How Not To Use A Carbon Fiber Post.
Iatrogenic, Retreatment October 22nd, 2008
The first picture is how this premolar arrived (with the patient) to my office. Discharge was present through the gums from a chronic abscess. Looks like a radiolucent post was placed practically to the apex. There’s some remnant gutta-percha or cement mid-root and probably an apical perforation at the base of the post.
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- August 2006.
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- May 2008.
The tooth was retreated over a couple of appointments. Sure enough there was a perforation at the apex of the root, but laterally. I was never able to regain the true canal beyond the perf. A carbon fiber post was removed, Calcium Hydroxide was used as an interappointment intracanal dressing, and then MTA (Mineral Trioxide Aggregate) was used to fully obturate the canal.
There is a 21 month interval between the two films. Osseous healing is progressing well, and no mucosal lesions were evident at the time of the second film.
This case also serves as an example of the fact that a 1-year recall on endodontic cases does not provide enough time to properly evaluate healing. From a strict radiographic interpretation, this case has not healed and is therefore not currently a success. One strike against the relevance or clinical significance of that Cochrane Review.
By the way, I did address the molar’s obvious periodontal issue verbally. The patient is aware of a guarded long-term prognosis there.
October 23rd, 2008 at 11:58 pm
Duly noted!
(fragileheart’s last blog post: Whether you like it or not, the season is upon us.)
October 24th, 2008 at 8:13 pm
This was one of the cases I presented at my presentation on Wednesday. It woke everyone up for various reasons.
October 24th, 2008 at 10:04 pm
So it went well? I didn’t ask because I assumed it did. You know your stuff (or so it appears to me, I wouldn’t know since I don’t know teeth hehe)
(fragileheart’s last blog post: Flickr Friday: Pink roses)
October 25th, 2008 at 9:09 am
Yeah. My presentation was the least scientific (deliberately) but turned out to be one of the more popular ones. Guess it’s good to know your audience.
October 25th, 2008 at 8:13 pm
Its only like lesson number 1 in Public Relations! Hello!!
(fragileheart’s last blog post: Flickr Friday: Pink roses)
October 26th, 2008 at 8:02 am
Yes, except many dentists fail at public relations — every patient gets managed exactly the same as every other one. Like a tooth assembly line.
October 26th, 2008 at 2:52 pm
Well that’s not very good. Thank goodness we have you
(fragileheart’s last blog post: Flickr Friday: Pink roses)
October 26th, 2008 at 4:53 pm
I never said I don’t fail at public relations