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  Tooth# 17
The opinions and photographs within this web page are not ours. Authors have been credited for the individual posts where they are. Photos: Courtesy of Marga Ree - www.rxroots.com
From: Marga Ree To: ROOTS Sent: Thursday, August 02, 2007 4:54 PM Subject: [roots] I needed 4 sessions to complete this one... This patient had already lost a tooth due to a perforation, and she wanted to do everything to save tooth 17. The perforation was midroot in the mesiobuccal root, and it was not easy to find the original canal. After a while I was able to negotiate the canal to full length, and that was the end of the first visit. Second visit was spent on the root canal filling and perforation repair with MTA. I could choose between 1. filling the whole mb canal with MTA, but I had my doubts about the adaptation of MTA in the apical part of the canal. 2. repairing the perf first, and trying to use a space maintainer for the canal portion below the perforation. This was not possible, because every space maintainer I tried (canal projector, resilon cone etc.) blocked my vision on the perf site, due to the curvature of the root 3. filling the apical part below the perf with resilon, and trying to prevent extrusion of too much sealer into the perforation site and subsequently repairing the perforation with MTA. I choose the last option, and that was the end of the second visit. I was pretty satisfied with the result. I am a control freak, so I almost always reschedule a patient after application of MTA. I was very glad I did it in this case, because after acid etching for the composite BU, I suddenly noticed a white spot. My assistant had already removed the files, and was surprised to hear me ask for a file # 10.........:-)) I tried to comfort myself by thinking that this canal would probably be confluent with MB 1 that was already filled, but I was wrong.........it had a separate POE, which I found out after a while................and so I scheduled the patient for a fourth session.................. And after 4 sessions, I was finally able to make the composite BU......thinking that I was about to miss a whole canal system, because I was so focused on repairing the perf, I simply forgot to expore the pulp floor meticulously, searching for canal orifices......it was a narrow escape..... Marga

Marga, Thanks for sharing this magnificent case!!! Inspiring case!!! - Carlos Heilborn

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