Life's Context

Luck Was On Our Side.

Periapex — Sat, 06 Feb 2010 14:53:18 +0000

Most times when a rotary file breaks in a canal, the fragment is either irretrievable or the risk to remove it is greater than the benefits. This is purely because they mostly break apically, around curves, and the fragment is often no more than 3-4mm in length.

Using ultrasonics to remove a fragment in a situation like that can very easily lead to excessive damage to the apical aspect of the root. Apical surgery is often a more predictable approach if the fragment must be removed. Many times, however, the prognosis of completion of endodontic therapy with the file fragment still lodged in the root (ie. obturation that incorporates the fragment) can lead to a decent prognosis still. It all depends on the presence or absence of preoperative infection within the tooth and the management of the tooth through the whole process.

I have found that when instruments break in canals like this, it often is more a manufacturer’s defect than poor technique.

Here you’ve got a fairly thick file that broke off leaving a long segment in the canal. The canal is fairly straight and the head of the fragment is visible in the coronal aspect of the canal. I was able to trough around the fragment to about 2mm beyond the head of it. The energy from the ultrasonic tip them unscrewed the fragment and it popped loose. Often applying the ultrasonic directly to a fragment will cause the fragment to further fragment, but this piece was thick enough, not around a sharp curve, and visually accessible enough that I was able to retrieve the file and proceed to complete the endo normally.

On the post-op film you can see how close I was to a perforation of the root even though I had good visibility of the fragment through my microscope. Imagine trying to do all of that troughing in the apical third of the root.

Note that this file has radial lands, a larger tip diameter, and a greater than 0.04 taper. It’s probably a GT file.

Am I An Ex-Blogger?

Periapex — Wed, 03 Feb 2010 11:00:49 +0000

As all bloggers have experienced over the last 3 years, the concept of sharing our thoughts, frustrations, and joys through short journal entries in a blog has changed. The social media webscape has forced that upon us and this is actually a good thing.

Tumblr, facebook, Twitter, and reams of other organizations provide canvases for us to share, share, and share. To top all of that off, I have gotten myself involved in activities and hobbies that no longer leave me time to blog as I frequently as I once did — and I don’t really need to.

The people that matter most to me are on facebook and see snippets of my life, as I see theirs. My brother and I have a photography business on the side with its own blog and we both spend lots of time on flickr.

I just don’t have the time to write down my thoughts about movies, theatre, and books with the same obsessiveness I once had. I’d like to, but I like too many things.

So what the heck am I going on about?

I’m saying that this blog is still a part of my life, but it’s a much smaller part than it once was because I share my thoughts in lots of other places. This is probably a good thing too because as I become more famous and sought-after for my opinions on movies, theatre, and books, it becomes more dangerous to have my life laid out in a single public forum on the internet.

At this point, I’m thinking that I’ll focus this blog more towards my experiences in dentistry. I’ll probably throw some interesting personal-life stuff in every now and then, but those of you that truly are interested in my personal life (god knows why you’d be) are already my friends on other sites where I expose more of myself anyway.

Refocusing has involved pausing my twitterfeed aggregation and limiting my use of Twitter. Facebook’s changes over the last year, along with a really useful RSS app, allows my brother and me to do things that we could only do in convoluted ways via Twitter in the past.

Times change and technology follows suit. Although the infrequent posts to this blog leave me appearing stifled, I am in fact the complete opposite because of these continuous innovations in the social media landscape.

Poor Restorative Margins?

Periapex — Tue, 26 Jan 2010 22:12:44 +0000

Just got a phone message from a referring dentist that I was hoping had stopped referring patients my way. The reason for that is a long story in itself and for a post some other day.

The back-story revolves around a patient from this dentist whom I saw for a consultation last week. She’d had root canal treatment done fairly recently and is experiencing persistent, residual symptoms. In my letter back to the dentist I mentioned, among other observations, “poor interproximal restorative margins”.

So this patient’s dentist calls today and says that she doesn’t see poor restorative margins on the PA that she has of the tooth (a recent PA of which I have a copy). She’s not sure where my assumption of poor restorative margins came from and would like a copy of my PA to see what I saw.

Here’s my PA which is not really significantly different from her PA — and this is just what you can see on film. My explorer got stuck under the mesial margin so heavily that I could probably have pulled that whole filling out if I had applied more force.

Rex and Lady.

Periapex — Thu, 19 Nov 2009 17:41:13 +0000

Say Hi to Rex and Lady (bet you’ll be able to tell which is which without me giving you any hints).

I’ve always preferred dogs to cats, but some convolutions of the universe knotted together to drop these two into our home: Our neighbour’s cat (a stray who goes to them for bed and breakfast) got knocked up and had some babies; We’ve had a crazy mouse infestation in our walls this year; When we saw these two, we knew they were way too cute for their own good so we decided that we’d better look after them.

They are currently in training. I’m getting them used to flash photography…

The Harder They Come.

Periapex — Fri, 02 Oct 2009 14:57:37 +0000

We were in Toronto last month to attend this show. It’s basically about a Jamaican folk hero whose life ended tragically…kind of a Robin Hood story with an unhappy ending.

Unhappy endings don’t really bother me, as long as the story is worthwhile, but I found the show just OK. I’m guessing that the show is actually more than just OK, but the strong Jamaican accents and patois were completely incomprehensible to me most of the time (and I’m from the West Indies).

Back From the Galapagos Islands.

Periapex — Sun, 27 Sep 2009 14:51:23 +0000

We’re back from our 11 day trip to Ecuador (Quito, the capital city, and the Galapagos islands). The most difficult part of preparing for the trip was deciding what photographic equipment to take with me. The Girl insisted that we carry my 180mm macro lens, which I never ended up using.

What I did end up using was my brother’s Crumpler Whickey and Cox camera/laptop backpack, his 70-200mm f/4, my 17-40mm f/4 and 24-105mm f/4, 1 light stand, 1 shoot through umbrella, 1 580EX II flash, my SD500 compact with underwater case, and of course the 5D II. Add in assorted gels, filters, blower brush, lens pen, and wireless triggers, and there was barely enough room for clothes.

Luckily for us we didn’t need a lot of fancy clothes.

We toured the islands as part of a GAP Adventures group. There were 15 of us tourists in the group and GAP gave us duffel bags to repack our suitcase contents into. This made for much easier travel between islands.

The trip was an extremely active adventure full of hiking, biking, and snorkelling. The weather cooperated, the animals posed for photo ops, and our assorted bangs, bruises, and electrocutions were minor issues compared to our rewards for enduring them.

Not only did we luck out with all of that, but our group leaders were absolutely fantastic.

I’m slowly posting pictures of the trip to flickr. The lack of high-speed at home means that it’ll take at least a couple of weeks for all of them to get there, but as you’ll be able to understand once you see some of the shots, I’m glad that I carted all of that camera equipment around with me.

The islands truly do live up to their nickname, “The Enchanted Islands”. Their enchantments will remain with me for as long as I live and I’m pleased to see that the Ecuadorian government is taking extreme measures to preserve the biologic uniqueness of which the islands boast.

At some point in the near future, I’m sure we will all be able to look at the stewardship of these islands as an example of how we should all live and interact with the world about us.

Riverdance.

Periapex — Fri, 28 Aug 2009 14:11:06 +0000

Riverdance was back in Toronto earlier this year. Although the concept is the same as when I last saw the show years ago, they’ve added a few things (or at least I don’t remember them being in the show back then).

The most memorable parts of the show for me this time were the two flamenco numbers. The experience was just an awesome fusion of Spanish and Irish dancing.

Watch the clip to see what I’m talking about: Lines, movement, footwork — unbelievably clean and expressive. I could watch this over and over again (except I still don’t have a high speed internet connection at home).

Progress Check.

Periapex — Sun, 16 Aug 2009 14:28:32 +0000

Summer has finally arrived here in Cowland. We’re seeing consistently dry, hot weather now and you can see that people out and about are in much happier spirits. Summer is only about a month late.

I’ve been busy trying to stay out of trouble.

So far I’ve succeeded.

Our annual summer party rainfest (it has rained every year except for one that we’ve had the party) went off successfully again — no injuries, one broken fence gate, some assaulted frogs, and 2 overfed dogs.

I’ve been schooled and am schooling.

The latest person to school me was Rudy. I was refreshingly pleased to be given a few insights into his political thought processes. He argued some political points with me on facebook recently, but did so with intelligence and practicality. He’s someone that has made his own political decisions through reason and research rather than as a crowd-following Lemming.

I’m schooling myself in photography, as many of you know. It’s my newest hobby and I’m working my way through a stack of books, from visual composition, to using Adobe Lightroom. Playing with off-camera flash is the coolest thing I’ve come across in a very long time. It’s actually what’s keeping me away from this blog the most. Fragileheart has patiently volunteered her time to a couple of photosessions for me to work on my lighting.

Here’s an example of what off-camera flash can do for you. Take for example a painting that was created with heavy brush strokes or a palate knife. The surface of a painting like this is as important as the image itself. The strokes convey texture, emotion, and movement to the underlying image.

Straight-on, or flat, lighting produces this:

Lighting from the side produces this:

The trade-off (isn’t life full of these) is that the more texture you show, the less saturated your colours become. The trick is finding the right lighting ratio and angles to strike a good balance between colour saturation and texture and thereby do some justice to a piece that will still be best viewed live.

The Alchemist.

Periapex — Tue, 14 Jul 2009 21:30:29 +0000

Reading through this book took some effort. The writing is simple and lacking in obvious metaphor. I became bored just past the halfway mark.

Perseverance paid off, however. No, the writing did not become more colourful, nor did the plot become more intriguing. In fact, the reason that this book has satisfied so many millions of people is because of the simplicity of the truths that it presents.

The book shows that life is about the journey — and true satisfaction in life is about a single-minded journey to achieve that which we feel calling out from our deepest recesses.

Everything falls into place along this path. Be it good or bad we learn from it all and step forward towards our goals. In the end, does it matter that what we desired was in front of us from the beginning?

The Alchemist is an allegorical story of wisdom. Most of us will lie on our deathbeds before we ultimately realize or understand what Coelho tries to show us in this simple tale.

Paulo Coelho is on Twitter here and has over 60,000 followers.

TroubleMaker Returns.

Periapex — Tue, 07 Jul 2009 16:27:57 +0000

TroubleMaker

Remember back in 2007, when we had my wife’s great aunt and her friend over from Romania for a visit? We couldn’t get rid of them fast enough because of the fighting between them.

So, in a moment of weakness, we decided to invite TroubleMaker (TM) back alone for a visit.

She arrived here after not having slept for 36 hours (combined travel and pre-travel insomniac excitement time). Nausea prevented her from eating well for the first day. While throwing up into the toilet during day 2, her lower denture fell in and then she accidentally flushed it.

“Can you get it back?” she asked.

I pointed to our septic tank. “See those green plastic covers in the ground over there?” I asked.

“Yes.”

“That’s where it is now.”

We took her to a denturist nearby. $1600 later and she now has 2 new full dentures (upper and lower). The previous lower denture cost 50 Euros (which we explained to the denturist as he looked at her old upper denture in disbelief).

The first three or four days with the new dentures was new-found torture for The Girl and me as the usual denture sores developed and TM was still not able to eat properly.

After a denture adjustment or two, TM was able to eat decently again. More importantly, she was able to take her “nerve” pill and keep it down. That wonder pill, the “nerve” pill, has almost transformed her into a normal woman. Almost…but definitely enough for us to enjoy life again.

She’s here until the end of July.

I hope to also be.