Retreatment and restorative follow-up|
From: Marga Ree
Sent: Friday, February 10, 2006 10:04 PM
Subject: [roots] Retreatment and restorative follow-up
The restorative follow-up of this woman was performed by one of my
regular referrers. What a beautiful result, it is so rewarding to
see these patients for a follow-up. I did the retreatments, the
usual stuff, removal of a silver point, barrier of CaSO4, MTA plug,
fiber post and composite build-up. - Marga
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Excellent work and case presentation Marga. Thanks for that.
Please can you give details of how you removed the silver point.
- Stephen Day.
In this case I used US. First I removed some tooth structure around the
silver point with a thin US tip, to be able to place a thicker US tip
directly on the silver point. Be sure that you use water as a coolant,
as this can regenerate a lot of heat. I used this technique because
the silver point was pretty fat, so no need to be concerned that the
point might fracture. In case you are dealing with thin points, don't
apply US directly to the point. In these cases, I use to remove the
silver point with a hedstrom file and a hemostat.
You can find this technique on the website of Steve Buchanan,
This technique is described for the removal of a thermafil carrier,
but is also useful for the removal of a silver point.
Thread a 21mm #15 Hedstrom file through the softened apical gutta
percha between the carrier and the canal wall until tight.
Clip a curved hemostat to the Hedstrom file shank just below its handle
and rock the hemostat onto the mesial adjacent tooth and lever the
Hedstrom file out as if using a crowbar. The physical leverage is
remarkable and most often the carrier will be launched out of the canal.
This Hedstom technique is also my preferred method for removing silver
I usually don't use a # 15, but try to thread a # 25 or 30 between
the silver point and the canal wall. - Marga
Beautiful work, Dr. Ree. Did the restorative dentist orthodontically
intrude these teeth to move the margins apically? From these radiographs
the tooth position does not appear changed and neither does the margin
on the tooth. Yet the photos of the new crowns, -obviously something
happened. This is a wonderful result.- Agriestic
The restorative dentists did a crown lengthening procedure on 11 and 12
by raising a flap and removing some bone at the buccal side of these teeth.
Marga, Beautiful endo and beautiful crowns! Your patient must be very
happy indeed. - Randy Hedrick
Marga, beautiful result. - Jörg
Two things. Great retrieval and fantastic restorations. Back in the
seventies when I was doing some silver points...wasn't doing much endo
...I always left a bit sticking out so I could retrieve and retreat if
restoration failed. Saw one yesterday that was 35 years old and still
clicking. Of course it would be nice to do the old Ceramco crown over
...really opaque porcelain. Guy