Orthograde Retreatment after Apico

The value of a discussion forum of colleagues continue to be an elusive dream for this blogster on www.oralhealthjournal.com – but I digress, I persist, I persevere and I perseverate.

Visit https://public.me.com/ken.serota160 first – look under PUBLIC for Oral Health 10.8.pdf [download] and imagine if the editorial consultants at OH each shared cases of this ilk and calibre with yee, IMAGINE THE POSSIBILITIES, REALIZE THE POTENTIAL – someone call American Express, I have a sound byte.

Case from this week:

Trauma 30 years ago, after RCT apiectomy has been performed just 1 year later. Since 5 months 22 showed signs & sysmtoms. Crowns 21 and 22 are planned to be renewed for esthetic reasons by referring dentist.

Pt. reported, that there former dentist placed two post per tooth! First I could not support this, but after reducing the casted posts in both teeth I knew what he meant: there has been a pin-preparation on the palatal side of every tooth to prevent the post to be rotated. Imagine what would have happened if I would have tried to rotate the post when using the Thomas-Post-Puller-System.

Temporisation by using the DT Illusion Posts by VDW. CaOh2 in both canals, sponge followed by a little bit of cavit. Then fiberpost and adhesive build-up. Sorry for the temporary crowns. I know I can do better. But the post-removal let me run out of time.

Second visit sinus tract was gone, tooth was free of symptoms. This time placing rubberdam has been much easier using flowable composite for keeping the dam down. Reentry is much safer with the DT illusion posts which are containing thermosensitive particles which can change colour when being cooled down. If I have to go for 2 visits I prefer this kind of temporisation: comfort for the patient, safe for the dentist (if using magnification ;),,)

Collagen barrier because of bony crypt around every apex. Should have used my VeraViewEpoc 3D to visualize the lesion. But would have changed that anything in my therapy? No.

Best regards from Berlin, Germany


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