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Photos courtesy Marga Ree - ROOTS
Difficult retreatment:GP cone:lentulo spiral
From: Marga Ree
Sent: Wednesday, April 02, 2008 7:05 PM
Subject: [roots] Difficult retreatment
This was a difficult one, the dentist couldn't find the palatal canal.
The root canal filling of the buccal was and extruded significantly,
and the patient presented with a sinus tract.
I suspected 3 canals, and indeed there was a deep split in the buccal.
I could remove the main part of the extruded gp cone, but some remnants
stayed behind in the peri-apical tissues. I had to extend the buccal
canal orifice in a mesio-distal direction, in order to get access to
Ca(OH)2 for 6 weeks, and today I finished treatment. Fiber post and BU
of composite as usual. - Marga
Marga, and i thougth that i am having the most complex cases in my practice.
stunning as usual. extremely well done, as usual.- Sergiu Nicola
Very,very nice Marga, as usual .How did you remove the GP cone ? - Paul
Thanks Paul. Before using any solvents, I always try to engage the
gutta-percha filling by screwing in a Hedstrom file, and remove it in
one piece. Because the filing had been extruded in the peri-apical
tissues, I didn't manage to remove it completely. - Marga
Marga, I love the treatment, the presentation and of course the result.
Can you please tell me how you place your Ca(OH)2 ? - Thomas
Thanks Thomas. I bring a lentulo spiral to WL for application of the
white stuff. - Marga
Dear Marga, How thick is the white stuff ? Is it watery or solid or in
between ? I am asking because lately I found out that sometimes it doesn't
flow well inside the canal especially close to the apex. - Thomas
Nice case Marga, Micholis
hi marga , as others have already said, excellent treatment and
documentation, we all look forward to your cases! In page 2
lower left is that CaOH extruded from the sinus tract? - Abdul
Abdul, Thank you for the kind words. Yes, that's Ca(OH)2 extruded
into the sinus tract. This happens once in a while when bringing
CaOH to length after instrumentation. Some clinicians try to
achieve this on purpose. When it happens, there is ususally a
quick resolution of the sinus tract. Just my clinical experience,
no scientific background - Marga
Hi marga. Just as a footnote to that. Traditionally when treating
ailing implant fixtures we have tried to detoxify the exposed
surfaces with things like acetic acid , or tetracycline, another
acidic medium. Recently, there have been reported some very
positive results attained by flapping, thorough debridement, and
the placement of caoh2 circumferentially around the ailing implant,
and suturing closed. In essence an external version of what we do
internally in endo.
Are you and paul going to be home Tuesday aug 5. Connie and I are
taking chrissy on a northern Europe cruise to celebrate her
graduation and I believe the carnival splendor will be in port in
Amsterdam that day for about 7 hours or so - Gary