Miracle of CaOH
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- www.rxroots.com -Photos courtesy Rick Schwartz
From: "Richard Schwartz"
Sent: Wednesday, June 06, 2001 7:21 AM
Subject: [roots] Re: 6 week apexification (or the miracle of CaOH)
Here is a patient I saw today. She is a 15 year old who presented on
April 22 with swelling in her maxillary labial gingiva and upper lip.
She had trauma to her anterior teeth at age 8 and the root canal was
done on #9 shortly thereafter. The pulp was necrotic in #8 and the apex
was wide open so my plan was apexification. I prepared the canal to
size 120, placed CaOH,
prescribed antibiotics and reappointed her for a week later. She was
a no-show for that appointment, and another one 2 weeks later. Finally
we got her back in today. Because of the difficulty in getting her to
come in, I decided to place an MTA barrier today and complete the
However, when I removed the CaOH, there was a solid apical barrier.
I poked around with a size 10 file and could find no holes. When I
obturated I placed sealer, filled the canal with the Obtura, downpacked
with the System B and then backfilled. No puffs! The first 4 pictures
are from April 22 and the last two from today. I didn't
think it was possible to form a solid barrier is so short a time
- Rick Schwartz
Rick, Nice case. Yes, that is quite fast to obtain a complete barrier.
Open up the owerpoint slide that is attached for a review of barrier
formation times. - Fred
Table courtesy - Fred
help the slow people .........can you explain what the slide is telling
Craig, Sorry...I should have explained this slide.
The slide shows the number of teeth for each study (No.), the percentage
of cases that developed a complete barrier (Barrier), and the average
time in months for the barrier to form (Time). In the Finucane et al
paper, the (p) denotes a parallel root apex, and the (d) signifies a
divergent root apex, which should and does take longer for a
barrier to form.
Please let me know if you need more clarification. This slide is taken
out of context from a lecture on trauma that I give.
Fred (BEAT L.A., BEAT L.A., BEAT L.A., sorry, Sixers mania is getting
the better of me). Once again, a great learning experience. I can't
believe how fast that the apexification occurred. Was there much
bleeding on day 1?
How do you pack the MTA in at the apex on a case like this if you want
to do it that way.
Dovgan Carrier I guess but how to pack it down there - Glenn
Glenn, After some drainage initially, I was able to dry it pretty well
at the first visit. I was going to try my new Dovgan Carrier for the
first time, but didn't need it in the end. I place the MTA with a
carrier as far apically as possible and then use Schilder pluggers
with a stopper to gently maneuver it to the apex. I clean up the
excess with large, wet then dry paper points. I'd be curious to hear
how other people do it - Rick
Hard-tissue formation, Ca(OH)2: