Page 32 - The Beauty and Sorrow in Endodontics-Chapter 1

drainage occurred as soon as the pulp chamber was opened, and the patient
reported instant relief of pressure. Obtained patency in each canal with

copious ultrasonic irrigation of NaOCl. Intracanal medication with NaOCl,
cotton pellets and a bilayer temp restoration (Cavit + composite resin)
placed (Fig 19C).

Rx: Clindamycin 300mg BID for 7 days

Appt 2: Temporary restoration removed with high speed until a thin layer

left, then a DG-16 endo explorer was used to puncture a hole in the material
followed by removal with a spoon excavator. Proper cleaning and shaping to
the proposed taper in each canal completed. The cone fit radiograph
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showed good canal shaping and fit of the master cones (Fig 19D). After final
ultrasonic irrigation with QMix, the canals were dried with paper points.
Warm vertical compaction (down pack + back fill) obturation completed

along with a core placement. The radiograph shows good obturation depth
and density, and the extruded sealers at the exit of each canal represent tight
apical seal (Fig 19E). The flow and taper of the obturated canals match their
corresponding root shape following the natural curvature of the original

canals (Fig 19F). The only disappointment was that no lateral or furcal
canals were seen obturated at the furcation area (Fig 19G).

2) Follow-up
2-weeks – The referring dentist reported that the patient had returned to his
#
office for follow-up and that tooth 36 is stable with no gingival
swelling. The dentist wanted to remove the existing core buildup
#
and replace it with a post and core for 36-x-38 bridge. Since 38
#
was mesially tipped, the author had recommended uprighting 38
#
prior to 36-x-38 bridge placement. Or else, a single crown for 36
#
and an implant 37 would be ideal.
1-month – The referring dentist had sent over a follow-up radiograph of the
#
prepared 36 abutment with a temporary 36-x-38 bridge (Fig
19H, 19I). The patient was ecstatic to have regained masticatory
function on the left side in such a short period of time.

3-months – It was a surprise to see that the permanent bridge had been
cemented. The patient reported high satisfaction with the
temporary bridge and had requested that the permanent one be
cemented. Radiographic examination revealed healing of the

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