Thank you for sharing with us. It was really good job . Would you please highlight what the material had been used in the resorbed portion of RC for obturation. Thank you
Does filling materials strengthen the weakened root with internal resorption ? as in is there a significance between use of GP , MTA or bioceramics related to fracture resistance of the root?[ citation of studies would be appreciated]
This was a lovely case! I do have a question: I think it's safe to say that the structural integrity of such teeth is compromised due to the severe lose of root structure. Although this treatment was done phenomenally, I wonder what is the long term survival rate of such cases? If predictability is a prime concern, and a patient asks me "wouldn't an implant be a better, safer solution?", how should I answer such a question?
It's a valid question; but for some reason, I've never actually seen these types of internal resorption cases fracture or snap off. They tend to do a lot better than our imagination conjures up. So, I would always recommend the RCT first in these cases. I've never seen the patient come back with the tooth snapped off. Cheers!
with this type of defect, why not use a Lightwalker laser PIPS technique which would have debrided the entire root canal system, no matter what shape the resorption lesion is? I would have preferred biodentine to fill the defect after obturation.
Whether PIPS coronal activation is adequate in cleaning these types of lesions is not clearly known. At least with 3D instrumentation one can expect direct contact of an instrument with dentin walls, which has been shown to be effective in removing tissue or biofilm. But this whole area is lacking some real clinical research. In terms of Biodentin, it could be used as a substitute here. The difference is that injecting the RRM syringeable is no doubt faster and easier than mixing, triturating, and incrementally applying and condensing BD segments before it sets. One would certainly have more difficulty injecting BD directly into the resorptive lesion that deep in the canal.
Biodentine takes 12 minutes to set. I can make it a little more runny and inject. I have never had a problem condensing it and adapting it in most situations. That defect looked quite large and I felt the biodentine would be a more structurally sound option than just a space filler. II am just worried about the tooth fracturing. and if you use Bioroot RCS, the chemistry is compatible and you get a sealed system. What do you think?
There is no advantage with BioDentin or BRRCS over the RRM. RRM is premixed and ready to inject. In terms of strength, it's strong enough with structural integrity in this region. So, no advantage for BD. So, if you prefer BD use it. But RRM is certainly easier to apply.
