Re-endodontics of tooth 2.4 using RetreatAll® files and Z-Activator® in irrigation
Dr. Marc Llaquet presents in this clinical case a re-endodontic treatment of tooth 2.4 using RetreatAll files to remove gutta-percha and the ultrasonic activation of Z-Activator in the irrigation.
Clinical case: Root canal treatment of a tooth with a previously treated acute apical abscess.
Patient with severe apical abscess in a previously treated tooth.
The patient comes with discomfort “when biting” in the second quadrant. In the clinical examination we observed numbness of the mucosa at the level of the left second premolar, with discomfort on palpation and percussion.
It’s observed a large apical lesion in tooth 24 (which has already been endodontically treated), both in the periapical radiograph and in the CBCT.
Final diagnosis: Previously treated tooth with acute apical abscess.
Dr. Llaquet decides to perform orthograde retreatment with the Zarc RetreatAll® file system. This simple system of 2 rotary files allows easy removal of coronal and apical gutta-percha, as well as other materials in the canals. With the canal flooded with sodium hypochlorite, the doctor starts by removing the coronal gutta-percha from the 2 canals with the ZR1 file (30/04, 21 mm) at 500 rpm. With the ZR2 file (25/04 25 mm) he finishes removing all the sealing material up to the length calculated in the CBCT.
We use the 8K and 10K hand files to permeabilize the palatal canal and check with the E-Connect S apex locator that both canals meet at 5 mm from the constriction. We instrument both canals with the ZR2 at 25mm.
Dr. Llaquet irrigates with 17% EDTA for 30 sec/duct and 5.25% sodium hypochlorite for 1 min/duct and activates it ultrasonically with Zarc’s Z-Activator® system, which achieves a unidirectional flow of the liquid. In addition, the movement of the tip multiplies the movement of the liquid inside the root canal, significantly amplifying the effectiveness of the cleaning. Finally, he seals the root canal system using the continuous heat technique with the Fast Pack and Fast Fill system.