Ortho Retreatment after apectomy

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Photos: Courtesy of Jörg Schröder  - www.rxroots.com
From: Jörg Schröder
To: ROOTS
Sent: Wednesday, May 17, 2006 11:35 PM
Subject: Ortho Retreatment after apectomy

# 26, 3 years after apectomy of mb1 and db, tenderness to percussion, Pt. didn't like to chew on this tooth, no
swelling, no mobility, pocketdepth WNL, no signs for VRF.

After access I saw, guess what? Only 3 root fillings, mb1,db and pal. mb2 was merging into mb1, lot of tissue left,
plaque between root filling material and canal wall. deep isthmus between mb1 and mb2. When I removed all GP in the mb1
(Microopener, little by little) I could see the retrofilling. Thought I removed it, but wire film shows something
different. the surgeon must have placed it only over the groove of mb2(or what he felt mb2 must have been) and only
touched the GP of mb1 a little, Although the db and pal filling seemed o.k. i retreated those canals also.

In the db I left the retro filling in place, because in the mb1 I already could look into the bony defect and had a
hard time to get GP and small parts of the retro filling material out of the bony crypt. Pal cone fit, db squirt, mb1
and mb2 with MTA Angelus. Got some surplus of MTA.

Pt is free of symptoms since 1 day after treatment.

Question: Is it preferable to remove all retro filling material through the canal in order to get all the bugs out of
the tooth? - Jörg Schröder , Berlin, Germany






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