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Retreatment and restorative follow-up

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From: Marga Ree To: ROOTS 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

Excellent work and case presentation Marga. Thanks for that. Please can you give details of how you removed the silver point. - Stephen Day. Thanks Stephen, 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, see: http://www.endobuchanan.com/technques/index.html This technique is described for the removal of a thermafil carrier, but is also useful for the removal of a silver point. Steve's recommendations: 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 points. 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 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 Next page

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Mark Dreyer
Noemi Pascual
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