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The
invited case # 3 : Dr. Peter D. Cancellier
Our third guest was Dr. Peter D. Cancellier. Dr. Cancellier graduated from the University of the Pacific with degrees in Biology and Communications Arts. He obtained his Doctor of Dental Surgery degree from the University of the Pacific School of Dentistry in 1982. In 1988 completed a two year residency in endodontics at the Veterans Administration Medical Center in Long Beach, California. Since then he has practiced endodontics in Encinitas, California. Dr Cancellier mantains his own web site (www.cancellier.com) and lectures internationally on endodontics.
Preop
xray 16 year old white female presents from out of
state with buccal fistula between maxillary right
lateral #7 and central #8. Radiograph reveals
dens-in-dente at #8. Mesial part of #8 tests vital.
Tooth #7 tests vital. Gutta percha probe in fistula
points to #8.
Access
Photograph. At the moment Dr. Cancellier treated
only the central canal of #8 with the hope of
resolving the fistula without surgical
intervention. RCT completed in one visit using warm
gutta percha and CRCS sealer (nonstaining calcium
hydroxide sealer)
Fistula
Xray of gutta percha probe pointing to #8 lesion.
Six month recall. The fistula did not
heal.
Locate Photograph. Two more canals are located in
tooth #8. Both were vital. Both canals are cleaned
and shaped and filled with warm gutta percha and
CRCS sealer.
Root-end
surgery is performed at the same visit. Lesion was
removed and sent for histologic evaluation. It was
diagnosed as a periradicular cyst. A very large
canal was found with granulation or necrotic pulp
tissue in it. It was possible to see the original
root canal filling at the coronal extent of the
large apical canal space. Obtura gutta percha was
injected into this apical space leaving 3mm space.
An acid-etched, Tenure bonded, Geristore root-end
filling was placed into the retroprep and over the
apical surface.
6
month recall xray shows some healing. The fistula
healed within three weeks of the surgery. The tooth
is asymptomatic and pocket depths are
normal.
12
month recall shows more healing, though a
dome-shaped radiolucency persists. This is the
shape of the Geristore retrofilling that covered
the root-end surface. However, further evaluation
is necessary.
24
month recall shows much more healing.
Clinical cases by prior guests :
¿Do you have an interesting clinical case that you would like to share with all of us ? Please send us an e-mail to carlosboveda@carlosboveda.com.
Carlos
Bóveda Z. July
1999 carlosboveda@carlosboveda.com