Click on the photo to see the result
The preforation was cleaned and repaired with MTA. A resorbable collagen matrix was used to prevent extrusion of the MTA into defect. The root canals were negotiated to their full length, chemo-mechanically debrided and filled.
At one year review there is no apical radiolucency and there has been significant reduction in the size of the radiolucency around the perforation repair.
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Careful negotiation of the mesio buccal root with small k files to establish a glide path
A curved root
This upper left 1st molar was referred due to the extreme curvature of the mesio-buccal root. After ensuring good straight-line access to the root caanls Martin established a glide path with hand files before, carefully, preparing the root canals with reciprocating files. After thorough chemo-mechanical debridement with EDTA and sodium hypochlorite the tooth was obturated with a warm vertical technique.
A perforated molar
The lower right 1st molar had been root treated some years prior to the patient seeing Martin. Clinically there was an isolated deep pocket buccally. Radiograophic investigation revealed a poor root filling and a perforation in the furcation region. Endodontic retreatment of the tooth was carried out over two visits and the perforation reapired with MTA.
At a one year review the tooth remains asymptomatic, the pocket has resolved and there has been significant bony infill in the furcation region.
Some of Martin's cases
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After accessing the root canal system it could be seen that 3 canals had been located and filled.
A missed canal
The upper left 1st molar had previously been root-filled but had persisting symptoms. Radiographic examination revealed a short and thin root filling and apical radiolcuencies. Orthograde retreatment was carried out over two visits. The existing root filling material was removed with files and solvents. A second canal in the mesio-buccal root was located using ultrasonic instruments. All four root canals were prepared with reciprocating instruments and chemo-mechanically debrided with EDTA and sodium hypochlorite. At the second visit the tooth was obturated using a warm vertical technique.
A fractured instrument
The lower left 2nd premolar fractured and required a post-crown to restore it. Unfortunately a previous dentist had attempted a root filling and fractured a small hand file in the root canal. Martin removed the instrument using a Masseran kit and following root treatment placed a fibre post and composite core ready for restoration with a crown