From: Jeremy Rourke
Sent: Wednesday, 9 September 2009 6:11 PM
To: 'ACEsthetics'; 'ROOTS'
Subject: Amazing images of Acute Pulpitis

Patient today 09-09-2009 presented complaining of pain on biting. I  did my standard rebound tenderness test
Bite down hard on a cotton roll and suddenly release
Lower Right Second molar was positive (LR7  47)
Transillumination showed a crack on the mesial and distal  on either side of the occlusal amalgam
The patient is a smoker with mild to moderate perio bone loss
I suggested an extraction as the preferred option
During the procedure the crown broke down the middle and the buccal fragment came out as shown in the images
In the past 39 years I have often told patients that this is what is happening with their pulp but I never expected
to see it so clearly
Even though the patient had two broken roots I stopped to capture these images with my camera
You can see the necrotic pulp in the pulp chamber while the distal pulp tissue is clearly still vital and looks
just like the thread of root canal pulp tissue you would remove with a barbed broach when doing a vital root treatment
I am sending this email out in the hope the images will find their way into University Dental school teaching material
If you want to send it on to University teaching staff please DO -  Jeremy Rourke




Nice Pic! hope the academicians here take note. - Sanjay Jamdade