From: Roberto Cristescu
To: ROOTS
Sent: Monday, May 15, 2006 8:19 AM
Subject: [roots] Molar Paste Retreat

I just started today this upper molar.

RCT done in 1999, and afterwards a PFM bridge placed. Same dentist performed the RCT and the bridge.
I saw under the bridge in the access cavity the cavit, than the cotton pellet, than only the DB and
the P treated (with red russian paste).

Although I was big time hammered by one of the prostho referral that I enlarge too much the access
cavities, I had to push the mesial wall to get to the MB root canal system and discovered MB1 and MB2
and an isthmus between them. My big concern is if I should have removed more from that isthm , maybe
trough it more with a bur....it looks black coloured, maybe black pigmented bacteria , or something else ?

Than the DB was severely blocked with paste. A case not to be treated without a scope. WIth great care,
and a lot of emotion :-), I was troughing the paste from the DB, little by little, until I managed
to get past by and insert a 025 file to WL.

The P was quite easy. Total time 2 hours for today. Placed CaOH2 and scheduled back in 30 days....

I wait suggestions and help....- Roberto







Tell the pros guy that "the mb access should normally approach the height of contour of the mb cusp
to acheive straight line access." What does he want, an intact restoration in the can? And yes, the
mesial isthmus should be troughed; it is especially important on retreats and necrotic cases..Good luck,
you are off to a great start. DougR

Thanks Doug ! I'll trough more that isthmus on the second visit and send pics for check up.....Roberto