From: Marga Ree
To: ROOTS
Sent: Tuesday, February 23, 2010 2:26 AM
Subject: [roots] When to use MTA?

This 14 year old girl was treated by a colleague who has got a microscope. Due to persistent complaints,
she was referred to our practice.  Looking at the leaking gp cones, you can almost smell the odor of bugs...
Removing  old gp has never been easier

I could also remove the chunk of sealer in the peri-apical tissues.

Today she came in for a 1 year recall. Looks as if it is getting better...:-) - Marga




did you use amalgam carrier and paper point to place MTA and pack it - Subhi Alnahas

I used a Dovgan MTA carrier, paper points and pluggers with indirect ultrasonic activation - Marga

The wonders of MTA :) Nice one! Grtz - Rafael

Dear Marga, Great work  as always. What instrument/s do you use to remove gp/sealer beyond the apex ?
I find this work tedious and very time consuming (and not always possible) -  Thomas

Thanks Thomas, I use a prebend file or explorer to retrieve the material, I call it "extraradicular fishing"....:-).
It's a matter of patience and luck, and you're right, it's not always possible, but if you can fish through
a wide open apex, it is doable. -  Marga

You must be a one hell of a fisherman - Thomas

Marga, Great case and very good resolution.. Why Gates used to that length? - Rodolfo

Thanks! I use LightSpeed instruments or Gates for length determination, and to gauge the foramen.- Marga

Great result.  Looks very good.  -  Terry

P.S Having a microscope probably doesn't mean you are Marga Ree ;)

Dear Marga, I find this case a masterpiece! Thank you for sharing! And I have a question - do you always
use an apical barrier like CaSO4 or colagen membrane or not? I had a case with sever apical resorption
and I was in dilemma - to use or not to use apical barrier! I did not used it and the result was quite good,
but I wonder if I made the right choice! - Bojidar Kafelov

Thanks Bojidar, If the apex is  wide open, I usually use an extraradicular matrix. I prefer to use calcium
sulphate. It gives me more control on the placement of MTA - Marga