TRANSPORTATION

TRANSPORTATION
The problem with the torn or “open apex” is there is no capacity to capture the maximum cushion of obturation material and mold it apically. Where there is enough tooth structure to achieve an appropriate, continuously tapering cone, ie, a “super foramen,” simply shape inside, fit the cone, and pack (Figures 4a to 4c). Where there is not enough tooth structure, place an apical barrier with Colecote (Sybron Endo, or Capset calcium sulfate bone-grafting material, Lifecore) and then obturate with sealer and gutta-percha using the Obtura (Obtura/Spartan) or “Calamus” Flow Obturation Delivery Device (DENTSPLY/Tulsa Dental, Figure 4d). A more recent technique is MTA obturation followed by composite restoration (Figures 4e and 4f). No gutta-percha is required.4 This can be a single-visit procedure and particularly useful when a child is noncompliant and whose visits are episodic.