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From: Carlos Saramago
Sent: Thursday, April 09, 2009 4:07 AM
Subject: [roots] Severe curvatures case
This case was referred to me by a colleague from the clinic after he did an emergency appointment.
Patient came with acute pain exacerbated by percussion. Vitality tests were negative. Colleague did
Symptomatic Apical Periodontitis and necrotic pulp. He opened the tooth and did pulpectomy
(without rubber dam, I believe).
When I saw the initial x-ray, I was afraid it would be very difficult to achieve patency, especially
in a non-virgin tooth. Fortunately, after coronal flaring and a ton of #6 and #8 files I managed get
to the wl. - Carlos Saramago
Great case Carlos. Maintaining patency can always be a bear in these cases and you nailed it!
- Rajiv Patel
Top class!! Great work Carlos!! - Javier Pascual
Just to say that you did an excelent case, all documentation is very nice - Grande abraÁo
Non-virgin cases are always more challenging than others. In this 3.8, I had to enlarge very well the
coronal third before I could take my K#6 to wl. I advanced very slowly through each one of the canals,
recapitulating with a smaller file before I place the next one. During the Glyde-path I used some
chelating gel and tons of NaOCl. I managed to do the Glyde-path in the first appointment,
and nothing else.
In second appointment I shaped the canals with Protapers and Profiles. The #8 file you see in the ppt
was a new, not pre-curved file I used just to check how curved the Mb canal was. When I did the x-ray
with the rotaries, I suppose I could have gone a bit further. At that time, I preferred not to risk
more and trust the power of irrigation.
Would someone prefer other way for obturating these canals? - Carlos Saramago
Hi Carlos, A truly challenging case magnificently managed and v well documented.
Could u explain what is Tagger technique or guide me to a source - Medha
Hi Medha: The Tagger Hybrid technique is quite similar to the McSpadden technique. Both use
thermocompactors. These can be the Maillefer ones (Gutacondensors), in SS with 2% taper, or Sybron ones
(Pacmac), in NiTi, available in 2 and 4%, I believe.
The McSpadden technique takes the Gutacondensor near the WL at 4000 rpmís. The Tagger technique takes
the instrument to 4-5mm the WL at 15000 rpmís.
These instruments are very good to do the backfill, if you use the System B to down-pack. Many use them
as solo, to fill the entire canal.
In this case I used it in the Ml canal, 18mm and joined the Mb, a 6% gutta-percha point and 2 accessory
points, at 14mm length and around 15000 rpmís. I didnít want to bland the gp from the Thermafill in the
main canal - Carlos Saramago
Thanks for the explanation Carlos. I have been using the Pacmacs, but never tried the gutta condensors v
AWESOME CASE!!! - Marga