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 MTA carrier and surgery
From: Bob Krauss
Sent: Tuesday, April 03, 2001 9:25 AM
Subject:MTA carrier and surgery

.....Has anyone else had a problem with MTA not setting up. I just redid
a surgery and when I flapped the area and curreted I was able to take a
micro explorer and go into the retroprep and literally lift out the MTA(not in one piece)
but it was "granular"? Would appreciate any feedback as this is
first time in many cases. - Best Regards Bob Krauss


Bob: The exact same thing has hapenned to me in one case. MTA granular
obviously not set up upon resurgerizing). I even mentioned it to John
Stropko.  He looked at  me....funny (he >was thinking ... you used it wrong
dummy) but said  nothing ....gentleman that he is.
To tell you the truth I sometimes feel nostalgic about
amalgam retrofills. Never was enthusiastic about EBA or IRM
I have not used Optibond or Retroplast but I have been impressed by Peter
C. 's cases and of course Gary's. -  Ben

From: "Peter D. Cancellier, DDS"
Sent: Tuesday, April 03, 2001 4:18 PM

Yes, I have had the same problem on two occasions. I presented one of them at
the AAE. It may have been that I was using some from a film canister given to
me before Tulsa started selling it or there is the infection concept. For me,
I only use it if I can not get a blood-free retroprep which is very rare. It
is a frustrating material because I like to rinse the crypt and stimulate
bleeding before closing and I worry that the MTA will ooze out. You can't
wipe the root-end without ditching the MTA.

Don't feel bad. You are not the only one disappointed with the material in
root-end situations. - Peter

From: Guido Costa
Sent: Wednesday, April 04, 2001 03 06

Did you see the Navy's table clinic in which they are applying Capsept over
the MTA?  I've not done it yet,but it is a good idea. - Guido

From: benschein
Sent: Wednesday, April 04, 2001 03 22

Those Navy Endodontists are smart!!!!

As you know MTA has the same components as Portland Cement.  Guess what they
put in Portland cement to accelerate setting?.......... Lime.   What is
Lime? Here is a pargraph on lime in the internet

Lime may be sold as calcium hydroxide or calcium oxide,
and we have been asked if both compounds can be used in
pickle recipes calling for lime as a crispening agent.
These two compounds can be used interchangeably as long as the package is
clearly labeled hydrated, slaked, builder's,
or household lime. Neither compound should be used if the
package is labeled agricultural, burnt, or quick lime. By
using up-to-date recipes and high-quality ingredients, firm
crisp pickles can be made without the use of lime.

Make your own conclusions......

From: I. Blake McKinley, Jr.
Sent: Wednesday, April 04, 2001 04 24

Ben, you absolutely amaze me with where you come up with information.  I
wonder what the concentration differences are between the lime for pickling
and the calcium hydroxide we use. - Blake Jr

From: Yosef Nahmias
Sent: Tuesday, April 03, 2001 23 02

As per MTA, you got it! My thoughts on it (I have tried to get as much info from
Portland Cement for my lectures!) are, I think that as dentist, we are manipulating
the material as if it were amalgam! It is not, it has to be Hydrated MORE! I am now
hydrating mine quite a bit, little by little as I put it in place! If it is too dry,
it wont set! As a matter of fact, I do not use it for surgery!  -  Yosi

From: Bob Krauss
Sent: Wednesday, April 04, 2001 23 18

Ben,  Sorry about being out in space. I am very careful when I use MTA and
having used it for over 3 years I do not think John needs to give me a look.
I know the material is very technique sensitive  and this is the first case I
have seen this on in probably 100-150 times using the material.

I have also done some bonded retroseals using Optibond and have had very
good succes. As Peter mentioned you must have excellent control of the field
and that is something we all strive for. It seems that if we go this route we
would be sealing much better because we are "capping" the apex not just the
retroprep. My question, and it might be a good study is how the bonded
retroseal would stand up to the occlusal forces we place on a tooth? Maybe I
can get Fred interested to try this as a study and then see if it affects
leakage.  Best Regards, Bob
Toughest root canal
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Implant # 20
Implant # 30
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2 step necrotic case

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Access and success
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MB2 or lateral
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