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First surgery with a composite refill - Courtesy ROOTS
From: Marga Ree
To: ROOTS
Sent: Friday, March 09, 2007 5:45 PM
Subject: [roots] My first surgery with a composite retrofill

I have posted this case before, but wanted to show you the 1 year follow-up.

This young woman sustained a trauma 12 years ago, at the age of 9, tooth 21 was avulsed and replanted within 1,5- 2 hours. In the meantime, her mother stored the tooth in her mouth. Root canal treatment was performed a couple of weeks after the trauma.

Two years ago, the patient noticed a sinus tract. After a while she decided to seek treatment, and was referred to me. I told her that the prognosis was guarded to poor, and after discussing the treatment options, we decided to retreat with long term Ca(OH)2.

After 3 months, the sinus tract was still present, and we decided to take out the knife: Significant bone loss, huge perforation, crack on the buccal side of the root. My first intention was to close the flap and recommend extraction. But, since we had nothing to loose, I decided to retrofill the whole root with composite. I also covered the buccal aspect of the root with composite. I told her again that the prognosis was very poor.

To make matters worse, ten days postop, she returned with a swelling and drainage of pus from the sulcus. There was pocket of + 10 mm on the buccal, till the resection surface. I prescribed AB, and felt very bad.

To my surprise, the 6 month recall was pretty encouraging, and today I did the 1 year recall. There was no probing depth, the patient was completely symptomfree, and look at the radiograph: beautiful healing.........:-)) There is a slight discoloration of the 21, but the patient doesn't find it disturbing. I'll see her back in a year - Marga

Dear Marga, absolute terrific treatment plan, clinical execution and documentation and yes.....
welcome to "The Official Club Of Outed Adhesive Dental Dreamers"! :0)))
Again congratulations! - Liviu