From: Raghu karantha
To: ROOTS
Sent: Thursday, June 22, 2006 4:54 AM
Subject: [roots] intracanal bleeding

I need to know how to stop bleeding in the canal after establishing patency in vital tooth, I had difficult time in controling
the bleeding in MB canal in vital tooth after establishing patency. - Raghu

Raghu, often the bleeding cannot be stopped so you can proceed with the obturation.  Under those conditions I place Ca(OH)2 and
reappoint to finish a week or two later.  I've tried various hemostatic agents on paper points with limited success.
I'm always concerned about the hemostatic agents effect on the set of my sealer.  The ferric hemostatic agents also leave
a brown/black coagulum that should be removed before obturation which is difficult to do without starting the bleeding all
over again.  Sometimes the bleeding is from inflammation in the periapical tissues and other times it is from accessory
canals and isthmus pulp tissue.  In either case Ca(OH)2 will help debride these complicated areas over a week or two and
you will get better results by medicating, being patient, and obturating at a later date. - Randy Hedrick ,Diplomate ABE

Distilled Water associated to Ca(OH)2 has been very useful for me in bleeding canals. 1 gram to 20 ml.
Check length too. - Marcelo Krauss

When that happens to me . it is usually solved by filing to a larger size. Remember the shape of these canals is not round
and it's easy to leave vital tissue behind. - John R. Wilson