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  Retreatment cases and instrument removal


The opinions within this web page are not ours
Authors have been credited for the individual posts where they are. - ROOTS
From: Bojidar Kafelov
To: ROOTS
Sent: Wednesday, March 23, 2011 4:03 AM
Subject: [roots] Another set of retreatment cases + C-shape

I'd like to present you another set of retreatment cases and instrument removal:

1. Case 1: A 45 year-old woman came in the office with mild pain on percussion.
She went through a RCS - Root Canal Something, because I can't say treatment.
The cause of the multiple RCTs is the bad periodontal condition!
The treatment plan was to make a bridge from right to left! Honestly, WTF?
Now he patient is undergoing a proper periodontal treatment and I'm doing the endo treatment.
After doing some of the teeth I started with 1.2 (#10). After cleaning and shaping I wanted
to do one final apical gauge. I took 40.02 NiTi Hand file and passively inserted the file.
After little, very little pressure I heard a click and got the file 2 mm short.
I thought a lot about it but I don't like to see files embedded in my obturation,
but I could not see the file because it was snug at 20 mm. So I decided to bypass the file...
and try the braiding techniqe. And it worked like a charm! Obturation with CWC technique.

2. Case 2: One of our nurses was complaining from slight discomfort from tooth 1.6 (#3).
The x-ray revealed a fractured lentulo in the MB canal. After the access cavity was made
and I was digging for the MB2 I saw a MB3. Maybe it was an isthmus, but I could enter only
in these three points. Instrumentation with ProTaper, Obturation using CWC.

3. Case 3: Similar to Case 2. 33 year-old male patient with no complaints. The NSRCT had
to be done because of the future crown replacement. Fractured lentulo spiral in the MB canal.
Couldn't find a MB2 canal. Very hard retreatment because of the Russian Red, cleaning,
shaping and obturation as above.

4. Case 4: An endo-perio lesion. The tooth didn't respond to hot/cold stimuli, pus was coming
from the periodontal pocket and first grade mobility was evident. I did my best but It was
very hard for me because that was my second C-shape tooth and I think this was not a true
C-shape after all.

Hope that you'll like the cases. Any feedback is more than welcome!

Best regards from Bulgaria,
Bojidar

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