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Conservative Surgical Approach to Heithersay Type 1 Resorption

Terry Pannkuk, DDS, MScDComplications: Advanced Management, Resorption Management, All by Date


The defect was re-prepped to freshen the dentin surface to enhance the chemical bond of the Geristore filling

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It is rare to avoid endodontic pretreatment before surgically repairing a Heithersay resorption defect

Patient: 64 year-old male with a noncontributory medical history

Chief Complaint: asymptomatic

Dental History: The patient reported having had a resorption defect on the linguocervical aspect of his maxillary right canine (tooth #6) discovered during a routine cleaning visit. The patient was referred to the author by his dentist.

Significant Findings (tooth #6): The patient responded with a questionable response to cold thermal stimulation but when tested with the electric pulp tester responded unequivocally. There was a 4mm sulcular defect at the mid-distal probing area.

A CBCT scan revealed a mesiolingual defect at the cervical area and was judged to be very small only slightly penetrating through the enamel and confined to a small area.

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Terry, does research tell us how fresh the trichlorocetic acid needs to be?

Great question! I had to work to check that one out: apparently it's stable for 23 weeks in an amber glass bottle:

J Dermatol Surg Oncol. 1989 Sep;15(9):974-5.
Stability-time profile of trichloroacetic acid at various concentrations and storage conditions.
Spinowitz AL1, Rumsfield J.
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Trichloroacetic acid (TCA) is a deliquescent chemical widely used for a variety of procedures. Stability of various concentrations of TCA in both amber glass and plastic bottles stored under refrigeration and at room temperature was measured at several time points. Extended stability data suggest that TCA potency is stable for 23 weeks and would best be maintained in glass amber bottles stored under refrigeration.

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