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| Notice the facial swelling |
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| I've outlined the extent of the bony defect |
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| The abscess is clearly visible as a swelling |
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| Initial incision with a No 15 Bard Parker blade |
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| Notice the thick stream of blood and pus |
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| I've indicated the reflected flap |
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| The arrow shows the defect in the bone over the root tips |
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| Drilling away the bone over the defect |
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| The arrows show the tips of the affected tooth roots |
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| Drilling cavities in the root tips for retrograde restorations |
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| Curretting away granulation tissue |
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| Placing the retrograde restorations at the root tips |
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| Retrograde restorations in place |
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| After carving the restorations: you can see one as a white spot |
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| Placing the bone graft analogue |
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| Defect filled by bone graft analogue |
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| Suturing |
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| Surgery site closed by suture |
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| Post operative X ray with retrograde restorations marked |
This young woman had had root canal treatment done on her upper front teeth and crowns placed a year or so ago. Unfortunately the root canal treatment wasn't done especially well, and speedily failed with pain and swelling over the gum, and a fairly large pus-filled cavity in the bone at the root tips, which extended internally up to the palate. Removal of the crowns risked fracturing the teeth, and I decided that the circumstances warranted a surgical approach through the gum and bone instead.
The idea was to remove diseased bone and tissue, expose the root tips, place fillings at the root tips to prevent the passage of bacteria to or from the canals, and then packing of the defect with a bone graft analogue. Once completed, the flap I'd raised at the outset would be closed with black silk sutures.
The surgery was completely successful, recovery uneventful, and there has been no recurrence of the problem.
Kind of grisly, but also very interesting. I'm fascinated by the mechanics of various dental and surgical procedures.
ReplyDeleteBut yeah, not for the weak of stomach ;)
You have done a very good job. Well, sometimes root canal treatment can lead to big problems like the above case. People should maintain the oral health properly. It is good to maintain a good monthly dental check up. If there is any problem then the dentist can start the treatment in the initial stage. The procedure will be simple and less painful for the patient.
ReplyDeleteMy teeth hurt!
ReplyDelete