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Buried into the deep (by Ilya Mer)

All clinical cases Cases by Ilya Mer Endodontics Fragment removal one step endodontics RetreatmentPublished January 13, 2012 at 4:45 am 1 Comment

Russian version

This patient has been referred to complete NSRreT, RD has tried but couldn’t negotiate one of the mesial canal due to “hard cement” in the apical third.

Preoperative X-ray showed poor coronal seal and secondary caries under restoration

After temporary filling has been removed I found strong blockage in MB which was located after the curvature and not visible in microscope. To prove my suggestion I made an X-ray with no files and that moment “hard cement” turned out to be a NiTi (according to metal density) high taper (according to its shape) broken fragment. That fragment looked like one which was broken in a typical location of merging mesial canals. If my suggestion about margining was correct I could try to get an aspiration with sodium hypochlorite between two mesials. And it worked!

Positive aspiration test made me use a kind of EndoVak , another words I placed a long plastic canule connected to suction in ML canal then put the irrigation solution in MB. I flushed 8 syringes of Hypo, then changed the canals. Canule in MB and suction in ML and flushed more 8 syringes. So this way allowed me to clean and to obturate (injection of termo plasiied guttapercha ) non negotiable space of apical portion and to bury the fragment insight.

Final X-rays

 

 

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