Blindsided by this crown on this second premolar – originally a near-perio-endo lesion on a bridge abutment, the pontic was sectioned and the tooth accessed and successfully obturated. The crown was sectioned and it is obvious the aggressive degree of preparation that no doubt had a role in the devitalization of the tooth in the first place, leaving us with minimal residual (no) ferrule to work with. The core was rebuilt and a post space developed using the Sybron Elements Free downpack unit to 10mm from the cavosurface margin. The canal space was extremely tight and you will see comparison shots of “depth of canal penetration” of the Centrix tip (which I normally use) vs. an Ultraetch syringe body and tip. We decided to try the latter and I must say it was remarkably difficult to extrude cement, but we were able to get a void-free adaptation/application of Clearfil DC Core Plus down before placing the post system (Voco Rebilda GT Post), which is a 0.8mm post composed of 4 smaller subposts with a flexural modulus of 11MPa (similar to deep dentin). Isolation was possible with the near tear-proof Dermadam by Ultradent and a Hu-Friedy 14 clamp on the second molar and a Brinker B4 on the second premolar.
Pre-operative radiograph shows Ultracal (CaOH) placed after initial access 3 months ago.
Post-post-placement radiograph shows acceptable healing of the perio-endo lesion previously seen.
Such good fun,
#Sybron #ElementsFree #Ultradent #Dermadam #Ultracal #Ultraetch #BrinkerB4 #Voco #RebildaGT #ClearfilDCCorePlus #HeroicDentistry