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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
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