A full thickness flap was raised with vertical relieving incision mesial to upper canine. A papilla based incision was made to prevent gingival recession, especially around the crowns. Osteotomy windows were made of about 4mm diameter and under steromicroscope 3mm of the root ends were removed.
The root ends were stained with Methylene Blue to check for any cracks.
The root ends were prepared by ultrasonics tips (JeTip, by B&L Biotech) to accept MTA to a depth of 3mm. MTA was packed in a dry field.
The gum was sutured closed with 5/0 Ethilon sutures and the patient was given post-op instructions regarding controlling swelling, bleeding or pain.
The x-ray below shows the retro filling in place.
Knowledge, Training and Skill is the key to successful surgical treatment. The surgical option can provide a good long term result and is well tolerated by patients. In our case the patient actually fell asleep during the procedure!!
I look forward to sharing some interesting surgical cases.