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Torturous apical anatomy - Courtesy ROOTS
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The opinions and photographs within this web page are not ours.
Authors have been credited for the individual posts where they are - www.rxroots.com |
From: Mark Dreyer To: ROOTS Sent: Wednesday, October 14, 2009 7:10 PM Subject: [roots] My best impression of Terry's apical recapitulations My initial impression from viewing the lesion at the distal on the pre-op rads was cracked tooth. There were no probing defects and no crack was noted internally so went ahead and shaped/packed caoh and brought her back a month later. All symptoms and sinus tract resolved by visit 2. My first impression on seeing the final rads was I transported the canals. However after studying the multiple angles I think I may be ok. There was no rotary files used in this tooth beyond the junction of the middle/apical third in the mb/ml canals due to the torturous apical anatomy. Wacky tooth for sure. I'm betting Terry will like my ugly "non-Tulsa" shapes. :-)) - Mark Dreyer, DMDThe root sure looks cracked and it looks like a Khademi access so I'm not sure you really know if it is cracked. This is precisely why I don't agree with Khademi pushing his access design principles. It may appeal to the pop culture of "Biomimetics Feel Good Restorative Empowerment" but it doesn't do crap for eliminating the endodontic vector of disease. Lower molar access preps should be extended to create a more rectangular form so that each corner creates direct access to 4 canals, which is common in the distal and may be present in your case. If there isn't a 4th canal the rectangle still needs to be formed to insure that a wide ribbon is clean and the oval orifice form is peeled away and explored for deeper unexplored anatomy. This is also necessary to smooth the walls and detect otherwise missed subtle cracks. Sorry about the bluntness, but this message has to be relayed because this concept is so grossly misunderstood by those preaching "conservative access" - Terry "Biomimetics Feel Good Restorative Empowerment" ROFLOL...this is hilarious - Joey D I don’t think that all lesions seen like this are cracked roots seen too many heal and get crowns when they heal. The highlighted statement is just solid common sense. I don’t know where John gets his philosophy and his passion about it but you nailed it - Guy Hi kendel terry loves natural shapes as he is not someone who loves artificial shapes and people and keeping things natural and being natural is the most difficult ,superb execution . Gurpreet
