IRM w/out cotton pallet for endo

[DancingKoala]

Hello.
I did endo about 2 weeks ago and temporized it with IRM.
But I didn't place cotton pallet before I placed IRM.
Does it affect the follow up procedure when I remove IRM? What's the purpose of using cotton pallet?

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[UCSD6]

easier access to canals, also prevents material from being placed into canals. Have you ever tried to remove composite from orifice/canal area = NOT FUN

 

[DancingKoala]

easier access to canals, also prevents material from being placed into canals. Have you ever tried to remove composite from orifice/canal area = NOT FUN

I see. But what if the gutta purcha was filled upto the orifice so that IRM can't go into the canals? Maybe it's not so hard to remove IRM?

 

[UCSD6]

I am assuming that you will be placing some type of build-up in the irm's place such as GI, composite, or amalgam. So, you want to remove all the IRM, it should come out fine just becareful when approaching pulpal floor/orifice areas, u dont want to perf.

 

[DrJeff]

Hello.
I did endo about 2 weeks ago and temporized it with IRM.
But I didn't place cotton pallet before I placed IRM.
Does it affect the follow up procedure when I remove IRM? What's the purpose of using cotton pallet?

I am assuming that you will be placing some type of build-up in the irm's place such as GI, composite, or amalgam. So, you want to remove all the IRM, it should come out fine just becareful when approaching pulpal floor/orifice areas, u dont want to perf.

Question and main answer.

It's much easier/"safer" when you're removing your temp material to 1st encounter that cotton pellet with your bur rather than the pulpal floor.

There's also plenty of literature out there that for an overall improvement in the long term success rate of an endodontically treated tooth, that you should place that core and essentially seal off the occlussal access point to the root canal system from oral bacteria the same day that you obturate the root canal system, while the tooth is still under rubber dam isolation.

Especially if you're doing a bonded core, let's be honest, it's not going to take more than a couple of minutes with that tooth isolated in the rubber dam to clean up the excess gutta percha extending out of the canals into the pulp chamber space, etch, bond and place the core material. Even if you're going to place a post, that's still going to be the best time to do so as any irregularities in the shape of the canal will be fresh in your brain from having just cleaned, shaped and filled that canal

 

[UCSD6]

Dr. Jeff great advice.
Also, remember that the eugenol in IRM can interfere with bonded materials such as composites, so this is something to think off when placing a temp material and when placing a build up material.

 

[DancingKoala]

Thank you everyone for great answers.
I was successfully able to get rid of all the IRM and retreat endo. And I had to be very careful near the chamber area 🙂
I will make sure to use cotton pallet from now on ' - '

 

[oledktvs]

you want to remove all the IRM, it should come out fine just becareful when approaching pulpal floor/orifice areas, u dont want to perf.

 

[Shunwei]

I am surprised that no one has mentioned the possibility of the IRM clogging the root canals. During the removal, I can see the IRM coming off in clump and if a small clump get into one of the canals, good luck getting it out. I always use cotton pellets to fully cover the canal orifices for this specific purpose.