• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

  514-667-9541

  REQUEST APPOINTMENT

HOME

ABOUT

DR PIZEM

FRANÇAIS

ENDOMONTREAL

ENDOMONTREAL

Dr Pizem Advanced Endodontics Clinic

  • Advanced Root Canal Treatment
    • Symptoms & Procedure
    • Why Micro Endodontics?
  • General Dentistry
  • Patients info
    • Frequently asked questions (FAQ)
    • Having a failed root canal treatment?
    • Treatment sequence at our clinic
    • Tooth saving tips
  • For Dentists
    • Refer a patient
    • Clinical cases
Contact Us

A natural tooth merely escaping from extraction

January 8, 2016 By Dr Pierre Pizem 4 Comments

Russian red removal and calcified root canal procedure pre operative  Russian red removal and calcified root canal procedure post operative

Due to the presence of rock hard Russian Red filling material in 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 maxillary premolar and to replace it by a dental implant.

Still, patient would rather save her own tooth and asked for a second opinion. Patient has been explained that this tooth periodontal prognosis is excellent, it is restorable and that its endodontic prognosis is solely linked to the difficulty of the case at hand. All it would take to preserve her tooth would be to clean and disinfect contaminated canal area. In order to reach this contaminated area, Russian Red paste had to be retrieved then, the calcified apical third of root canal system had to be cleaned and shaped. Root canal perforation and blockage risks associated with this procedure where also explained. Patient choose to accept those risks.

Russian Red paste has been brushed away with ultrasonic tips from Spartan under high magnification (OPMI PROergo operative microscope from Carl Zeiss) and both calcified canals were shaped and cleaned to length (25 mm long tooth)  with C endodontic files, K files, Protaper Universal system and lots of chelating agent (RC Prep). Irrigation PUI with sodium hypochlorite 5%. Interim Calcium hydroxide was left in root canals for 10 days, then these were subsequently filled with both Pulp Canal Sealer and single cone technique.

It is sad to note that this first maxillary premolar narrowly escaped from extraction and dental implant therapy only because patient insisted on asking for a second opinion.

Filed Under: General, D.O.M. versus completely calcified systems, Dealing with N2 (Sargenti Paste) removal Tagged With: dental implant, endodontic files, endodontic revision, extraction, implant, operative microscope, opmi proergo, pulp canal sealer, rc prep, root canal perforation, russian red, sargenti paste, sodium hypochlorite, chelating agent, protaper universal, blockage, pui

Reader Interactions

Comments

  1. vO1_V50iLnB4aQfM10UM9BVHPoimsoMTI7M2wQt_Qm0QNc_Sy6jTvWdBPO1_eRf3 says

    January 8, 2016 at 10:47 pm

    Hello pierre. Best wishes for this New year.
    Nice clinical case. How many time for the first setting ?to find patency in apically area?
    Sometimes I face these kind of situations often in premolar.
    I use kaps microscop Led Light which is really performant.but I m wondering When i have to be raisonnable and stop trying find patency with k files and hypochlorite. Due to the increase of perforation s risk? What advice could you tell me?
    Fabien

    Reply
    • Dr Pierre Pizem says

      January 8, 2016 at 11:37 pm

      Thank you Fabien, happy new year!
      One hour for the first setting to completely remove the Russian red paste and to locate canal entries. One hour for the second appointment to clean and shape to full length. This is not much sometimes it takes me more time to obtain a satisfying result. Microscope will most of the time allow you to see a canal entry, I usually give myself an hour to finish shaping and cleaning , if patency cannot be obtain by then , I stop.

      Reply
  2. vO1_V50iLnB4aQfM10UM9BVHPoimsoMTI7M2wQt_Qm0QNc_Sy6jTvWdBPO1_eRf3 says

    January 13, 2016 at 12:14 am

    Thank you for Your response and advice.

    Reply
    • Dr Pierre Pizem says

      January 13, 2016 at 4:15 pm

      You are most welcome Fabien.

      Reply

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

Primary Sidebar

Quality Endodontics

 25+ Years of Experience
in Root Canal Treatment

 300+ Clinical Cases
Published for dentists

 Conveniently Located
Near Metro Vendôme

Call for an appointment:

(514) 667-9541

Clinical cases by categories:

Pierre Pizem Endodontics

A little message from Dr Pizem:

« I understand how stressful going to the dentist could be for you, the patient. So let me reassure you. I’ve built my entire reputation on my professionalism and the passion I pour into my craft. I will not compromise on equipment quality, nor on the efforts necessary to restore your teeth. In the end, my greatest satisfaction is to see you fully recover your dental health, so you may grab big bites at life again. »

Ready to start your treatment?

In order to avoid risks of further complications, we recommend you book a visit as early as you can. However, if you're already feeling pain or urgent symptoms, we'll make every attempt to see you today.

Get in touch

Footer

Contact

514-667-9541

REQUEST APPOINTMENT

Monday
8:30 am - 4:30 pm
Tuesday
8:30 am - 4:30 pm
Wednesday
8:30 am - 4:30 pm
Thursday
8:30 am - 4:30 pm
Friday
8:30 am - 4:30 pm
Sat. Sun.
Closed

Clinic info

  • Home
  • About
  • Dr Pizem
  • Publications
  • Referring Dentists
    • Refer a patient
    • Clinical cases
  • Français

Patient info

  • Root Canal Therapy
  • General Dentistry
  • Endodontic Retreatment
  • FAQ New Patients
  • Tooth Saving Tips
5025 Sherbrooke St. W, Suite 330A
Montreal (QC) H4A 1S9
Near Metro Vendôme       Directions

Copyright © 2021 Endomontreal

Return to top