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Root Canal Retreatment to Preserve a Tooth. Dealing with Silver Points Removal

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Dental Operative Microscope and Retreatment, Dealing with Silver Points Removal, Root Canal Treatment Pre-Therapy 471546-1Dental Operative Microscope and Retreatment, Dealing with Silver Points Removal, Root Canal Treatment Per-Therapy 471546-1  Dental Operative Microscope and Retreatment, Dealing with Silver Points Removal, Root Canal Treatment Post-Therapy 471546-1

Case study number 471546

Symptomatic (and badly worn tooth), endodontic Re-treatment implied two silver points removal in mesial root, Re-treatment of distal root, calcium hydroxide dressing for one week and a gutta percha and Pulp Canal Sealer final obturation.

Amalgam post and core build up will allow for a porcelain fused to metal crown preparation and cementation.

Silver Points Retrieval and Endodontic Retreatment on First Maxillary Premolar

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Dental Operative Microscope and Retreatment, Dealing with Ledges and Apical Zip, Root Canal Treatment Pre-Therapy 34571514-1Dental Operative Microscope and Retreatment, Dealing with Ledges and Apical Zip, Root Canal Treatment Post-Therapy 34571514-1

Case Study Number 34571514

Pre-operative X ray film shows symptomatic maxillary right premolars. Four years after retreatment, recall radiographic follow-up (above) shows complete healing. Teeth are still asymptomatic and functional in 2010.

Silver points have been present in root canals for 25 years, sealer in apical region is long gone due to coronal “macroleakeage”, this allowed for silver points to come into contact with tissue fluids and a huge amount of corrosion occurred.

“Corrosion products such as silver sulfide, chloride, sulfate and carbonate not only occurs on the point itself but also in dentine and within the adjacent periapical adjacent soft tissues”

Pocket atlas of endodontics by Rudolf Beer,Michael A. Baumann,Andrej M. Kielbassa 

This spreading of silver points corrosion products and the important deterioration of root canals walls in the apical region by tooth decay explains why root canals had to be enlarged to a number 80 endodontic file.