My first squirt - 2year recall

From: Siju Jacob To: ROOTS Sent: Sunday, June 01, 2008 6:18 PM Subject: [roots] my first sqirt (2 year recall) Here is a case where I tried squirting for the first (and last) time. I tried squirting on the mesials thinking i'd get better control on the narrower mesials compared to the distal. Traditional cone -down pack -backfill on the distal. I extruded a lot of gutta percha. looked pretty ugly Turned out okay though. lesion healed Crowns need to be changed though ;-(( Again, what does an Endodontist tell the patient and the referral in a case like this? - Siju

Hi Siju, Beautiful healing! You tell them the truth---"the excess filling material, while not desirable, is irrelevant." As you found out, the "narrow-ness" of the canal is not what provides apical control. The chronic lesion destroyed the constriction requiring a demanding apical preparation if obturating without cones. No wonder you never tried again! ;-)) A far more critical issue, as you point out, is the coronal restoration. The longevity of your hard work depends on it! Cool case, thanks for sharing,- Kendel Hi Kendel, Yes, I have seen several clinicians post good cases obturated without cones. The problem was with me and not the technique:-)) - Siju siju great case.great question.sometimes when pathology is present prior to treatment the apex is mottled and irregular. I find in those cases it is more likely that i extend sealer beyond the apex. Fortunately, my referring docs, see enough of my work to know that it is an unusual occurance. I tell the patient that there is some filling material beyond the end of the root, and that it usually does not effect ultimate healing. then I have the patient back at 6 month intervals to watch healing and over time resorption of the over extended filling. - mike feldman Siju, when we did those in the military, always left the silver point long and bent it down. There was an obvious expected failure but we didn’t have much time with those kids being sent to Nam as cannon fodder. Probably a good Sargenti would have been a better service than silver points but silver points was the standing order of the day. Guy