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The opinions within this web page are not ours. Authors have been credited
for the individual posts where they are. photographs courtesy: Winfried Zeppenfeld
Fragment beyond the apex - Courtesy ROOTS

From: "Jörg Schröder"
To: "ROOTS"
Sent: Monday, March 23, 2009 1:05 AM
Subject: [roots] This one has been long!

Referral case, fragment has been beyond the apex, obviously 
"fixed" by guttapercha.

After reducing the buildup and removing the post I started 
removing the guttapercha  step by step with endosonore files. 
When I first could visualize the fragment I was quite afraid 
of pushing it out.

Irrigation with CHX and sonication removed the debris and 
I was able to move the fragment back into the canal with a 
microopener. In cases like this I prefer to remove the crown 
also, to have a better visibility and access to the fragment.

Single visit with Collagene as a barrier, MTA Angelus and 
adhesive Build-Up. Recall after 8 months shows healing is in 
progress. - Jörg Schröder

Hey Jorg, As always superb.... Best, Gustavo Text book case!! Beautifully handled! - Marga Excellent case, beautiful documentation!!! - JOSE Hello Jorg, Very nice presentation and very nice job. I think you are a micro opener specialist because it is not the first time that you present such a case . Which particular size and brand do you use ,Maillefer? ,MC? ? Personally I find the 10 and 15 too flexible to do this kind of work? What do you use? - Paul NOYER from Amsterdam Hello Paul,I use the 10/04 from Maillefer. In my opinion it is stiffer then the MC file. In this case I removed the rectangular bend of the original instrument, so I had more "working length" which makes it easier to have a good view. Sometimes I prebend the tip also in order to get beside things I want to remove (guttapercha, retrofill, fragments) - Jörg Fantastic work Jorg......did you take the microopener beyond the apex to pull the fragment back into the canal? - Sachin Yes, I did leave the canal and "worked" in the granulation tissue.In order to avoid transporting debris periapical I irrigated extensivly until I could see that the walls have been "cleaned" - Jörg

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