Broken dowel post (RCT)

An anxious 42 years old patient called me up to tell me that her crown fell off .   Upon oral examination,  her titanium (dowel) post in her tooth no. 11 broke in halves. I checked her periapical x-ray and saw nothing unusual around the root.

I used a 801 round bur to open the pathway to the canal and to have a better access to the broken titanium dowel. Then i used my ultrasonic instrument moving it inside in circumferential motion around the dowel pin to dislodge it from its cement. It took around 10 mins to remove it from the canal. I cleaned the canal with chlorhexidine 0.20% and dry the canal.  I accidentally perforated the canal at the lingual side due to over instrumentation or a weakened wall . I used MTA denstply (white) on the perforated wall . I prefer MTA denstply here over MTA angelus eventhoigh it's in a syringe type. The strength and hardness of MTA denstply is superior to that of MTA angelus. I used angelus fiber post # 1 and cemented it with Rebilda voco up to the post build up. I used Duolink bisco to cement the Zircnia crown.

Zirconia crown (cement used Duolink bisco)

Broken dowel pin inside the canal

Loosen pin

Rebuild the post with Rebilda voco

Angelus fiber post #1 was cemented using 

Acute Pulpitis - Root Canal Treatment

peri-apical xray 

A 29 year-old-male came with complaint of severe pain in his lower right molar. He said that he experienced (intermittent) pain for about a month and would just take NSAID (Non Steroidal Anti-Inflammatory Drug) then for two consecutive nights he had this throbbing pain before he came to our office. Upon visual examination revealed of cracked restoration. Radiographically the periapex is normal. Diagnosis: Irreversible pulpitis.

 

tooth no. 46  

the caries weakened the cement filling 

to check my work I place LED/halogen light cure at the buccal side. still at the roof of the pulp chamber. These holes are the pulp horns

access the canal with no.10 files

to flare the coronal third of the canal, Gates-Glidden reamers were used  

Irrigated with saline and chlorhexidine gluconate 0.20%

Denstply AH Plus and gutta percha : Voco Rebilda

gingival retraction

porcelain fused to metal