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Miracle of CaOH
The opinions within this web page are not ours. Authors have been credited
for the individual posts where they are. - www.rxroots.com -Photos courtesy Rick Schwartz


From: "Richard Schwartz"
To: "ROOTS"
Sent: Wednesday, June 06, 2001 7:21 AM
Subject: [roots] Re: 6 week apexification (or the miracle of CaOH)

Here is a patient I saw today.  She is a 15 year old who presented on 
April 22 with swelling in her maxillary labial gingiva and upper lip.
She had trauma to her anterior teeth at age 8 and the root canal was 
done on #9 shortly thereafter. The pulp was necrotic in #8 and the apex
was wide open so my plan was apexification.  I prepared the canal to 
size 120, placed CaOH,

prescribed antibiotics and reappointed her for a week later.  She was 
a no-show for that appointment, and another one 2 weeks later.  Finally 
we got her back in today.  Because of the difficulty in getting her to 
come in, I decided to place an  MTA barrier today and complete the 
root canal.

However, when I removed the CaOH, there was a solid apical barrier.  
I poked around with a size 10 file and could find no holes.  When I
obturated I placed sealer, filled the canal with the Obtura, downpacked 
with the System B and then backfilled.  No puffs!  The first 4 pictures
are from April 22 and the last two from today.  I didn't
think it was possible to form a solid barrier is so short a time 
- Rick Schwartz

Rick, Nice case. Yes, that is quite fast to obtain a complete barrier. Open up the owerpoint slide that is attached for a review of barrier formation times. - Fred Table courtesy - Fred
Apexification
Hard-tissue formation, Ca(OH)2:

F. Barnett
help the slow people .........can you explain what the slide is telling us/me.....craig Craig, Sorry...I should have explained this slide. The slide shows the number of teeth for each study (No.), the percentage of cases that developed a complete barrier (Barrier), and the average time in months for the barrier to form (Time). In the Finucane et al paper, the (p) denotes a parallel root apex, and the (d) signifies a divergent root apex, which should and does take longer for a barrier to form. Please let me know if you need more clarification. This slide is taken out of context from a lecture on trauma that I give. Fred (BEAT L.A., BEAT L.A., BEAT L.A., sorry, Sixers mania is getting the better of me). Once again, a great learning experience. I can't believe how fast that the apexification occurred. Was there much bleeding on day 1? How do you pack the MTA in at the apex on a case like this if you want to do it that way. Dovgan Carrier I guess but how to pack it down there - Glenn Glenn, After some drainage initially, I was able to dry it pretty well at the first visit. I was going to try my new Dovgan Carrier for the first time, but didn't need it in the end. I place the MTA with a carrier as far apically as possible and then use Schilder pluggers with a stopper to gently maneuver it to the apex. I clean up the excess with large, wet then dry paper points. I'd be curious to hear how other people do it - Rick
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