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  First surgery with a composite refill - Courtesy ROOTS

The opinions and photographs within this web page are not ours. Authors have been credited
for the individual posts where they are. - Photos courtesy of Marga Ree
From: Marga Ree
Sent: Friday, March 09, 2007 5:45 PM
Subject: [roots] My first surgery with a composite retrofill

I have posted this case before, but wanted to show you the 
1 year follow-up

This young woman sustained a trauma 12 years ago, at the 
age of 9, tooth 21 was avulsed and replanted
within 1,5- 2 hours. In the meantime, her mother 
stored the tooth in her mouth. Root canal treatment
was performed a couple of weeks after the trauma.

Two years ago, the patient noticed a sinus tract. After a 
while she decided to seek treatment, and was
referred to me. I told her that the prognosis was guarded 
to poor, and after discussing the treatment
options, we decided to retreat with long term Ca(OH)2.

After 3 months, the sinus tract was still present, and 
we decided to take out the knife: Significant
bone loss, huge perforation, crack on the buccal side 
of the root. My first intention was to close the
flap and recommend extraction. But, since we had 
nothing to loose, I decided to retrofill the whole root
with composite. I also covered the buccal aspect of the 
root with composite. I told her again that the
prognosis was very poor.

To make matters worse, ten days postop, she returned 
with a swelling and drainage of pus from the sulcus.
There was pocket of + 10 mm on the buccal, till the 
resection surface. I prescribed AB, and felt very bad.

To my surprise, the 6 month recall was pretty encouraging,
and today I did the 1 year recall. There was
no probing depth, the patient was completely symptomfree, 
and look at the radiograph: beautiful healing

There is a slight discoloration of the 21, but the 
patient doesn't find it disturbing.

I'll see her back in a year - Marga

Dear Marga, absolute terrific treatment plan, clinical execution and documentation and yes..... welcome to "The Official Club Of Outed Adhesive Dental Dreamers"! :0))) Again congratulations! - Liviu

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