOTS"
Sent: Saturday, January 13, 2007 4:22 AM
Subject: [roots] Treatment suggestions needed
42 y old patient, had an accident many years ago, needs full mouth
rehabilitation. Does anyone see a chance to save 31, 33 and 12
(#7,22,24 US)?
These teeth are probably filled with some metal post, apico was done
many years ago. The way these posts are wedged, I have little hope to
get them put. Considering the size of the posts, I have little hope to
negotiate the missed canals. My only idea would be to cut a groove
around the post with a tiny ultrasonic retroprep diamond, prepare the
isthmi and retrofill with MTA . But I'm rather thinking implants. Any
other suggestions? - Winfried
Winfried, I'm in agreement--implants seem a more predictable choice
here. - Kendel
Winfried, Titanium is your friend here I think.
Do you have a panoral film?
Wonder what the notches in the posts are for?
Little radiopaque bits on each of them. - Bill
Hi Bill, I think those notches are designed for intentional breakage.
I think I saw that system when I went to dental school, but I forgot
the name. You cement and wedge the apical part and when you turn the
post ofter wedging, it shears off at the notch and the apical part
stays as a plug. Haven't seen any that worked yet :-( . I think the
lowers are titanium, the upper might be silver. I attach a pano for
you. Another thing is that the pt wants it all done this year for
insurance reasons. So I think there is not much time for herodontic
experiments - Winfried
Winfried ,Little bit like sectional silver points when you trimmed
them with a diamond and then rotated once in the canal. I actually
saw a consult this week with a silver point placed 2 years ago in
the UK. It's failing cos of missed canals though.
This is gonna keep you busy for some time, I'm glad I have
restorative guys in the practice who can deal with this sort of stuff,
I'm learning more and more about implants all the time, but this
isn't the case to pick as your first one! Let us know what happens.
- Bill
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