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From: sashi nallapati
Sent: Monday, December 05, 2005 1:08 AM
Subject: [roots] resilon discoloration
for those of you using resilon , please make sure you take the obturation below the CEJ to prevent any discoloration.
this is a retreat that i did where 6 months later patient called me to complain of the discoloration that she never had before..
its a pink discoloration , i think ,from the dyes from the resilon. too bad i didnt have a preop photo...
she is presently in sodium perborate and it would be interesting to see if the bleaching will fix the problem - sashi
what material was placed to fill the coronal access? was this internal bleaching being done?
was anything bonding wise placed over the obturation prior to bleaching? - Gregori M. Kurtzman
paracore (dual cure resin) (white in color) was over the resilon.
these pics are before bleaching was initiated.
i shall see the patient next week for the 2 week period.
i placed some flowable resin over the resilon before placing sodium perborate - Sashi Nallapati
did the external color change any after you cleaned out the resilon to the cej level before placing the flowable?
- Gregori M. Kurtzman
no, it didnt - Sashi Nallapati
Sashi, This looks like a retx case. Regardless, all root filling materials should end at or just below the level
of the orifice. Although I have yet to see this type of discoloration during the last 2 years, I have heard it once before.
Some silver-containing sealers will routinely cause a dentin staining as well - Fred
fred, thanks for your input..
i routinely take my obturations below the crestal bone level and was surprised to see in this case i didnt...but it was
taken below the gingival level...
i hope the manufacturers come with a position statement that they have the removed the dye that could be resposible
for this discoloraton.. Sashi Nallapati
what if the cones were off white in color (no pink dye) would that be an issue with the users? - Gregori M. Kurtzman
Sashi, This is the first time I see such a discoloration. Thanks for sharing this. I have treated many front teeth with resilon,
but never saw this on one of my patients. I always take my obturation 2-3 mm below the CEJ though. Keep us informed on the outcome.
Didn't you all get the notice on discoloration from pentron? I think they
fixed the problem in the new material.so the pink wont happen. But there is
a precaution to avoid it. Wheres Bruce? - Rick carter
Sashi - Thanks for posting this. I am also seeing a lot of Resilon discoloration, & I have been making a real effort at
taking it below the CEJ !. I wonder if even a little bit of sealer can cause this discoloration. I found that removing
it & bleaching have taken care of most of the problems.
On a related note - when doing a non-vital bleach over Resilon - what are they suggesting now? When it was over
gutta percha, I was taught to place a small layer of cavit over the GP. But if the Resilon is bonding to the dentin
in the canal, is this extra layer necessary? It seems to me to be superfluous.
What does everyone else think?? - Robin Hinrichs
For internal bleaching, a layer of GIC had been recommended..especially when 30% H2O2 was used. I would still place
another barrier over the root filling. Now that Superoxol is not frequently used, the risk of cervical resorption
should be greatly reduced as well - Fred
If one has properly sealed the top of the obturation with flowable resin or similar, why would it be necessary to do
anything in addition? I would agree application of gic or a bonded layer of say the purple ultradent would be in order
if this wasn’t done at obturation, but is that not what we are teaching currently. I know nothing leaves my office
with exposed resilon - gary
with GP based obturation it was recommended to either place GI over the pulpal floor or bond with a resin to prevent
the internal bleach from migrating apically. I would still follow that with resilon or other bondable obturaiton
materials just as a precaution - Gregori M. Kurtzman,
robin, i would personally protect the dentinal tubules in CEJ with some GI or resin (to prevent possible resorption),
and would not trust resilon to do that for me...especially if it is taken below the CEJ.
thank god, the bleach will take care of the problem... Sashi Nallapati
I used to use IRM but now I use a flowable composite. Makes life much easier. Carol