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for the individual posts and photographs where they are. -

5 year recall

From: Terry Pannkuk
To: roots
Sent: Tuesday, February 21, 2012 8:59 AM
Subject: [roots] 5 year recall with apices on the mandibular nerve_CBCT video

Hereís another interesting CBCT long term recall today.  I got her 
back for a 5 year recall even though I examined her a year ago 
(had to be 5 years to qualify as long term.

The scan is very interesting because both mesial and distal root 
apices are exactly on top of the mandibular nerve.  I had a very 
small stream of sealer coming off the mesial at the time of obturation.
Itís gone now.  As Iíve said before,  I really never worry about the 
mandibular nerve when I treat mandibular molars figuring I exercise 
diligent apical control on every case anyway and it shouldnít
be any different for a high risk molar.

This patient had no symptoms and did fine, but I have to admit I was
amazed at the proximity of the mandibular nerve.  This issue is
probably fraught with opinions about how careful is careful,
how much control do we really have with compaction of a cone and 
sealer?, is there a sufficient pericortex around the mandibular nerve 
that prevents a file from damaging the nerve if used passively
the way itís supposed to be used anyway?

The video capture is interesting.   I sliced through transversely and 
you can see right when the root apex disappears, you are seeing right 
into the mandibular canal - Terry

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