From: Rajiv Patel
Sent: Monday, August 28, 2006 8:37 AM
To: ROOTS
Subject: [roots] SILVER POINT REMOVAL technique

In continuation with SILVER POINTS....

Here is a case where I tried to wedge the silver point between a hollow tube  (not the hollow tube theory...:)
and a K- file.

I have not seen too many silver point cases, but it seemed to work fine with this one, the same technique
can be used for separated instrument removal as an adjunct to IRS, Cancellier and other instrument
removal systems  - Rajiv Patel














Very nice series and case Rajiv!!!! - Terry

Rajiv this is nice stuff.  I guess you don't need core-paste or other adhesives when you use a tube like that.
very clever. I learned something today. Thanks for sharing it. - ahmad

Thanks Terry and Ahmad for your kind comments
You are right Ahmad, this would avoid the need for core pastes etc, but it helps to have a whole bunch of ideas
in your bag of tricks.... and I am not that smart, I learn from you guys all the time.....but I don't tell....
thanks once again for the comments - Rajiv Patel

Rajiv, what about coronal leakage here? - Carsten

Good observation Dr. Appel, This tooth was scheduled for a new crown right after my root canal, since the mesial
margin was leaking. Would you have disassembled this one for the treatment? - Rajiv Patel

Rajiv, What a nice presentation! I have learned something new here!
I do share Carstens concern about coronal leakage. Are you sure that the tooth is restorable?
Whenever I am in doubt about the restorability, I remove the filling or crown, and re-evaluate whether to proceed
with a root canal treatment - Marga

Well done Rajiv. Can we call it The R.R.S? - Siju

Siju, I think the "R" is already taken---we'll have to use the "P" ;-) PRS - Kendel

Bravo! Nice presentation! Very educative! Thank you! - Liviu

hi rajiv, perfect documentation - Holger Dennhardt

Hi my friend! Another one to add to your file on my computer! Congratulations.
I like very much you ppt presentations and clinical cases - Marcia

I am impressed and learned a new trick here.  Many thanks my friend.  Excellent - gary

cool case -  Jörg

Very nice case Rajiv!  I have used this technique many times and I love it. I use Hedstroem files as recommended
in the original article :
Suter B. A new method for retrieving silver points and separated instruments from root canals.  JOE 1998;24:446-48.

I like your idea of cutting the file off at the length of the tube.  One other suggestion I can offer for points
that are lodged into the canal and cannot be removed by pulling with your fingers.  You can use one of the weighted
crown pullers or a pneumatic crown puller to jolt the point loose.  Hook it under the file handle and jolt it loose
with the crown puller.  Sometimes it scares the patient for them to feel so much pressure when you are pulling hard
on a tough one.  When you use a crown puller there is one instantaneous small impact and it comes loose.  It also
has a bit of a "Wow" factor to it.  I used to use this crown puller technique with the Brassler endo extractors
with super glue but since I saw this article I haven't used them since - Randy

If anyone can get a hold of that original 1998 article, would be worth reading.  I tried to get it from joe online,
but we only go back  to 2000 - gary

Thanks  Randy,Gary, Siju,Kendel and Jorg

I have the original article....a copy of the original, I have scanned it, It is too large of file to waste your
bandwidth, if somebody wants to read it please email me privately.

Randy, thanks for the tip, I would love to try the crown tapper, would you ditch your file handle so as to retain
the crown tapper tip onto it, prior to the "JOLT" , to avoid slipping of the tapper off the file
- Rajiv Patel

here is a smaller version of the page you sent - gary



Rajiv, I leave the file handle on so I can hook the tip of the crown puller on the handle.  If you take the file
handle off then you would have to bend the file shaft into a hook to have a place to attach the working tip of the
crown puller - Randy