Real World Endo Forum
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Endo Questions for the RWE Faculty:
In this area, users are encouraged to ask questions from the RWE Faculty regarding Endodontics in General and the EndoSequence Technique.
Endo Questions for the RWE Faculty:: Bleeding
Anyway, once that happens, we get a little bleach out, then add to that a specific case where there's possibly a slightly longer bleeding time with that given patient as well as an anatomical situation where a larger arteriol was passing by and then you get lots of bleeding. It shouldn't happen often. It happens to me, I would say, in 5% of the cases. Most of the time it can be controlled with paper points, water, maybe packing Ca(OH)2 or some hemostatic agent; but there shouldn't be any bleach used at that time. It dissolves the clot and will begin the bleeding again. In a small percentage that I can't control the bleeding then I stop, pack Ca(OH)2, and reschedule the patient (very important not to fill with blood everywhere as the protein component mixes with sealer and can affect the future seal. It may be less of a problem with a hydrophilic sealer like BC Sealer but that's not something I'm willing to test in order to find out! So, I act the same way (only situation where I do a case in two visits.)
Maybe I'll make a video and go into more detail. But for now, try to subtract .5mm from your length and make sure you're not using positive pressure with bleach at high concentration that triggers this kind of reaction. Of course, occasionally, you can have a patient with a very oval shaped root with tissue tags on the side but 99% of heavy bleeding is out of the apex and not from inside the canal. Good luck! :)
I am a general dentist. I recently did a RCT on #4. After final instrumentation with Endo sequence file #40, the buccal canal started to bleed when reaching apex, I think because of over instrumentation. I was able to stop the bleeding but the buccal canal was still oozing. I obturated with BC sealer thinking it is bioceramic so it should work in a moist/blood environment. The pt is asymptotic after 2 days. What would you recommend to do at this point, retreat the canal or proceed with the core buildup? Thanks and appreciate your help.