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Alveolar bone height : Mesial marginal ridge crack
From: Terry Pannkuk
To: ROOTS
Sent: Thursday, July 09, 2009 3:47 AM
Subject: [roots] Wishful Thinking
Here's a retreatment case I started one month ago. There was a crack through the mesial marginal ridge coursing
to the MB2 orifice which then appeared to take an abrubt 90 degree turn horizontally. It wasn't a good prognosis,
but we decided to place CH for a month and see if the symptoms resolved; they didn't and the patient continued
to have discomfort upon lateral forces on the tooth. Next visit: study models, extraction, and planning for an
implant replacement in 4 months. The alveolar bone height is a least 10mm and probably more from the slight
radiographic image distortion. It's always a good idea to weight the implant option versus the heroic endo option.
Once in a while the heroic endo option is favored. The endo option is a very poor idea in this case and is
virtually certain to fail.
If the alveolar bone height had been 2-3mm and the fracture compromising only the distobuccal root, possibly a
distobuccal root amp would be considered. DB root amps are pretty much the only roots I'll consider amping on
these teeth, these days, but only if the implant option is unfavorable.
The more options you have available, the more you have to think about - Terry
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