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Root canal retreatment

Article  in  Dental update · December 2006


Source: PubMed

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Phillip L M Tomson
University of Birmingham
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%NDODONTICS

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$ENTAL5PDATE .OVEMBER
%NDODONTICS

&IGURE0HOTOGRAPHOFUNMODIFIEDANDMODIFIEDBELLY'ATES 'LIDDENDRILLS

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$ENTAL5PDATE .OVEMBER
%NDODONTICS

&IGURE0HOTOGRAPH OF #ANCELLIER TUBES WHICH &IGURE  "UCHANAN FILE BENDER WHICH MAY BE
MAY BE USED WITH SUPERGLUE TO HELP REMOVE USEDTOPLACEASMALLBENDONTHEENDOFAFILETO
FRACTUREDINSTRUMENTS HELPNEGOTIATELEDGEDCANALS

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THEPULPCHAMBERFLOORINMULTI ROOTEDTEETH TOTHECERVICALAREAAREMORELIKELYTOBE
DURINGACCESS ORLABIALPERFORATIONDURING ASSOCIATEDWITHPERIODONTALBREAKDOWN WHILST
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PROBLEMS&IGURESA B A B ESPECIALLY POSSIBLETORENEGOTIATEANDOBTURATETHE
IFTHEREISLIMITEDVISIBILITYDUETOINFLAMED APICALFEWMILLIMETRESPASTTHEPERFORATION
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3EVERALMATERIALSHAVEBEENADVOCATEDFOR INSTRUMENT B ULTRASONIC TROUGHING PRIOR TO
THEMANAGEMENTOFPERFORATIONS WITHTHE ENGAGEMENT USING TUBE AND CHEMICALLY CURED !NTIMICROBIALMANAGEMENT
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MATERIALREQUIRESATWO STAGEPROCEDUREAND TREATMENTANDTHESIZEOFTHELESIONBOTH
OTHERSINGLESTEPTECHNIQUESUSINGBARRIER MANAGEMENTINVOLVESLENGTHDETERMINATION INFLUENCINGTHEOUTCOME4HECLINICALABILITY
TECHNIQUESMAYSTILLBEUSEDONOCCASIONS USINGANAPEXLOCATORANDPAPERPOINTS TOCONTROLINFECTIONINRETREATMENTCASESMAY
4HEFIRSTSTAGEOFPERFORATION DEBRIDINGIRRIGATINGTHEAREACAREFULLYTO BEDUETOSEVERALFACTORS"ACTERIALYINGIN

.OVEMBER $ENTAL5PDATE
%NDODONTICS

A B INFECTIONWITHINTHEROOTCANAL THEFLORA
OFWHICHCANBEVARIABLE)NCASESWHERE
MUCHOFTHEROOTCANALSYSTEMHASNOTBEEN
INSTRUMENTED THENTHEFLORAISLIKELYTOBE
POLYMICROBIALINNATURE SIMILARTOTHATOFA
NECROTICPULP ANDANTIMICROBIALMANAGEMENT
FOLLOWSCONVENTIONALLINESTHATIS THOROUGH
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#A/( )FTHEPREVIOUSROOTTREATMENTHAS
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THENTHEFLORAMAYBEDIFFERENT WITHONLYA
C D FEWSPECIESBEINGPRESENT/NEORGANISM
THATHASBEENASSOCIATEDWITHSUCHFAILURES
IS%NTEROCOCCUSFAECALIS WHICHISRESISTANTTO
ELIMINATION4HEREFORE INSUCHCASES ATEN
MINUTESOAKWITH)+) FOLLOWINGPREPARATION
ANDSMEARLAYERREMOVAL HASBEENADVOCATED 
TOGETHERWITHADDING)+)TOTHEUSUAL#A/( 
INTERVISITDRESSINGTOHELPERADICATETHIS
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NOTTOUSE)+)INVIEWOFITSALLERGENICPOTENTIAL
FURCALEXTRUSIONCANBESEENTHISWASUNEVENTFUL

#ONCLUSION
CANALRECESSESMAYBEPROTECTEDBYRESIDUES PREVENTANOPTIMALLEVELOFDEBRIDEMENTAND 4HESUCCESSOFRE ROOTCANAL
OFFILLINGMATERIALANDTHEREBYNOTEXPOSED ROOTFILLING TREATMENTISGOOD´ WHENITIS
TOANTIBACTERIALAGENTS%XISTINGLEDGES !SSTATEDEARLIER THEAIMOF BEINGUNDERTAKENTOACHIEVEATECHNICAL
TRANSPORTATIONANDOBSTRUCTIONSMAYALSO RETREATMENTISTOREGAINACCESSTOANDTREAT IMPROVEMENTINPOTENTIALFAILURES7HEN

A B D

&IGURE#ASESHOWINGLABIALPERFORATIONA PRE OPERATIVERADIOGRAPHB LABIALPERFORATIONC GLASS IONOMERREPAIRFOLLOWINGPLACEMENTOFABARRIERAND


D POSTOPERATIVERADIOGRAPH

$ENTAL5PDATE .OVEMBER
%NDODONTICS

PERIRADICULARPATHOLOGYISPRESENT THE INTHEENDODONTICOPERATORY*%NDOD  "ERGENHOLTZ' ,EKHOLM5 -ILTHORN2


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$ENTAL5PDATE .OVEMBER

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