This dog belongs to a local law enforcement agency in Atlanta. The officer astutely noticed the discoloration of the canine tooth. Any tooth that is discolored intrinsically as this one is should have root canal therapy or be extracted. The pulp is dead or in the process of dying and will cause problems with bone destruction at the root apex (tip) Notice the wide periodontal ligament space associated with this tooth radiographically. The obturation material consisted of a simplifil plug and Guttaflow.
I am curious if you also filled the pulp chamber coronal to the access opening (assuming that you made the access opening several millimeters from the gingiva). Is the first radiograph showing a lightspeed file? Bulbous canals in canine teeth like this case is hard to fill completely. Do you have a good success rate with Guttaflow? What do you think about filling the canal completely with guttaflow without a simplifil plug? Would that increase apical leakage? Since guttaflow is a mixture of root canal sealer and microparticle gutta percha, do you use another root canal sealer before introducing guttaflow into the canal? Sorry about asking a bunch of questions, I just wanna learn some more about this guttaflow. It sounds like a good way to fill the canal since it is cold flow and does not have the risk of gutta shrinkage.
Thanks
Hi Ozgur,
I do fill the access with GF then use a microbrush to clean it out, then place glass ionomer then flowable composite. I always place crowns on canines and PM4s. The first is a lightspeed file. Guttaflow has been very effective for me. No research has been done with GF alone that I know of. You do not want another sealer.
Brett
Some more questions if you dont mind: if the canal is narrow, what kind of obturation do you use? what is your opinion on single file obturation? Also, what type of root canal sealer (calcium hydroxide-based, epoxy resin-based, methacrylate resin-based, silicon-based, etc) and bonding agent (etch-and-rinse three bottle, two bottle or self-etch two bottle, single bottle) do you use?
If narrow I still use guttaflow carried on a lentulo. Single cone obturation is fine and has been done for years as long as you follow the text outlined procedures. Only guttaflow, no sealer but I used to use AH Plus. I use Bond 1 SF almost exclusively as a bonding agent.
The color of the tooth is secondary to infiltration of pigment (hemosiderin) in dentin wall. Is there a way to do tooth whitening, during root canal? For here we use oxygen peroxide heated to 75% in the root canal. What is your opinion?
Hi Leon,
There are several ways to accomplish whitening. We don’t recommend it and I personally have only done it in labs. If placing a crown you can use Bruxzir that is tooth colored and you get the benefit of an impenetrable access site seal as well.
Brett