From: Mark Dreyer
To: ROOTS
Sent: Tuesday, February 15, 2005 5:23 AM
Subject: [roots] angled x-ray

Here’s an excellent demonstration of the value of the angled x-ray.  I kind of suspected from the pre-op film that
I was dealing with more than one canal, but I cound only find one at the first visit.  I put caoh and scheduled a
second visit.  All symptoms went away during caoh phase.  I obturated the one canal I found and if I had accepted
the straight on x-ray, I’d have thought all was well.  I made the assistant take another x-ray at an angle and found
obvious evidence of another canal.

I removed about half that gp from the buccal canal and worked another 30 minutes or so and while I finally found what
looks to be a lingual canal orifice.  I ran out of time (Valentine’s Day…the staff didn’t want to stay very late),
so she’ll be coming back for a third visit.  I imagine I’ll have over 3 hours or more in this one before I finish.

Lower bi’s are either the easiest or the hardest teeth to treat - Mark



Mark,  The second canal is'nt obvious to me. What radiographic system are you using? - Mac

Mac, I think Mark is referring to the bit of sealer going off to the left.  Guy

Hi Mac, I’m using the Digora Optime phosphor plate system - Mark

The dang things are also the hardest to restore so that they don't fracture.  I have quit crowning them automatically
because you weaken them at the neck with a crown.  Upper bi's have to be crowned due to the morphology.  Lower bi's
often do not.  I'm using a lot of onlays on the lower bi's rather than full crowns.  I hope them work.  Guy