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Removing calcificated tissue from the orifices - Courtesy ROOTS

The opinions and photographs within this web page are not ours. Authors have been
credited for the individual posts where they are - www.rxroots.com
From: RafaŽl Michiels
To: ROOTS
Sent: Tuesday, August 03, 2010 4:00 AM
Subject: [roots] Tempted to do the build up anyway.

Here is a case that I did today. Sadly it was in the practice were I do not have a camera on the scope.
So no clinical pictures.

History

Patient had some swelling and the referring dentist opened the tooth, did a preliminary endo.
He put in calciumhydroxide and prescribed clindamycine ;-). He could not locate the mesials very well.

Treatment today

I opened the tooth, removed some calcificated tissue from the orifices of the mesial canals and started
cleaning and shaping. The tooth had several fractures, but none of the fractures went further than the
floor of the pulp chamber.

The ML cusp is going to fracture, since it is undermined with a horizontal fracture.
In short, this tooth needs a crown. Normally I seal the cavity with a cotton pellet and some glass ionomer,
whenever a crown is needed. But since the tooth is too weakened coronally, I could not take that risk.
I wanted to do the core in composite myself, but ... that is not appreciated over here.

So I sealed the orifices with a layer of composite of 1mm, above that a cotton pellet and above that
a glass ionomer filling.

I was so tempted to do the core myself, but in the end did not do it, so I guess the composite layer
was the best thing I could do, to prevent possible contamination when the tooth would crack.

Grtz, - RafaŽl

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