A patient came in with pain on tooth No. 30. He had pain on chewing and releasing reproduced by a tooth slooth. Pulp testing revealed a partially necrotic pulp with acute apical periodontitis and a crack in the distal wall. The crack was not evident on the x-ray, clinically, nor would it show up on CBCT (Figure 1).
I performed the root canal in one visit using Bioceramic Gutta Percha and Bioceramic Sealer by Brasseler USA (Figures 2 and 3). I used this material since the tooth had a crack (if the crack propagated into the root, then it would have needed to have been extracted), and Bioceramics increases the fracture resistance of teeth after endodontics.1
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Figure 2. The postoperative x-ray of tooth No. 30 with an inverted view shows the lateral canal on the distal root. |
Figure 3. The post-op x-ray of tooth No. 30 in a traditional view. |
Bioceramic sealer has a very nice flow. However, it does not do well when applying high heat. Since the material is hydrophilic, heat desiccates it, causing it to clump. Use low heat to sear off gutta-percha and condense cold. The sealer is actually the filler. The gutta-percha allows it to be retreatable and uses hydraulic pressure to seal the canal as well as the accessory canals. Look at the large lateral canal on the distal.
Reference
1. Topçuoğlu HS, Tuncay Ö, Karataş E, et al. In Vitro Fracture Resistance of Roots Obturated with Epoxy Resin–based, Mineral Trioxide Aggregate–based, and Bioceramic Root Canal Sealers. J Endo. 2013;39(12):1630-1633.
Dr. Short attended the Medical College of Georgia (MCG) School of Dentistry to attain a DMD degree in 1999. In 2002, he earned his postdoctorate degree in endodontics from Nova Southeastern University and then became a Diplomate of the American Board of Endodontics in 2009. Dr. Short is an expert consultant in endodontics to the Georgia Board of Dentistry and assistant clinical professor at the Dental College of Georgia in Augusta. He is endorsed by the American Association of Endodontists speakers bureau, and his private practice, Apex Endodontics PC, is located in Smryna, Ga. Dr. Short also has authored a book, Getting to the Root of Your Problem: 365 Days of Inspirational Thinking. He can be reached at dr.short@yahoo.com.
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