endomontreal

 Case study number: 495336

Symptoms: Acute pain to pressure, patient is eating on the opposite side. Root canal was done three years ago. (X ray image number one)

Tooth root canal system has been retreated ( reshaping and cleaning) and calcium hydroxide paste inserted as an intracanal medication (x ray image number two), symptoms subsided.

A week later, final root canal obturation with gutta percha and pulp canal sealer completed the root canal procedure, an amalgam post and core build up was done during the same appointment to seal coronal part of the tooth. (X ray image number three)

Six months recall shows a complete healing (X ray image number four). Patient's dentist can prepare the tooth as an abutment to receive a crown.

Study case number: 491047

We have been presented with this previously treated tooth. The canal system has been filled with Sargenti's paste and a separated past filler still remains in mesial canal. Second image displays a mesial root close up with the broken paste filler reaching it's apical third. 

Patient is informed about these facts and is made aware of the tooth poor prognosis if separated instrument cannot be removed and if Sargenti's paste cannot be completely removed from canal system. Extraction and implant therapy is considered but patient wants to keep her own tooth. Informed consent is given by the patient.

Pulp chamber is accessed trough amalgam obturation, filling material is then removed with ultrasonic tips and two canal entries (out of three) are localised. Sargenti's paste is broken into smaller pieces until a softer aspect of the material is found, coronal part of paste filler is exposed and the separated instrument is retrieved and an Xray dental film is taken (Third image). First instrument, a number 06 ISO K file is reaching the apex in fourth X ray image. Fift image is a" calcium hydroxide paste insertion" post operative X ray dental film. Last image (bottom to the right) is a final obturation with Pulp Canal Sealer and gutta percha (lateral and vertical condensation).