Fragment beyond the apex - Courtesy ROOTS
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photographs courtesy: Winfried Zeppenfeld
From: "Jörg Schröder"
Sent: Monday, March 23, 2009 1:05 AM
Subject: [roots] This one has been long!
Referral case, fragment has been beyond the apex, obviously
"fixed" by guttapercha.
After reducing the buildup and removing the post I started
removing the guttapercha step by step with endosonore files.
When I first could visualize the fragment I was quite afraid
of pushing it out.
Irrigation with CHX and sonication removed the debris and
I was able to move the fragment back into the canal with a
microopener. In cases like this I prefer to remove the crown
also, to have a better visibility and access to the fragment.
Single visit with Collagene as a barrier, MTA Angelus and
adhesive Build-Up. Recall after 8 months shows healing is in
progress. - Jörg Schröder
Hey Jorg, As always superb.... Best, Gustavo
Text book case!! Beautifully handled! - Marga
Excellent case, beautiful documentation!!! - JOSE
Hello Jorg, Very nice presentation and very nice job.
I think you are a micro opener specialist because it is not
the first time that you present such a case . Which
particular size and brand do you use ,Maillefer? ,MC? ?
Personally I find the 10 and 15 too flexible to do this
kind of work? What do you use? - Paul NOYER from Amsterdam
Hello Paul,I use the 10/04 from Maillefer. In my opinion
it is stiffer then the MC file. In this case I removed the
rectangular bend of the original instrument, so I had more
"working length" which makes it easier to have a good view.
Sometimes I prebend the tip also in order to get beside things
I want to remove (guttapercha, retrofill, fragments)
Fantastic work Jorg......did you take the microopener beyond
the apex to pull the fragment back into the canal? - Sachin
Yes, I did leave the canal and "worked" in the granulation
tissue.In order to avoid transporting debris periapical I
irrigated extensivly until I could see that the walls have
been "cleaned" - Jörg