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 

Pain in her porcelain fixed bridge

A 56 year old female came to my office and complain of pain in her tooth no. 34 and 35.

Upon dental check-up, there's a 3 unit porcelain fixed bridge on these two teeth. It was the main support that resulted in a cantilevered bridge. As you can see in my first x-ray, there's an overhang unit after tooth no 35. That cantilever or the unsupported unit had put pressure on tooth no 34 and 35. It caused microscopic leakege sipping to the abutment tooth due to the seesaw effect during mastication. There was no dramatic seesaw effect but the movement was in microscopic effect.

I removed the unit and did a root canal therapy on tooth no. 35 (AH Plus). On tooth no. 34, I did the pulpotomy using the new medicaments Pulpotec from Switzerland. I prepared those teeth for their porcelain cap. My patient is still pain free and problem free with her new unit since 2009. I gave her oral health instruction to follow and do religiously to maintain a healthy gums.