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Acute pulpitis - Courtesy ROOTS
The opinions within this web page are not ours. Authors have been credited for the individual posts and photographs where they are. Photo courtesy: Hadi - www.rxroots.com
From: H.M. Sent: Thursday, September 07, 2006 1:11 AM To: ROOTS Subject: [roots] Acute pulpitis

This OPG is for 19 years old girl, had a huge carious lesion on 47 “second right molar” came to the clinic with acute pulpitis I extirpate the pulp but wondering what are the chances of getting 48 to occupy 47 space…. Or it may tilt only doing harm rather than help. I can not really justify doing RCT on 47 if there is any chance of getting 48 to drift to 47; but thought taking your opinions will help . Thanks in advance - Hadi

Hadi, Interesting plan. I really like it and think you should probably take the second molar out. I’m not sure what your buccolingual tooth structure looks like, so I’m somewhat speculating. But I suspect that once it’s prepped for a crown there will be little retentive tooth structure left, and as it is now, it’s very prone to vertical fracture. I don’t see the tooth having a decent long-term prognosis. If you take the tooth out now the third molar may drift in without much tilting and the problem is solved. Worst case scenario you plan for an implant later - Terry Beautiful pano! Which machine are you using? - Mark Really do not know Mark!! But it took me couple of months to find a close centre that deliver such nice digital OPGs. I can drop them a buzz next week and find out if you are interested - Regards, Hadi I agree with taking out the second molar. The third molar probably won't “naturally” drift into the space but could be mechanically coaxed into it. But, the main issue with this patient may be home care and compliance - Arturo Hadi, just wondering what your rationale is. why can't you justify doing root canal for that second molar? - Dr Barden I would expect the tooth to fracture within couple of years if she is lucky - Hadi HIDI; THIS PAT. T.PLAN:EXTR.1-8;2-8; 3-8 AND 4-7 THIS PAT NEED ORTHO!!!!!!!! NOT ENDO TREATMENT!!!!! - J.ROSS Julius, When she was 13 years old her 23 has been extracted because it was palatally displaced :o( !! The mid line shifted now about 7mm to the left….. plus a crowded lower arch. The ortho was the first thing I suggested but as a result of her traumatic experience “extraction of 23 and pain associated with palatal expansion plate” she does not want any braces. Having said that, she told me that she will have another thought about it. If she decides to go with ortho treatment then extraction of 47 is inevitable - Hadi HADI. I BELIEVE THAT DAMON SYSTEM CAN DO WITHOUT MECH. PALATAL EXPEN.(I ,M WORKING EXCLUSIVE WITH DAMON SYSTEM) PLEASE CK ORMCO .COM OR DAMON .COM) EXPANSION PALAT BY MECHANICAL SCREW ARE ELIMINATED.HAVE A SECOND OPINION WITH LOCAL DAMON -ORTHODONTIST. GOOD LUCK!!!! JULIUS ROSS DDS , SWITZERLAND 19 years old with nearly no more coronal structure left I am talking about 0.5 to 1mm left all around..... I would expect the tooth to fracture within couple of years if she is lucky - Hadi