Dentaltown September 2013 - (Page 28)

endodontics message board » Advice Regarding #8 RCT and Large Apex Dentaltown.com > Message Boards > Endodontics > Endodontics - The ENDO Files > Advice Regarding #8 RCT and Large Apex glai Member Since: 08/23/10 Post: 1 of 47 t There are loads more (about 200,000) interesting endo posts on the Dentaltown.com message boards. Head on over! This Heals or No? Search: This Heals or No? How to Fill the Longest Root Canal I Ever Treated? Search: How to Fill the Longest Root t This case is complicated enough for a referral. What would you do? Hello. I wanted to get some advice regarding this case. Patient had presented for initial exam and I noted a buccal fistula on #8 with large periapical radiolucency (PARL) evident on PA. Patient states she had RCT on #8 completed 14 years ago in Mexico. Patient was advised that tooth needs retreat (as well as #9). When the tooth was opened, noted single gutta percha cones floating in the canal space. I was able to remove the gutta percha cones and proceeded to clean/shape. I was not able to get a consistent reading with the apex locator until using a size #60 handfile but that still went through the apex according the apex locator. Finally, with a size #70 handfile, was able to get good binding at 17mm, which is where the apex locator was indicating it was at the apex. However, when I took a PA at the so-called WL, it appears way short of the radiographic apex. I also did a paper point test, which was dry to 17mm, the same WL that the apex locator was indicating. I was wondering if people had any thoughts about if the apex locator is reliable in this case or is the handfile short of the real apex? I was thinking maybe the apex area could be resorbed? I’m planning to send this case to the endodontist since I think it will most likely need mineral trioxide aggregate (MTA) to fill in the apex area. n Gordon Fig. 1 Fig. 5 Fig. 2 Fig. 3 Fig. 6 Fig. 4 Fig. 7 Fig. 1: Pre-op PA Fig. 2: Lingual view showing failing composite Fig. 3: Individual strands of gutta percha Fig. 4: Fistula on facial Fig. 5: Gutta percha cones removed Fig. 6: #70 hand file at 17mm where apex locator is indicating it’s at WL Fig. 7: Paper point test showing it is dry in canal up to 17mm Fig. 8: Calcium hydroxide placed Fig. 8 MAY 22 2013 continued on page 30 28 SEPTEMBER 2013 » dentaltown.com http://www.Dentaltown.com http://www.Dentaltown.com http://www.dentaltown.com/MessageBoard/thread.aspx?s=2&f=113&t=209102&v=1 http://www.dentaltown.com/MessageBoard/thread.aspx?s=2&f=113&t=209044&v=1 http://www.dentaltown.com

Table of Contents for the Digital Edition of Dentaltown September 2013

Howard Speaks: Getting Poised for Growth
Professional Courtesy: Say Hello to Great Service
Second Opinion: Why Won’t My Practice Sell?
Advice Regarding #8 RCT and Large Apex
Patients Who Refuse Perio Treatment
Corporate Profile: Sesame Communications
Office Visit: Building Bridges in Dentistry
Enhancing a Smile with Cosmetic Dentistry in the New Economy
Top 10 Questions Dentists Ask When Buying or Selling a Practice
Women’s Time in Dentistry Has Come
The Benefit of Associate Agreements in Dental Practice Sales
Retirement Transition: “Mr.” Instead of “Dr.”, What Do I Do Now?
Paperless is NOT the New Black
Simple Safe Gingivectomy Around Implants Prior to Impression
Laser-Assisted Peri-Implantitis Procedure
In This Issue: Close Your Mouth
Perio Reports
Profile in Oral Health: Nose Breathing for Good Health, Fitness and Correct Craniofacial Development

Dentaltown September 2013