Concluded Case

How to Repair endodontic Perforation

what is your opinion endodontic perforation 100% confirm or deep pulpal floor , No pain on probing the floor of pulp and clinically floor of pulp chamber fo not seem perforated , Radiographically looks very deep , what should i do ..give your opinion , how should we repair this pulpal floor than obturation..i want to save this tooth at any cost of hardwork lets share your experience and skills thanks

2 Likes

LikeAnswersShare
Concluded answer
Thanks Everyone for answering and giving valuable opinion , i did Root canal completed in this tooth and 15 days since treatment and patient has no complaints now
All Answers
Hello doc, while access opening, the bur should not go below the CEJ as this is the area where you will find all your canals ( 1-2mm deeper will do if you suspect an extra canal ). This tip was for your future cases. Now, coming onto this particular case, I don’t think there would be any bleeding when you place a file into the canal. ( Please tell me if there is bleeding or not ). Ques. How to rectify this ? Ans. Complete the CMP and then place the last no. file into the canal. Mix MTA & place it into the chamber, surrounding the file. Give a closed dressing and Call the patient after 3 days. After 3 days, you are good to go for obturation.
You can use microscope goggles to see pulp floor is intact or not and also you can use smaller file (no-6 or8) to check any bleeding If bleeding persist then check perforation and seal that with type-9 GIC and go for obturation. If bleeding is not seen then directly go for obturation.
Dear doctor, as per this iopa ,I couldn't come to a conclusion about pulps floor because iopa is two dimensional, I strongly recommend cbct imaging for that particular teeth
Thank you doctor
0
Check for perfo with 6k or 8k... if it bleeds seal it with flowable composite you can use voco or ivoclar or gic9 as well. I would suggest you to use endo z bur further cases.
If there's any perforation , you can seal it with MTA it work good. You can even place it on the pulpal floor if you think its necessary.
Dear doc..see for fresh bleeding is there or not on passing the file ño8 or10.n correlate clinicaly..
Thank you doctor
0

View 2 other replies

U could take a radiograph by passing a file through the ruptured pulpal floor or go for a cbct for confirmation... I have used Dycal followed by gic on the pulpal floor for these type of cases..and worst cases have done hemisection.. make sure proper isolation is done .
Thanks Everyone for answering and giving valuable opinion , i did Root canal completed in this tooth and 15 days since treatment and patient has no complaints now
Use MTA