From: Valeri Stefanov
To: ROOTS
Sent: Tuesday, September 21, 2010 4:59 PM
Subject: Re:[roots] The power of bioceramic ;-)

14 years old girl. Lower left first molar. Pulp necrosis with subperiosteal abcess. Hand files used only.
2.5 % hypo, 17 % EDTA, 3 % hydrogen peroxide used for rinsing.

Canals were filled with bioceramic sealer only.

Sequense of the photoes

1. State before treatment
2. State right after filling of the canals
3. Six months after filling
4. Nineteen months after filling

- Valeri Stefanov






From: Roman Bakowicz
Re:[roots] The power of bioceramic ;-)
To: "ROOTS"

How you will be fighting against such a great power if you face retretment?

That's the usual question asked ;-))).

Removal of  hardened ceramic, if you have used a "single cone" technique is no harder than removal of
hardened Russain red paste. ( you should be familiar with Russian red paste, since I see you practice in Poland  )

Not that for over two years of use of bioceramic I needed to make any re-treatment !
But I know this because I need to remove part of it from the canal to allow space for root post relatively frequently.

In pulpitis cases usually anything goes, if canal is properly instrumented and cleaned.
In cases when periapical lesion is present I usually fill the canal with bioceramic only ! I am not in favour of
second / third re-treatment attempts in cases with periapical lesions. May be because I place implants, too ;-) ?

But the only case I have not being able, up to now, to achieve success was an incisor with double oblique fracture
in which basically bioceramic can do nothing for the leackage through one of the fracture lines ( see attached
radiographies ). Where achievement of  sealing of the fracture line was possible there are no traces of
previous lesion at all.

I started clinical use of bioceramic in endo in Dec. 2007 and so far results are excellent. (at least mine are J )
For PA lesions larger than 5 mm I combine apical suregry with re-treatment, whenever patient agrees with such
treatment plan and whenever clinical situation allows for such combined treatment.

Hope that answers the question.- Valeri Stefanov