Russian version

Resistant pain after NSRCT (by Ilya Mer)

All clinical cases Cases by Ilya Mer Endodontics Perforation repair RetreatmentPublished January 9, 2013 at 12:27 pm 1 Comment

 

Русская версия

The initial situation was that: RD has started non surgical re-endo of 36 which had been treated by resorcinol formaldehyde technique in the past. The dentist could negotiate all the canals but not the MB one because of the ledge in the middle third. He has obturated all available space and prepared the tooth for crown. Patient suffered from pain which was appear a week after the build up was done.  RD decided to take out all the guttapercha and fiberpost and placed calcium hydroxide, then next visit Ledermix, finally left the tooth open and sent the patient to my office.

Initial X-rays on the left. First visit I removed all old restorations and made a new build up with new access which was sealed with IRM. I have tried but couldn't bypass the ledge. Ca(OH)2 was placed and the patient was rescheduled for next day.

Patient was with a constant pain and had to take painkillers . Initial X-rays on the left. First visit I removed all old restorations and made a new build up with new access which was sealed with IRM. I have tried but couldn’t bypass the ledge. Ca(OH)2 was placed and the patient was rescheduled for next day.

The patient was still in pain. The second visit was spent to complete the GP removal and get patency in all canals. Perforation was revealed on the furcal wall of the distal canal that probably was created during fiber post removal. All root canals were dressed with Ca(OH)2 and the access sealed with IRM

The patient was still in pain. The second visit was spent to complete the GP removal and get patency in all canals. Perforation was revealed on the furcal wall of the distal canal that probably was created during fiber post removal. All root canals were dressed with Ca(OH)2 and the access sealed with IRM. I asked the patient to be in touch with me after several days and got the ring 4 lays later that pain had disappeared.

At the third visit all preparations for the obturation were done and root canal system was obturated with GP and resin sealer

At the third visit all preparations for the obturation were done and root canal system was obturated with GP and resin sealer

The perforation was sealed with MTA Angelus and the build up was completed wit fiber post and access filling

The perforation was sealed with MTA Angelus and the build up was completed wit fiber post and access filling

Final result

Final result

 

 

 

 

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