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 #14 implant
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From: Maarten Meire Sent: Wednesday, August 23, 2006 4:25 PM Subject: [roots] case Interesting case of today: Last month, patient had an acute abscess on tooth 25. GP prescribed antibiotics and referred to our office. Today, she was symptom free. I looked at her tooth and thougth the endo wasn't too bad. Though, an apical lesion was present at the lateral aspect of the root. I explained the lady that maybe an untreated canal could cause this kind of trouble, or even a vertical fracture. Upon access, I discovered the entrance of another canal. However, after only a few mm, it merged with the main canal. I continued the retreatment and enlarged the apical diameter of the prep. Obturation warm vertical (System B), and excited to see a large lateral canal filled at the site of the lesion. I don't think any cold condensation technique would have yielded this result. I was mainly trained with cold obturation techniques, but I gained interest in warm vertical (partly due to ROOTS!), and it's pretty exciting, although sometimes I'm concerned with the apical few mm's of GP. I'm not sure if this part is really molded into the apical preparation. Can anyone convince me of that? - Maarten Meire

You are definitely on the right track maarten. Here's an example of what can be achieved with cold lateral condensation. Good news is this is an 8 year followup on a replanted evulsed tooth - Gary

Ok, Gary, that Dr. really 'threw' the cones in. Did you retreat it? (I would!) In fact, cold lateral is not a bad technique at all if well executed. I attached an image of a tooth prepared an filled by someone just beginning postgraduate endo training. The prep could be better, but the obturation (cold lateral) is fine - - Maarten Meire

Beautiful result, and I have no doubt that will heal. I always love to see a puff going into a lateral lesion. As for your question about gp deforming in the apical third, treat some extracted teeth then shave them back and look for yourself. This is the best way to prove to yourself what is going on - Mark You are definitely on the right track maarten. Here’s an example of what can be achieved with cold lateral condensation. Good news is this is an 8 year followup on a replanted evulsed tooth - Gary

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