Perforation
The opinions within this web page are not ours.Authors have been credited for the individual posts where they are. - www.rxroots.com photographs courtesy: Marga Ree From: Marga Ree To: ROOTS Sent: Saturday, January 29, 2005 3:26 PM Subject: [roots] Perforation This is a previous post from January this year, to show you a similar tissue lesion after a perforation. I think that it must have been the NaOCl that caused this effect, but it healed uneventfully. - Marga This 50 year old woman presented with irreversible pulpitis of tooth # 35. The referring dentist did an attempt to start a rct, but he made a perforation and didn't find the original canal. He told me that he had irrigated with NaOCl, tried to dry the canal with paperpoints (and I suspect with air from the air-water syringe) and all of a sudden the patient reported a sharp pain. He stated that he stopped the treatment immediately, filled the access opening with Ca(OH)2 and removed the rubber dam. Then he noticed that there was a swelling of the left side of her face. He referred the patient to me with the request whether I could see her the same day, which I did. I noticed a perf to the buccal side, and after cleaning and shaping the original canal, I closed the perf with MTA, applied Ca(OH)2 and rescheduled the patient within 3 days. I told her that the swelling might have been caused by an air emphysema or the NaOCl. After 3 days the swelling had decreased, but the patient reported a numb feeling in the left side of her face, and the whole area was very sensitive upon touching. There was a soft tissue lesion present, which I cleaned out. I removed some necrotic tissue and remnants of set MTA. Then I finished the rct. Today I saw her again, 1 week after I finished the rct. She was almost free of symptoms and reported that the normal feeling was coming back. The soft tissue lesion was closing and showed signs of healing. What caused the swelling? Was it indeed an air emphysema or NaOCl? What caused the soft tissue lesion? Ca(OH)2? NaOCl ? A combination of the above mentioned factors? Looking forward to your input. - MargaHi Marga, I saved all the information you sent to me! I will read carefully the articles you sent...and will pay attention to your protocol and guidelines. I hope to see the patient tomorrow. She scheduled an appointment at the course with us...I have a particular interest to follow up this case...so...I SCHEDULED her to one of my best students...so it will be possible to me to act in the case...and she will follow my guidelines and we will follow together ROOTS guidelines...ROOTS UNIVERSITY...sharing cases, learning with cases and experiences around the globe...Digital archive... Articles in the folders to read and remember....WONDERFULL! NEXUS!!! I will try to take pictures to keep you informed! Thank you very much! - Márcia Valéria (Brasil)
