PubMed · 6574878
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S Oliet, L I Grossman. Root resection.. https://pubmed.ncbi.nlm.nih.gov/6574878/
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CASE REPORT: This case report describes the outcome of a number of retreatments on a failed root filling in a maxillary first molar. The patient wanted all amalgams replaced by tooth-coloured Cerec restorations, including one in a symptomless maxillary molar. This tooth had a pulpotomy or a poorly done root-canal treatment 10 years earlier. The molar was root-canal retreated before placing the Cerec restoration and the palatal canal was filled 5 mm short of the radiographic apex. About 1 year later the patient presented with pain. Suspecting that a second mesiobuccal canal (MB-2) had not been located, a second non-surgical retreatment was instituted. MB-2 was not found and the palatal canal was retreated a third time, setting the working length 2 mm short of the radiographic apex. Because pain persisted palatally an apicectomy was performed and the tooth became symptomless. The resected palatal root apex was subsequently serially cross-sectioned, photographed and the canals analysed. Obvious apical transportation occurred during the cleaning and shaping procedures. Analyses of the canals showed that despite the retreatments, 11% of the canal cross-sectional area remained uncleaned although 7% of the root area was 'shaped'. Radiographically, the obturated palatal canal appeared reasonably well centred. However, this was disproved by the cross-sections, indicating that in this case, the clinician did not know where the K-Files had 'gone'. Apically, the obturated canal was certainly not within the natural canal. The pain located palatally was probably due to inadequate cleaning and shaping of the apical part of the root canal and its accessory canals.
This study was designed to enumerate the number of perforations to the maxillary sinus while performing apicoectomy on maxillary premolar and molar teeth and to evaluate possible complications as a result of these perforations. A total of 472 apicoectomies were performed in 440 patients; perforations occurred in 10.4% of teeth, 23% in molars, 13% in second premolars and 2% in first premolars. No cases of acute or chronic sinusitis were recorded. It was concluded that apicoectomy, carried out using a meticulous surgical technique and proper postoperative care, should be considered as a treatment option before contemplating extraction.
OBJECTIVES: This study compared the surface topography of roots resected with #57, Lindeman, and Multi-purpose burs. Further comparisons were made after refinements with either a multifluted carbide or an ultrafine diamond finishing bur. STUDY DESIGN: Three groups of single-rooted human teeth were resected with each resection bur, and resin replicas of the root ends were made. Root ends from each resection bur group were finished with either a multifluted carbide or an ultrafine diamond finishing bur, and the root ends were replicated. All replicas were evaluated at a magnification of x20 for smoothness and surface irregularities. Data analysis was done with the Wilcoxon signed rank test and the chi-square test at a significance level of p < 0.05. RESULTS: The Multi-purpose bur produced a smoother and more uniplanar surface than the #57 bur and caused less damage to the root than either the #57 or the Lindeman bur. The multifluted carbide finishing bur tended to improve the smoothness of the root end, while the ultrafine diamond tended to roughen the surface. CONCLUSIONS: The Multi-purpose bur produced the smoothest and most uniplanar resected root-end surface with the least root shattering. The multifluted carbide finishing bur produced a smoother surface than the ultrafine diamond bur.