Do you notice what these three endo cases have in common? Let’s see if you can spot it.
Did you figure it out?? Should I tell you? Drum roll please…. All three of these patients still had the cotton and cavit left in the chamber at their one year recall, AFTER the crown was permanently cemented.
Now, go back and look at the chamber from the postoperative radiograph to the recall. Do you know what the clinical significance of this is? Well, most people don’t show up for their one year recall, especially when they are feeling great, but these three patients did come back at one year. Why? Because their tooth was starting to bother them again. Why? Recontamination.
This sponge is a magnet for bacteria and if you are leaving it in the chamber and sealing it in under the crown, you are just creating a happy home for those bugs.
Let me tell you, this is a very uncomfortable conversation for the endodontist to have with the patient. But, perhaps some of you feel that as the endodontist, we should not say anything. At this point, the patient is blaming us that their root canal didn’t work. I will be honest, most of the time, I don’t say anything unless I have a really inquisitive patient and I just redo the root canal for free. But, don’t take advantage of that because it’s quite possible that one day your endodontist may not bail you out.
So, all I ask is that you take 3 seconds to check and make sure the cotton and cavit is out of that tooth, and you are doing a fresh buildup. Or maybe ask your endodontist to do the buildup under isolation in order to prevent something like this.
This is just another opportunity to look bad and lose another patient, and nobody wants that.