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 2 post removals & retreat

From: Carlos Heilborn 
Sent: Thursday, February 22, 2007 6:01 AM
Subject: [roots] 2 post removals & retreat

Two cases that took a lot of time I think Images can tell the story, What do you suggest for improving? Thanks - Carlos

From: Carlos Heilborn To: ROOTS Sent: Friday, February 23, 2007 6:42 AM Subject: [roots] Another post removal case This patient (Doctor) came to the office with severe pain on the left side of his lower jaw, referred to the ear, very sensitive when he bites over the molars. I could see an expanded buccal cortical bone related to the first lower left molar very sensitive to percussion. Dx. Peri Radicular inflamation (a strip perf was also considered as a possible feature) Tx Plan Non surgical retreat. Took me a long sesion to cut, and retrieve the mesial post, it was an articulated cast post cemented with GIC a few years before. Found two canals in mesial root, could go to length in MB but not in ML Could not get patency nor drainage neither Protaper Plus tech MAF 40 NaOCl 5,5% Ultrasonically activated and EDTA 17% as final rinse for 3 min Caoh + CHX for 30 days MTA in ML Guttapercha and Grosmann sealer In MB with hybrid thermoplastic compaction and vertical finally. the arrow poins a possible lateral canal (related to the lesion) that could be filled Control Rx with new restoration cemented (not mine) If I had to do a this case again I would remove the distal posts also, in order to prevent a placement of such a big post in mesials and prevent a strip perf in future. Comments and critics are always welcome Thanks in advance and best regards from Asunción, Paraguay PS Do any of you think that an implant could have been a first option here?

Dear Carlos, Not retreating the distal on lower molar invites problems. Because those roots are more centred in the bone, the lesions on those roots appear LATER then on the mesial ones. If you see a lesion on mesial canals and not on the distal, there is a chance there is a lesion on the distal as well. The bugs don't differenciate between the distal and mesial roots. I retreat all canals whenever possible - Thomas

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