Retreatment of a second upper premolar
11/07/2024
Fabio Gorni
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The patient came to my office with a big swelling and acute pain , after the pre-op X-ray the situation was clear , apical periodontitis plus a lateral lesion . The previous endodontic treatment is short and we have a perforation on middle one third of the root located on the distal aspect of the root , the original anatomy is really tricky due to the double curvature reason of the failure .
After the coronal disassembling and the removal of the fiber post , now we are ready to remove the gutta-percha in the coronal two thirds of the canals using the Bull-y file (the first instrument of the RETREATY KIT) by Perfect-endo. The cutting efficiency of this file is really great and in few seconds we can remove the gutta-percha emptying the coronal part of the canals , the disassembling of this area has been completed with the removal of the material occluding the perforation using different kind of ultrasonic tips.
Now the access cavity is completed and the visibility of the root canal system is optimal that’s why it’s time to scout the canals with SKINN-Y ( the second file of the Retreaty kit , austenitic file .04 taper ) creating a glide path to the apex . Despite the difficulties of the anatomy it was possible to reach the foramen confirmed by the manual instrument . Depending on the anatomical condition of the tooth we decided to finalize our shaping using as last files SHAP-Y1 .05 Taper GOLD ALLOY #20 on the tip, this instrument has a good balance between flexibility and cutting efficiency, perfect for the final shaping in these anatomical conditions .
Single cone with bioceramic sealer it was the choice for the obturation and bioceramic putty to seal the perforation. In the X-rays it’s possibile to evaluate the final result after the post-op and the follow-up with the final healing .
Conclusions
The ReTreaty kit allows performing effective and conservative retreatments