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Endo tips    Better Endo    Endo abstracts    Endo discussions

Sinus and probing defect - Courtesy ROOTS

The opinions and photographs within this web page are not ours. Authors have been
credited for the individual posts where they are - www.rxroots.com
From: Venkat
To: ROOTS
Sent: Saturday, March 13, 2010 6:02 PM
Subject: [roots] Surgical repair of my failure.

It is  humbling to see my failures when the patient returns for their 6month's / yearly/ 2nd year recalls.
This tooth was accessed by the referring dentist and was perforated just below the level of the crestal bone
in relation to the disto-buccal orifice. Patient reported no pain but a sinus and 5mm pocket depth (Image1)
I decided an internal repair with MTA matrix and resin (blue) build up. (image2) You can see the evidence of
pulp in the DB and MB canals.

I used white MTA (Angelus). I do not use this anymore as I have seen reports from other clinicians that it
does not set as well as the grey MTA.

Sinus healed after repair and pocket depth was normal (image 3)
1 year recall tooth asymptomatic but recurrence of  sinus and probing defect.(image4)
Convinced the patient to go ahead with one more attempt to save this tooth (with no charge)
Repaired the the defect surgically. The white MTA was easily removed when I degranulated the lesion. Crater like defect
I prepared the defect. The internal repair blue resin is seen. Achieved hemostasis and filled with Fuji9. (Image 5)
I hope to see a better outcome during next recall in a year.
Lesson learnt: Consider surgical repair at the outset if the perforation is close to gingival margin?? - Venkat

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