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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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