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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 canal

Missing

Joined: April 2017

Rank: Rookie

Posts: 6

#1
Dear Dr. Nasseh 
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.
I removed temp material today (5 days after RCT) and checked gp, everything seemed hard and stable to me 
What would you recommend to do at this point, retreat the canal or proceed with the core buildup? Thanks and appreciate your help. 
Allen_ali_nasseh

Joined: August 2013

Rank: Faculty General

Posts: 299

#2
In reply to Faddi Salim You should upload an x-rays here so I can see how the case looks. THere's a big difference between over instrumentation and potential zipping/transportation/apical perforation. The prognosis varies. But having pain after 2 days is not a surprise. I would recommend placing a strong core and waiting a month and go from there. But again, the prognosis is dependent on the case at hand. If you can upload an x-ray do that. Good luck. 
Missing

Joined: April 2017

Rank: Rookie

Posts: 6

#3
Thanks for your reply. Here are x-rays of the case.

Attachments: Img_1946 Img_1947

Allen_ali_nasseh

Joined: August 2013

Rank: Faculty General

Posts: 299

#4
In reply to Faddi Salim I think you should be fine. Wait 3-4 weeks and if all the symptoms are gone you should be able to proceed. Next time try to Ca(OH)2 the case if you get drainage. It helps reduce some of the uncertainty. 
Good luck!
Missing

Joined: April 2017

Rank: Rookie

Posts: 6

#5
Thanks you doctor. I will keep you posted on the case.