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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:: Fractures in Pulp Floor / Canals

Missing

Joined: May 2015

Rank: Sergeant

Posts: 12

#1
Firstly I highly appreciate your videos and the time taken to help clinicians.I wondered if the physical properties of BC Sealer might help avoid condemning a tooth where fractures in the pulpal floor or canals has been deemed poor prognosis, following microscopic investigation. My thoughts were it may flow into this fractures and act almost like how we repair perforations. Maybe there is no evidence base to support yet but I wondered if it is feasible to attempt BS Sealer use if the patient's only other option is to extract.
Allen_ali_nasseh

Joined: August 2013

Rank: Faculty General

Posts: 299

#2
In reply to Stephen Shepherd Thank you Stephen for the kind words. I've tried this but am not happy to report that if you do have a crack on the furcation even BC Sealer can't help it. The main problem is that these are unpredictable and while some cases I've tried where I've seen a crack on the distal of a second molar have worked just fine, once the crack is on the furcation, then it means it's far too extensive and will eventually cause a split tooth. Therefore, I still recommend extraction when I see that as it soon becomes a mesiodistal fracture. 
The key is predictability and also what's the patient's alternative in such case and how does that compare in predictability. But typically, I'm very conservative and do not try to expose patients to a higher risk of failure that the alternative treatment. Of course, I discuss this with the patient to see what their personal value and priorities are before we set a treatment plan. 
Have a good day !