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From:Marga Ree
To: Roots
Sent:Friday, December 01, 2006 7:02 PM
Subject:[roots] Missed canal
This patient was referred for retreatment of 25. The endo had been
performed by a good clinician, and you can see that the quality of
the build-up is also nice. Nevertheless it failed. Why?
I took an angled radiograph, an there it was, the root filling
didn't stay centered, so there had to be a second canal. Upon entry,
there was a very wide canal, so it must be a bifurcation in the apical
third. I thought I saw a dark spot in the scope at the buccal side,
so I picked, and picked with prebended files.........took the EAL,
made a rad ........wrong direction, see fourth rad, I ended up witha
small perf.....:-(
Then I saw another spot, and I was luckier this time, see fifth rad :-)).
Then I knew it was a matter of patience, instrumented with K3 taper 4,
filled with Resilon.
Whenever there is an apparant good sealing composite filling present,
I remove as much composite as possible from the inner side, and leave a
thin shell of the old composite in place, place a post (in this case 2,
because of the oval shaped canal) and fill it up with composite.
Then I remove the upper part of the posts, and submerge them in
composite, to prevent possible leakage by the post. The old layer of
composite will be removed when the dentist does his crown prep - Marga
brilliant as ever. I just wish I had such an Endodontist in town. and
by the way. what happened to the pain in the end? did it disappear?
- Ananya.
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