Allen_ali_nasseh

Submitted by: Allen Ali Nasseh on 07/07/2018

Category: Endo » Non-surgical treatment

Tags: Perforation Diagnosis Repair Friday

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How to disinfect a perforation prior to repair (Friday Questions) basic free

Dr. Nasseh shares his technique for disinfection and preparation of the perforation before repair.

Description

Peroforation repair should be done as soon as possible after its occurance. Dr. Nasseh shares his technique for preparing the site for repair by disinfection and hemostatsis. 

Comments (9)

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Allen_ali_nasseh

Rank: Faculty General

Comments: 205

Allen Ali Nasseh

Quick note: After disinfection and hemostasis please make sure the walls of the perforation are dry and devoid of dry, coagulated blood. If dry blood is present remove it with gentle ultrasonics and water. Leaving the blood smear in place will interfere with the bond of the bioceramic to the dentinal walls. If you have any questions or concerns please leave them below. :)
Dr.rusheena_balakrishnan

Rank: Officer

Comments: 71

Lovely video as always doc...thank u...if we do not have a bio ceramic sealer in our practice....Wat according to u will be the next best material to seal perforations besides mta and biodentine and bioceramic sealers.....wats ur take on gic and any other materials that are available. ...of course nothing like bioceramic s..mta n biodentine ....but wat other material would u use as an immediate sealing material if u did not have the above 3 in ur practice at a time...Wat would u go for next???? Thank u Kind regards Rusheena.
Allen_ali_nasseh

Rank: Faculty General

Comments: 205

Allen Ali Nasseh

@Rusheena: Thank you. But what do you mean no BC, MTA or BioDentine? What kind of practice are we talking about here?! LOL! ;) Just kidding... obviously, all studies show that bioceramics are superior to all previous generation of materials since they are self adhesive. But if you really have no access to them, if you can achieve reasonable hemostasis and have a very dry field, then a compomer might be helpful or even SuperEBA. If you have difficulty with hemostasis Amalgam might work too since it's less moisture sensitive but it's best to be avoided as it's not really the standard of care anymore. Bioceramics are the Standard of care, any of the three you mentioned are within the standards. We've developed the BC Putty since it's pure and has better handling characteristics. Otherwise, the chemistry of bioceramics is what you need in these types of situations, not the more cytotoxic resin and ZOE containing materials. Cheers! :)
Missing

Rank: Rookie

Comments: 1

Saeed Aladib

Thank you Doctor for tha lovely video as usual, recently I have some papers says inducing bleeding under MTA or any repair material it's better for the regeneration process so I think iam confused should I do hemostasis or induce blood And another question is there any deference in handling process between newly fresh perforation and old one ?? Me regards
Missing

Rank: Rookie

Comments: 3

Joseph Cwikla, DMD

For hemostasis, I’ve used i/1000 ophthalmic epi in a cotton pellet since the early ‘70’s and continue to do so. Very effective during apical surgery and as effective for a perforation.