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From: Sashi Nallapati
To: ROOTS
Sent: Sunday, April 15, 2007 11:11 PM
Subject: [roots] retreatment series
Retreatment series 1
Here are a few cases that I treated this week.
referring dentist did the initial treatment on her brother.
patient continued to have symtoms. Murphy's law...
palatal canal was not treated to the working width and Mb root split at 15mm in a 20mm tooth. i found it when i was just
about to wrap up. I used the Munce Discovery burs for the deep troughing.
after 3 weeks of caoh, patent was asymptomatic and i obturated.
patient is seeing his sister to change the core and crown.
I wonder how many I missed before the scope and even after...Dr. Sashi Nallapati
Retreatment series 2
Here is another garden variety retreat.
I used the self cure blue core from schein. so far i am impressed with the handling.
I wish it had a little bit more radioopacity though...
in a tooth like this, where there is all of the buccal tooth structure and a mm of ferrule on the lingual, an onlay with
cuspal coverage is a better choice than a PFM crown?
what restorative tx will you recommend ? - Dr. Sashi Nallapati
Retreatment series 3
One distal canal confluent with the other was missed in the original tx., and mesials under treated.
I finished this in one visit. Blue self cure core , rough prepped for the crown. i separated an SX in the process in the
Mb root.
However I bypassed it with out much trouble and the ML was confluent with the MB. the file stayed to allow some density
to the look of the obturation - Dr. Sashi Nallapati
Retreatment series 4 - a tough one
# 32 with tough access.
after using every trick in the book, i could not grab and remove the silver point in the distal root. it was very tight,
brittle and kept snapping off.
I used the masseran, core paste and tube, ultrasonics, bypass and grab with headstroms, and finally all grabbing diveces
I had in store..no luck
after 2 visits i got frustrated, took the munce and drilled the silver point till i can see it. at about a mm or so
from the apex i stopped as i could not see it any more..
patients symptoms were completely improved after the first visit and the distal root was innocent in the infectious
process.
this qualifed as one of the toughest cases that I treated.
hope the last mm of the retained siver point will ot come back to haunt me.- Sashi