Doctor, I performed root canal treatment on tooth 12 four days ago. Today, because of extensive loss of tooth structure, we decided to place a fiber post. When the patient came in today, I removed the gutta-percha, thoroughly etched and rinsed the entire area, and a few seconds after drying it, the patient's right cheek and eye began to swell. At first, I thought it was caused by the anesthesia, but then emphysema came to mind. I had compacted the gutta-percha tightly using lateral condensation. Could it have moved out of place during removal?

We took the patient to the emergency department. Dekort was given intravenously, along with physiological saline, and Prednol and an antibiotic were prescribed.
I placed a single cone and compacted it tightly with accessory cones, Doctor.

Doctor, I removed the gutta-percha using the bur supplied in the fiber-post kit.

On the second radiograph I took, the gutta-percha had not moved at all, but I think the sealer separated from the walls and a gap formed.

Question

Doctor, I performed root canal treatment on tooth 12 four days ago. Today, because of extensive loss of tooth structure, we decided to place a fiber post. When the patient came in today, I removed the gutta-percha, thoroughly etched and rinsed the entire area, and a few seconds after drying it, the patient's right cheek and eye began to swell. At first, I thought it was caused by the anesthesia, but then emphysema came to mind. I had compacted the gutta-percha tightly using lateral condensation. Could it have moved out of place during removal?

We took the patient to the emergency department. Dekort was given intravenously, along with physiological saline, and Prednol and an antibiotic were prescribed.
I placed a single cone and compacted it tightly with accessory cones, Doctor.

Doctor, I removed the gutta-percha using the bur supplied in the fiber-post kit.

On the second radiograph I took, the gutta-percha had not moved at all, but I think the sealer separated from the walls and a gap formed.

Doç. Dr. İsmail Davut Çapar · Accepted Answer

More than one factor may cause this situation. I prefer to avoid using drills as much as possible when preparing a post space. Drills can cause excessive loss of tooth structure and perforations. In addition, if used without water cooling, they can cause high heat and bone necrosis. You later messaged me that you had extracted the tooth in this case and that there was indeed a perforation.

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