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Acute pulpitis - Courtesy ROOTS

The opinions and photographs within this web page are not ours. Authors have been
credited for the individual posts where they are -
From: Guy Moorman
Sent: Friday, April 30, 2010 12:08 AM
Subject: [roots] 30

Patient is a referral from another office.  Iíll preface by noting that I did not like the fill on the bicuspid
after the angled shots and went back and redid it.  That can be noted in film #1.  Both 29 and 31 were suffering
from an acute pulpitis.  The bicuspid have a blatant exposure on a new restoration done at the same time that
new crown on 31 was seated.  Thatís always fun when you place a new crown and it blows but in the case the patient
was hot and cold sensitive and told the dentist so placing the crown was his mistake.  I was able to go through
the crown but in my report I recommended he redo it since it was supposed to be new.  The case was done with
TFs and K3s to finish apexes and give me a true taper.  Resilon and Real Seal was the obturant using
System A/warm vertical or as my friend TP says, a mush of trash and dentin chips.

But the purpose of this post is #30.  Please no heat but this was done by an endodontist in a community in the area.
I canít help what I canít help.  I truly do not believe the inter-radicular lesion was present when the original
endo was done.  But it is there now and having pointed it out, the dentist wants it addressed.  Sadly, he did not
notice it on his PAX.  My question is how should this be addressed?  Is it a strip perf, internal resorption,
external resorption?  It should be a surgical address Iím sure but Iíve got to find someone capable of doing
this type surgery.  I told her that it might be more prudent to just remove it and place an implant.
Thatís what Iíd do in my mouth and I told her that.  She is totally asymptomatic since treating both 29 and 31
so this lesion is not an issue as far as discomfort.  All advice is appreciated.  I can get a CT done at the
hospital to determine the actual location and positioning of the lesion - Guy

Protaper flaring
6 yr old Empress
Cvek pulpotomy
Middle mesial
Endo misdiagnosis
MTA retrofill
Resin core
BW importance
Bicuspid tooth

Necrotic #8 treatment
Finding MB2 / MB3
Deep in a canal
Broken file retrieval
Molar cases
Pushed over apex
MB2 and palatal canal
Long lower third
Veneer cases
CT Implant surgury

Weird Anatomy
Apical trifurcation
Canal and Ultrasonics
Cotton stuffed chamber
Pulp floor sandblasting
Silver point removal
Difficult acute curve
Marked swelling
5 canaled premolar

Sealer overextension
Complex anatomy
Secondary caries
Zygomatic arch
Confluent mesials
LL 1st molar (#19)
Shaping vs Cleaning
First bicuspid
In Vivo mesial view
Inaccesible canals

Premolar 45
Ortho and implant
Lateral incisor
Churning irrigant
Cold lateral
Tipped to lingual
Acute pulpitis images

Middle distal canal
Silver point
Crown preparation
Epiphany healing
Weird anatomy
Dual Xenon
Looking for MB2
Upper molar resorption
Acute apical abcess
Finding MB2

Gingival inflammation
Irreversible pulpitis
AG BU ortho band
TF Files
using TF files
Broken bur
Warm technique
Restorative prognosis
Tooth # 20 and #30

Apical third
3 canal premolar
Severe curvature
Interesting anatomy
Chamber floor
Zirconia crown
Dycal matrix
Cracked tooth
Tooth structure loss
Multiplanar curves