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From: Winfried Zeppenfeld
Sent: Wednesday, November 05, 2008 6:00 AM
Subject: [roots] Interradicular lesion
I did this 26 (#14US) 4 months ago with Resilon/Epiphany
(System B/Obtura, palatal squirt). Adhesive seal on each canal.
Today I obturated 27 (#15US) and saw a lesion developing around Resilon
extruded through a large lateral canal going off mb2 (it’s only enlarged
to MTwo 35/04, so I doubt a strip perf) in the furcation . There was a
lesion when I obturated it, but I seems to be larger. What would you do?
1. Wait and see how it develops
2. Access the mb2, perf it on purpose in the area of the extruded material,
remove the extruded material, disinfect, close with MTA.
3. any better idea
Thanks for help, - Winfried
Hello, You have done a terrific endodontic treatment of tooth 26.
If the patient do not have any symptoms you should observe.
I am not sure that the lesion is larger
Your projection is a little bit different so I think it is impossible to
compare the size of the lesion on the X-rays provided.
I would have waited 12 months before a follow-up if patient free of symptoms.
Otherwise a small explorative operation with removal of extruded material and
removal of the lesion seems a easy way of solution when we know that you
did the RCT. - Harald Prestegaard, Norway
Winfried, I’d observe and if it enlarged, treat it as a strip perf.
It is too accessible to ignore. - Guy
The radiographs are taken from different angles so 1. the lesion may appear
bigger but it may be an "angulation lesion". Also 2. after 4 months it could
be in reaction to the sealer - it is in an area where the cortical plate is
close so loss of bone will show up easily. As long as there is no perforation
and no infection it should sponteneously heal.
Bottom line: Wait and unless there are symptoms follow up again at the
one year period. DO NOT DO ANYTHING NOW. - Bob Gannon