This video is about a dentin bridge I found during a root canal re-treatment of an upper seven molar. Every time I found them I like to preserve these structures to avoid tooth weakening. Only with the help of the microscope we can distinguish these kind of formations from pulp stones. In this case the bridge was crossing the palatal canal.
What is great in man is that he is a bridge and not a goal.
In this case, the doctor referring the patient asked me if I could retrieve the broken file.
File retrieval is always changeling for me because usually requires a lot of time and the collaboration of the patient trying not to move due to the high magnified field of view where I work on and a lot of patience as well; the use of the proper equipment plays a very important role.
This case has been done with ProUltra ultrasonic tips (Dentsply) under the LabomedMagnasurgical microscope view.
These tips are made of titanium and can be pre-curved allowing to work in the direction you want. The bad side of these instruments is that they tend to get blunt and break very easily.
The use of the macriscope is a must, you need to see where are you activating the ultrasonic tip to preserve as much dentin as possible and to avoid perforations.
The broken file it behaves as a rigid body due its short length although the alloy what is made of should let it behave as a flexible metal. As I told before, be patient and remove dentin little by little to create more space is the only way to get the file out of the canal.
My advice for this kind of situations is try to bypass the broken file first, and if you can’t, try to retrieve it. Bypassing instruments is something that I’m not able to do 90% of the time.
This is a re-treatment of an upper second molar #27 through an Emax crown . These kinds of treatments are difficult. However, sometimes they can be easy, and other times they can be impossible. The re-treatment of the tooth depends a lot on the work carried out by the previous dentist therefore, I endeavour to be honest with my patients, as sometimes I am not able to fix everything.
In the following case I had to re-treat a tooth filled with Thermafil. Although Thermafil is a great system and works very well in the hands of some endodontist, it doesn’t work for me. I feel that I can’t control the obturation in 3D and the plastic carrier can be easily exposed without guttapercha around.
For that reason, I feel much more comfortable and secure using vertical condensation with System B, it requires maybe more training under the microscope but is worth it and works really well for me.
– Tooth #27
– K-Files #10 #15 #20
– Wave One Gold
– Bioceramics + System B
Dr. Pablo Salmeron.
“Never give up, because when you think it’s all over, is the moment where everything starts.” — Jim Morrison.
Aquí os muestro una re-endodoncia de un primer molar superior. Antes de extraer el diente debemos pensar en hacer este tipo de tratamientos o derivarlos a alguien con capacidad de hacerlo. Vuestro paciente os lo agradecerá.