Non-Surgical Re-Treatment

Repeated endodontic treatment is a common solution for the state of periapical pathology after a previous endodontic treatment. This situation is typical for countries where endodontic treatment is part of basic health insurance services and is not reserved exclusively for endodontic specialists. Unlike initial treatment by an endodontist, one must account for a variety of logical and undesirable states that arose during the initial treatment, regardless of whether it occurred due to the procedure itself, the operator’s inexperience, underfunding, or hastiness. Typical situations addressed during RCRT include:

• Removal of a crown / extraction of a post
• Repair of the access opening
• Removal of root canal fillings from various materials (gutta-percha, epoxy/resin sealer, resorcinol-formaldehyde resin, calcium silicates, phosphate cement, silver points, and their combinations)
• Incomplete preparation of the root canal system (coronally, apically)
• Ledges (a ledge in the canal due to incorrect instrumentation)
• Incomplete preparation (does not reach the apex, does not include all branches)
• Mechanical damage to the apical part of the root (zipping)
• Incomplete disinfection / repeated infection of dentin tubules
• Perforation of the root system
• Removal of instrument fragments from the root system

Although this list is not exhaustive, it is clear that it is impossible to prepare for all eventualities of RCRT in a single exercise. Only repeated practice with supervision will provide the experience to solve all or at least most of the situations outlined here. The practical exercises of the current course will focus on the most common problems associated with RCRT. In addition to prepared replicas, we will also use your brought extracted teeth to expand the exercise with unexpected situations.

Syllabus:

1. Theoretical introduction to the practical course
2. Gentle removal of GTP (TrueTooth replica) – using a solvent
3. Removal of resorcinol-formaldehyde resin (Foredent, TrueTooth replica) – mechanically + solvents
4. Repair of ledge (plastic canal)
5. Removal of NiTi instrument fragment (TrueTooth replica)
6. Application of MTA on an open apex using the MAP system (TrueTooth replica)
7. Questions, case studies by attendees
8. Work on your own brought teeth (please immerse 15 min in 1% NaClO beforehand)

The course consists of 2x 5 teaching hours and the course is limited to a number of participants that allows everyone to work with an operating microscope. All necessary equipment will be available at the course. If you find something interesting, perhaps even challenging but theoretically solvable, among the extracted teeth, bring it, and we’ll try if I could manage it myself.