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Removal of a silver cone
From: Marga Ree
To: ROOTS
Sent: Wednesday, April 26, 2006 12:35 PM
Subject: [roots] removal of a silver cone
Yesterday I saw this patient for a 1 year follow-up.
Look at the nice healing !
Here is the story: Patient came in with a sinus tract
and AP of tooth 12.
I treated this case in 3 sessions:
First session: removal of build-up and silver point:
I removed 3 mm dentin around the coronal part of the
silver cone with a fine US tip, then I applied direct US
activation of medium power (don't do this if you deal
with a thin silver point, they can fracture very easily)
with a thicker US tip with copious coolant (this can
generate a lot of heat without coolant) and in the final
stage, after the cone was loose, I used nice micro-pliers
to grab it. Ca(OH)2 as an intracanal dressing
Second session: sinus tract had disappeared, application
of MTA, used the old post as a temporary post to provide
retention for the provisional.
Third session: insertion of a fiber post and a build-up of
composite, which I grinded in the shape of a tooth. I used
LuxaCore A 3 as core material, and a flowable composite as
a top layer on the labial surface to match the color.
I liked the shape, but I was not satisfied with the fact
that you could see the upper contour of the post through
the buccal surface of the build-up, right in the middle of
the labial surface. The patient didn't care, he didn't see
the problem at all:-)), he was very satisfied with the
build-up. Because he wanted to wait for signs of healing,
the build-up served as a temporary restoration for 1 year.
At the 1 year follow-up visit he told me that the dentists
had made the prep for the definitive crown. I was a bit in
doubt about the shape of this "nail" prep, it is really tiny,
I would have prepped it differently, but hey, I have to do
endo's, so I keep telling myself:
mind your own business.........:-) - Marga
Beautiful case Marga! What is the blue material that covers
the gingiva with the split dam technique at the first appointment?
Looks like it flows just right before it sets up.- Randy Hedrick
Randy: Marga i believe uses the same thing i do, ultradent's block
out material, which is actually lc. you place it, nuke it with the
light, and it doesn't flow ever again. i find it to be much
easier to use and doesn't flake away than their rubber dam caulk,
cavit, dycal, or anything else - Gary L Henkel
Thanks Randy. Gary answered your question already, it is called
"block-out resin" from Ultradent. Originally developed for blocking
out a plaster model, prior to the fabrication of a bleaching tray.
It can be used as a secondary isolation material, it sticks to
tooth material, rubberdam and soft tissue and it's light cured.
- Marga
And one other big caveat. It will also stick to your composite
core buildups as it is a resin. Ask me how I know. J it is also
very useful for blocking out under a bar on an overdenture
impression, and because it’s light cured you place it, nuke it,
and it stays put. It can help stabilize a rubber dam clamp with
a precarious perch on a tooth. And lastly, but most importantly,
it is a really pretty color of blue - Gary
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