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Einstein implant case to completion
From: Fred Barnett
To: ROOTS
Sent: Friday, January 16, 2009 12:01 AM
Subject: [roots] Einstein Surgery #3 MB DB and P
from one of my 2nd year residents...Fred
Pt had retreat completed 12 months ago by another Einstein resident.
Case was extremely difficult anatomically. Symptoms resolved after
treatment and then 5 five months ago a sinus tract on the buccal
appeared. Her symptoms ranged from 2/10 to 7/10. She occasionally
took Pen and Amox when the swelling got worse. I saw her for the
first time for a consult 4 weeks ago. I discussed redo the
endo,crown/ext implant/ and surgery. She wanted to go with surgery
first, and go from there.
The tooth presented with really interesting anatomy.
The DB and P roots were fused with a DB2 untreated.
Also the MB was treated, the MB2 not. I resected all the roots
and then prepared them for MTA retrofills. The P was a bear,
and I had to hub the air impact 45 to the buccal plate to reach
the palatal aspect of the palatal root. I prepared the DB like
the MB, troughing the isthmus to the untreated portal of exit.
The post-op suture shot isn't too pretty, mostly because the
sinus tracted became inflamed in the past 48 hours, so I feel it
looks pretty bad. Hopefully in 3 months it will look back to normal.
Flap design: I was planning full sulcular incision, as they have
worked really well for me in the past with posterior teeth,
but I followed the "encouragement" of the attending and switched
to a sub marginal design. It seemed to work well in the end,
made suturing through the scope a little easier.
Feedback welcome. Jared
Fantastic case!!! - Jose
CLAP CLAP CLAP CLAP!!! THIS IS BRILLIANT!! NORMALLY ITīS NOT
POSSIBLE TO GET ACCESS TO PALATAL ROOT IN A VESTIBULAR APPROACH!?!
(QUESTION... SPANISH ENDODONTIST NEED/WANT TO LEARN SURG)
I REALLY LOVE THIS CASE.- Javier Pascual
Superb! I wonder what your 3rd year residents have for results,
because you are always posting cases from your 2nd year residents.
- Greetings, Rafaël
We only have 1st and 2nd year residents.
I will have some first year cases to post next week.- Fred
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