Comments on: Recall of the Week. http://www.endodontics.ca/2006/08/30/recall-of-the-week/?utm_source=rss&utm_medium=rss&utm_campaign=recall-of-the-week I am Lesion, for there are many. Sun, 15 Jan 2012 16:01:00 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: Answers. » Life’s Context http://www.endodontics.ca/2006/08/30/recall-of-the-week/comment-page-1/#comment-14558 Answers. » Life’s Context Mon, 01 Feb 2010 21:43:47 +0000 http://www.enfusion-group.org/~anthony/blog/?p=74#comment-14558 [...] Here are some answers to recent questions: [...] [...] Here are some answers to recent questions: [...]

]]> By: Dr. Mommy, D.D.S. http://www.endodontics.ca/2006/08/30/recall-of-the-week/comment-page-1/#comment-43 Dr. Mommy, D.D.S. Thu, 31 Aug 2006 13:13:00 +0000 http://www.enfusion-group.org/~anthony/blog/?p=74#comment-43 i had RCT done on my 46 just over a year ago, my old boss did it for me. i had a bit of a toothache that kinda lingered, but i just felt sick all over and not myself. when i finally dragged myself to the office, they took a periapical and sure enough i had a nice substantial radiolucency surrounded by a wicked condensing osteitis at the distal root. i felt like a million bucks after she opened the tooth up. i should take another film of that tooth and see how that's healing up. this is the same tooth that a rotary file separated, but she was able to navigate through it and continue instrumenting and pushed it to the side.<br/><br/>do you have a digital camera/digital radiography at your office? i would like to start uploading some cases i have for my blog. how do you (and dentist down under) get and post such great pics of your cases? i had RCT done on my 46 just over a year ago, my old boss did it for me. i had a bit of a toothache that kinda lingered, but i just felt sick all over and not myself. when i finally dragged myself to the office, they took a periapical and sure enough i had a nice substantial radiolucency surrounded by a wicked condensing osteitis at the distal root. i felt like a million bucks after she opened the tooth up. i should take another film of that tooth and see how that’s healing up. this is the same tooth that a rotary file separated, but she was able to navigate through it and continue instrumenting and pushed it to the side.

do you have a digital camera/digital radiography at your office? i would like to start uploading some cases i have for my blog. how do you (and dentist down under) get and post such great pics of your cases?

]]> By: Ameloblast http://www.endodontics.ca/2006/08/30/recall-of-the-week/comment-page-1/#comment-42 Ameloblast Thu, 31 Aug 2006 10:48:00 +0000 http://www.enfusion-group.org/~anthony/blog/?p=74#comment-42 My goal is always to preserve existing crowns if they fit well. That's usually not a problem. I get a little more concerned with upper laterals and lower incisors that have crowns and I have to remove posts in them. These teeth are so much smaller that there's a good chance the porcelain will chip to the point that a new crown will be necessary.<br/><br/>Apical ext resorption like this could be from trauma but is more likely from the chronic apical periodontitis. Dentin and bone are similar hard tissues and so osteoclastic activity will cause resorption of bone but can also cause root resorption if left unchecked long enough.<br/><br/>I still think there might have been a previous apical resection. If you look at the pre-op film, the apical gutta-percha appears to be carved out along the same contour as the defect in the root. It's unlikely that resorption would cause this.<br/><br/>The tooth has normal physiologic mobility, so I'm not overly worried about perio. The root length is what you'd see after apical surgery and the pt isn't a bruxer or anything.<br/><br/>According to Orstavik, 85+% of teeth that show signs of healing during the first year post-endo will go on to fully heal over the next four years. So I have high hopes for this one.<br/><br/>BTW, I probably used a 120 or even a 140 file in this tooth...In cases like this I sometimes have to use the back end of a gutta-percha cone to obt the apex since the largest cone that we have is still too loose.<br/><br/>One of the reasons I do recall some of my pts is to see positive results like this. Not everything that I do is successful and to only see your failures (these almost always return to you) can make you feel like your work is pointless. My goal is always to preserve existing crowns if they fit well. That’s usually not a problem. I get a little more concerned with upper laterals and lower incisors that have crowns and I have to remove posts in them. These teeth are so much smaller that there’s a good chance the porcelain will chip to the point that a new crown will be necessary.

Apical ext resorption like this could be from trauma but is more likely from the chronic apical periodontitis. Dentin and bone are similar hard tissues and so osteoclastic activity will cause resorption of bone but can also cause root resorption if left unchecked long enough.

I still think there might have been a previous apical resection. If you look at the pre-op film, the apical gutta-percha appears to be carved out along the same contour as the defect in the root. It’s unlikely that resorption would cause this.

The tooth has normal physiologic mobility, so I’m not overly worried about perio. The root length is what you’d see after apical surgery and the pt isn’t a bruxer or anything.

According to Orstavik, 85+% of teeth that show signs of healing during the first year post-endo will go on to fully heal over the next four years. So I have high hopes for this one.

BTW, I probably used a 120 or even a 140 file in this tooth…In cases like this I sometimes have to use the back end of a gutta-percha cone to obt the apex since the largest cone that we have is still too loose.

One of the reasons I do recall some of my pts is to see positive results like this. Not everything that I do is successful and to only see your failures (these almost always return to you) can make you feel like your work is pointless.

]]> By: Dr. Mommy, D.D.S. http://www.endodontics.ca/2006/08/30/recall-of-the-week/comment-page-1/#comment-41 Dr. Mommy, D.D.S. Thu, 31 Aug 2006 02:37:00 +0000 http://www.enfusion-group.org/~anthony/blog/?p=74#comment-41 did the patient get a new crown or where you able to preserve the existing one? and what would cause such a localized extensive resorption like that (other than ortho movement but you'd see that on the remaining incisors) was there any mobility? what's the long term prognosis, esp perio now that all that support's gone?<br/><br/>nice work, btw! (not that you need a pat on the back from 'lil ole me) see, that's why sometimes it feels so good to do what we do, when you see all your hard work was worth something. i love it!!! did the patient get a new crown or where you able to preserve the existing one? and what would cause such a localized extensive resorption like that (other than ortho movement but you’d see that on the remaining incisors) was there any mobility? what’s the long term prognosis, esp perio now that all that support’s gone?

nice work, btw! (not that you need a pat on the back from ‘lil ole me) see, that’s why sometimes it feels so good to do what we do, when you see all your hard work was worth something. i love it!!!

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