Patient experienced recurrent pain episodes and swelling coming from an infected previously treated root canals on tooth 15. Extraction and Implant surgery was the sole option offered to her until she landed in our office to get a second opinion. Upon radiographic examination, noticing the fact that the bone rarefaction was mostly located on the distal aspect of the root, we suspected an infected lateral canal. Treatment plan was a root canal revision procedure, a new core build up and a crown.
Root canal system has once more been completely cleaned, shaped, irrigated with NaOCl and then filled with an interim Ca(OH)2 paste. Patient came back a few weeks later and symptoms had completely subsided. Not all lateral canals will create such an infection issue but this one did. For that specific reason, I felt I had to find a way to fill this oddly located one for a better outcome. Neither cold lateral or WVC did allow for an adequate filling, thus a new technique was needed.
The technique: Both canals were filled in their apical third with NeoMTA root canal sealer and gutta (cold lateral condensation). The remaining coronal part has been loaded with NeoMTA root canal sealer and I have used a sterile strip of Teflon for its thermoplastic properties, condensing it to make the sealer squirt through the lateral canal. The ”Teflon Hydraulic Condensation Pressure Technique”was born. An amalgam post and core build up has then been placed into the coronal part of the root canal.
Tooth is now asymptomatic and functional, a crown will be the next and final step to prevent that tooth from being extracted.
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