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Endo tips
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Endo discussions
 25 years long term recall
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From: Roberto Cristescu
To: ROOTS
Sent: Wednesday, August 17, 2011 2:26 PM
Subject: [roots] long term recall 25 years
Saw this patient this morning.
Both treatments done more than 25 years ago, the second molar got a new composite filling recently.
First molar has distal decay until the bone level , bleeding of the gum with probing.
Otherwise asymptomatic.
Discussued with her the options:
1. surgical crown lengthnening + retreatment + crown
2. Extraction and implant or bridge
3. Extraction and nothing in place
4. Do nothing (?)
She opted for number 2.
Those are defintely "fat shapes"in the canals. Defintely loss of PCD. Both in first and second molar,
not to mention the first upper molar as well. As you can see they all "survive"in the mouth, more than
25 years. Yes, with apical disease.
Should we extract the first molar and send a letter to the treating dentist from 25 years ago and tell
him because of his lack of PCD preservation and "fat shapes" the tooth is lost ?
Oh and yes, btw seems that amalgam also gets secondary decay :-) - Roberto
Hi roberto, not as long as 25 years, but hereby a 7 year recall - Sander Loos
Hi all, I think the debate is going to be endless in this matter. I mean, both sides have correct
and fair opinions in the argument.
It is all common sense in preserving as much PCD as possible as it is common sense to use rubber dam
during the RCT (btw, how many RCT's performed without RD are successful?).
What one side is missing to emphasise is how difficult and how skill-full a practitioner should be
to perform RCT in Khademi style?
For me personally, even if I am training towards MSc in Endodontology or I am working under a surgical
microscope, it is very hard and unpredictable to perform RCTs in this manner.
And then I come to Terry and Roberto conclusions and I am trying to follow the classic endodontic
concepts of cleaning to the best of my abilities of the apical region under the best visual control.
Just because I know that if I failed this, the short term prognosis of the tooth would be poor.
And sometimes with "unnecessary" sacrifice of PCD...- Cosmin Fetcu
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