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This Patient Chose Orthograde Endodontic Revision Procedure on his Mandibular Premolar Instead of Extraction and a Dental Implant

June 7, 2013 By Dr Pierre Pizem Leave a Comment

Dental operating microscope (D.O.M.), D.O.M. versus partially calcified systems, Root Canal Treatment, Endodontic Revision Procedure Tooth #45 Pre Op.
Because of the huge post cemented within its root canal, the endodontic revision procedure to save her tooth seemed to be too difficult or too risky for the former practitioner to perform, consequently, patient has been offered a surgery to extract this infected and painful mandibular premolar and to replace it by a dental implant.

But patient would rather save her own tooth and asked for a second opinion. Patient has been explained that all it would take to preserve that tooth is to clean and disinfect contaminated canal area. In order to reach this contaminated area, a huge casted post must be removed from root canal, Sargenti paste must also be retrieved and a ledge has to be bypassed. Risks associated with this procedure where also explained. Patient choose to accept those risks.

Dental operating microscope (D.O.M.), D.O.M. versus partially calcified systems, Root Canal Treatment, Post removal and endodontic revision  Dental operating microscope (D.O.M.), D.O.M. versus partially calcified systems, Root Canal Treatment, Removed Crown and Post, ultrasonic tips

It took twenty minutes in order to retrieve the casted post. Sargenti paste has been brushed away with ultrasonic tips from Spartan under high magnification (OPMI PROergo microscope from Carl Zeiss) and  ledge was bypassed within 10 minutes working time. A number 10 file displays full canal patency on this X Ray dental film.

Shaping and cleaning, Calcium hydroxyde, Provisional filling Cavit

Calcium Hydroxide  has ben used as an intra canal medicament and left in for 8 days

Root canal obturation

Tooth became asymptomatic on following appointment.
Final obturation (Pulp Canal Sealer + Gutta Percha).
Provisional obturation material: Clip from Voco.
Tooth has been saved no implant needed.

Filed Under: Dental operating microscope (D.O.M.) assisted R.C.T., Dental operative microscope and retreatment, NEW CASES, Root canal systems calcifications, What's new?, D.O.M. versus partially calcified systems, Dealing with casted and machined posts removal, Dealing with ledges and apical zip, Dealing with N2 (Sargenti Paste) removal Tagged With: bone destruction, calcified canal, casted post, condensation technique, endodontic microscope, endodontic revision, Endodontist, Gutta percha, ledge, Microscope, Opmi Proergo microscope, pulp canal sealer root canal procedure, sargenti paste

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