From: Guy W. Moorman, Jr. D.D.s.
To: ROOTS
Sent: Thursday, August 24, 2006 5:00 PM
Subject: [roots] An interesting one

88 year old gentleman who is now a bit confused but still here.  He was brought in by his daughter.  Try to get past
the implant because it is ten years old and functioning fine.  I think the problem was that the head of the implant
was buried so deeply that there was either tissue between the transfer analogue or it moved up during cementation
due to extremely fibrous tissue.  I can't probe the open margin even with a perio probe so tissue has filled the
open margin.  It's working like a champ...mesial abutment of a three unit bridge.

But the story was this patient of mine took her father to the endodontist in Jacksonville he'd used before with #8 hotter
than a fresh fired pistol ball from her description.  The endodontist half accessed it and told them the canals were
calcified and he needed another implant.  She brought him to me since I've done a couple of endos on her.  It wasn't a
piece of cake but the canal wasn't massively difficult to find.  Once found it opened to an F3 ProTaper and finished to a
45 apex.  He reports that he fell on this tooth when he was six years old while roller skating.  I'm suspicious that
there is a fracture right at the defect that filled in and that little puff is from that fracture and not a lateral.
I think the tooth is ankylosed and extracting it would be a bitch.  I filled the canal with Epiphany/Resilon using
System A.  This proves that not all endodontists are of the same quality AND never diagnose solely from a radiograph - Guy




Nice save Guy!
As for that implant it appears it was placed sub crestal and the system was not designed to be placed that way.
Definitely a gap and its surprising it has not created any issues to date - Arturo

At his age, it had better hurry.  Guy

so why did he need a root canal? - ahmad

Irreversible pulpitis.  Severe sensitivity to hot requiring cold to relieve it.  You have to fight these people
for their cup of ice.  Guy

Guy,  Don't stop. I do like your post - John Anderson