GuttaCore to the Rescue!

A Case from Dr. Diwakar Kinra

Recently I encountered a tricky case with a high radius of curvature in the MB canal. Fortunately, GuttaCore came to the rescue, and I was able to obturate the canal successfully.

 

Diagnosis and Access

The patient came in with chief complaint of pain to biting and a dull ache in the upper right.

Exam of the patient revealed pain to percussion and biting, but no response to cold. My diagnosis was a necrotic pulp with symptomatic chronic periodontitis.

It was difficult to obtain straight-line access. The patient felt extreme fear, and access was limited.

Post-access, I located three canals. This was also confirmed with a CBCT provided by the referring GP.

 

 

Shaping and Obturation

I scouted with a #10 C-file, and then opened up the coronal third with a ProTaper Gold SX orifice opener. I continued to negotiate the working length hand files and rotary PathFiles. Lastly, due to the difficult curvature, I decided to create the final shape with ProTaper Gold. The palatal canal and DB canal were fairly straightforward. In the MB canal, however, it wasn't possible to negotiate the apical third with a rotary file due to extreme curvature and either blockage or a ledge in the canal.

I noted in my master cone radiograph that I was short of working length, so I hand filed, soaked with NaOCl, used EndoActivator, soaked some more with QMix, and then paper point dried the canal.

I knew that my heated plugger was not going to heat to the apical third within the canal. I decided that heating the GP outside of the mouth and then delivering it via a carrier would be the obturation method of choice. So I decided to use the heat and hydraulics of GuttaCore size 25 to obturate the case.

 

 

 

Post-Case

After completing the case, I referred the patient back to the GP for final restoration.

I felt satisfied knowing GuttaCore was able to provide a nice, complete fill for my patient.


About Dr. Kinra:

Dr. KinraDr. Kinra began his solo private practice limited to endodontics in Flint, Michigan, in 2004. He has spoken on clinical endodontics and practice management since 2005, at over 20 universities domestically and abroad. In 2008, Dr. Kinra also accepted a dual position as an adjunct professor at The University of Detroit-Mercy endodontic and periodontic departments.

In his spare time, Dr. Kinra is active, spending time with his son and triplet daughters. He also enjoys playing tennis, water sports, snowboarding, and anything outdoors. He owes much of his success to his wife of twelve years, Disha Kinra.

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