after metapex placement

A patient with huge swelling regarding 46. Done with rc swelling subsides. Yesterday I placed metapex in it. But swelling appearing again wt should be done?

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Yes as one can clearly see pain is because of extrusion of metapex. This is going to take time to heal. Just regularly call patient for saline Irrigation. And give pain killers and antibiotic course

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Kindly post the x ray. Bmp done? Try to give open dressing only for few hours. Irrigate properly with saline.

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Cause of swelling is inflammation.Reason of simply Inflammation is irritation due to various chemicals released by body,bacteria or direct apply of chemicals like Sodium hypocholorite.. Now you have to find what is reason behind this swelling. 1.Not all canals are negotiated or there are pulp remnants. 2.Negotiated but poor bmp so there are bacteria. 3.Improper obturation there are space for bacteria to growth 4.Injury due to over instrumentation or naocl. 4 no point is not so important for swelling. Find one reason rest of three and treat as per protocol. If reason is no 1,,Take IOPAR,see thoroughly or take advise from specialist of you dont find. 2.If reason no 2 you have to do Re RCT. 3.if reason is three,you can find it on IOPAR.remove all give icm and put patient on anbiotic.obturate after sign and symptom subside. Thank you.

Ok now you have posted x ray..It will subside.wait and watch.It is because of extrusion of material beyond apex.you can put patient on steroid on tapering dose i.e. prednisolone.

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post a xray.irrigate throughly..dry with paper points ..obturate only if asymptomatic

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Kindly share IOPA post metapex placement, sometimes it's normal to apper swelling when we push metapex beyond apex that will subside on its own but this will only be possible if all canals are properly prepared till working length and metapex is properly filled till apex.. rest can be clear only after seeing IOPA..

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As I said earlier as well, sometimes swelling occurs due to extrusion of material beyond apex, so nothing to worry about just wait and watch!

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Apico-ectomy

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