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Endodontic clinical case presentation 2

Endodontic clinical case presentation 2. Prepared by Dr .hisham al- zaidan. Personal Data. Age : 15 years old Gender : male Nationality : Saudi Marital status : Single Personality : Positively cooperative

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Endodontic clinical case presentation 2

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  1. Endodontic clinical case presentation 2 Prepared by Dr .hisham al-zaidan

  2. Personal Data • Age: 15 years old • Gender: male • Nationality: Saudi • Marital status: Single • Personality : Positively cooperative • Date started: 17 November 09 • Date finished: 17 November 09

  3. Medical Status Medical History • Significant medical problems: None • Medications: None • Allergic reactions: None Family Medical History • Significant family history: None

  4. Subjective Dental chief complaintI have pain on this tooth ”lower right” I want to repair these teeth to look better please History of chief complaint 3months ago started to feel pain when eating sweets History of trauma to on upper anterior teeth since he was 9 YO

  5. Objective • Extra-oral • Facial swelling NAD • Lymph node NAD • Soft tissue NAD • Intra-oral • Swelling none • I.O sinus related to# 11 • Clinical crown #11 fractured lingual surface, composite (UCCF) #21 fractured incisal edge ,discolored ,TF(CCF)

  6. Tooth exam

  7. Periodontal exam

  8. Radiographic findings

  9. Diagnosis • Pulpal • #11 pulp necrosis • # 21 substandard RCT • Periradicular • #11 AAA • #21 AAP

  10. Treatment plan • Endodontic treatment plan • RCT #11 • Retreatment #21 • Periodontal treatment plan • none • Restorative treatment plan • Composite restoration and refer for orthodontic treatment

  11. Biomechanical data#11,21

  12. Access

  13. Pre operative x-ray

  14. Initial file

  15. Master GP cone

  16. Final condensation

  17. Classification of tooth fractureAndreason et al 2007

  18. Issues for discussion 1-To use or not to use GP solvent that is the question?! • One of the methods of removing GP in large canals is to make space in GP using a hot instrument and the insertion of broach's or headstrom files to yank the whole GP out with out using solvent

  19. Removing the GP and sealer (AH26) with solvent (chloroform) with hand files showed the most debris remnant in the canal. lisa et al 1987 • Removing large GP with out solvent by pulling the RC filling with headstrom files. wilcox 1993

  20. 2-Single visit RCT VS Multiple visit RCT • There is no significant difference SVRCT and MVRCT in term of healing capability soltanoff, montclair 1978 sathorn ,pararashos ,messer 2005 • When the canal is dry and the tooth is asymptomatic then the canal is ready for obturation. Trope , grossman 1985

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