Patient presented with a sinus tract -buccal of tooth # 8
History of initial root canal 36 years prior and PA surgery with MTA fill and without retreatment by an endodontist 5 years prior.
Orthograde Retreatment – removing the hardware: pre-fab metal post, gp, MTA and software – cotton fibers, Placed white MTA apical plug after resolution of sinus tract.
I use Matrix buttons/ impression – in this case TempTabs, especially for anteriors as a contingency for any possible mishaps with the crown. I did not have to use it to make a temp in this case.
2 year recall CBCT
Excellent results, Rajiv. A prime example of the need for retreatment prior to surgery. A subtle clinical tip for the residents/students: He did not place a rubber dam clamp on #8, and instead clamped #9 or used Wedjets.
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Wow, 36 years since the initial root canal! That’s impressive longevity, even with the PA surgery. It’s great you were able to resolve the sinus tract with the orthograde retreatment and the MTA apical plug. The TempTabs are a smart contingency plan, especially for anteriors – it’s always better to be prepared! I wonder if a more playful option, like an Eggy Car shaped temp, would help ease the patient’s anxiety in similar situations in the future!
I have the impression that Dr. Reuben Joseph is a genuine authority in his profession. Being able to witness his dedication to providing care of such a high doodle baseball standard and his enthusiasm for endodontics is a source of motivation.