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Retreatment tooth #45 & tooth #47
- Courtesy ROOTS

The opinions within this web page are not ours. Authors have been credited
for the individual posts where they are. Photos courtesy Jörg Schröder, Venkat - ROOTS

From: Jörg Schröder
Sent: Wednesday, July 04, 2007 3:11 AM
Subject: [roots] Retreatment

Pt. has been referred by the oral surgeon! He was planned for 
apectomy on both teeth by the original referral!!

Retreatment of #47 and 45. Coronal leakage on both with a huge 
amount of debris/plaque inside the canals. Even the guttapercha 
has been coloured by the bugs! 2 visits, adhesive build-up, MTA 
on #45 due to resorption on the foramen and ISO# 60 diameter. 
- Jörg Schröder

Beautifull work and documentation!!! Congratulations!! - Carlos Heilborn Dear Dr.Schröder! Thanks for sharing this case! I love your style of documentation.- Noemí Pascual Jörg , could you tell how did you got throw the old filling? did you use rotary instruments for removal previous obturation solvents? did you have to negotiate any ledge? - Carlos Heilborn Carlos, I used GG and tiny burs in the upper third, then I tried rotaries, but I do not like the "explore" new land with rotating instruments. ultrasound and microopener (reamer with a handle) for the rest. A lot of warmed irigation. No solvents, because I was afraid of pushing some gp into the lesion. (The removal of the very last parts of gp in the distal took me 1 hour!) The mesial canals have been very narrow, but with prebended files/ ProFile 15/04 in a pecking motion and some EDTA i was able to negotiate them. - Jörg jorg, awesome work - Sashi Thank you Sashi, just trying to give a little of the knowledge,I got from people like you,- Jörg Fantastic work Jorg. I see you isolate the complete qudrant. Is that to help you do the build up at the end? what matrix system do you use? - Venkat Thank you Venkat, you are right, it is to make sure, that I can do the build up no matter what type or size of defect I have to handle with. And in some cases it increases the space available for my instrumentation. Of course it takes 1 or 2 minutes more, but at the end it is worth it. If I did the Build-up in a previous visit, I will just dam one tooth. I am using a partially matrix system formerly made by 3M. I attach some pictures. - Jorg

Impeccable work and documentation. Your style rocks,- Thomas Thank you once again Jorg for some great pictures. I need your inputs regarding rubberdam placement. As you see in the pics I attached, the interdental dam tears duirng application and wedge placement, especially with tight contacts. Hence I started using splitdam (2nd pic - not ideal but compromise) does it matter? Do you use a seperator before dam placement? Do you use any lubricant? What gauge dam do you use, Med or Heavy? - Venkat

Hi Venkat, it seems to me that there is too much tension on the interdental part of your rubberdam examples. Do you use medium gauge? Try to create more space between the holes, use holes 1 size smaller. I prefer heavy gauge, although it is hard sometimes to get it through. No lubricant ( for example shaving foam, because I hate the taste of it!) and no seperators. I prepare the dam for each patient. No holes in the dam to safe 10 seconds. So I am able to create the right distance between the holes. The result is less tension on the interdental dam. My 2 cents - Jörg

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