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Apical trifurcation : Mesial canals: tapered peeso - Courtesy ROOTS

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From: John A. Khademi, DDS MS
To: ROOTS
Sent: Saturday, September 23, 2006 3:29 AM
Subject: Re: [roots] Apical trifurcaton

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Kinda like these cases you posted Barry?
There are other problems with these cases as well.... John A Khademy







Punked or Peesoed  ;-)) - Fred

Barry, What's are these?  (Dotted yellow line looks like PDL to me)
Black gap by blue arrow that continues down the root...
Radiodense mass by green arrow.....
Mesial canals....Hmmm.....are those really a size 35? - John




John, You got me. Perhaps, the dentin is thinned out more than it should be. The cases are certainly working and
I'm going to guess that most on Roots would say they are well done. However, your point is appreciated which is
why we developed the new tapered peeso called the pleeser which significantly reduces the potential to take away
excessive tooth structure. The concept of straight line access however is a good one and allows greater freedom
in shaping the apical end of the canal to a diameter that truly removes the pulpal contents along the entire
length of the canal. I have seen so many beautiful white lines in molars done with rotary Niti where the
prepartion is obvioulsy no more than a 25/04. Pretty picture, but it doesn't necessarily do the job  that is
required of them particularly in the bucco-lingual dimension. When concern for separation determines the degree
of apical preparation there is a fundamental problem with those techniques and those advocating them the way
they are presently being used. In the meantime, you are the best at finding those extra canals - Barry

What are "Extra canals"  ?  They are either canals or not surely - Bill

AAE Glossary:

Def.  Extra Canal:

1. a major root canal system that requires additional productive chair time to treat, that if missed would not be
   noticed by an amateur clinician viewing a poorly taken radiograph.
2. Any portion of a root canal system that fails to concern the business interests of an entrepreneurial endodontist.
3. Root entitities that fail to be covered by insurance codes if treated.
4. Synonymous with, and Anonymous as extra-terrestrial in New York City. - Terry

Terry, you made me a smile and weep at the same time. Weep for the truth in that statement
(too much true here in Israel) and smile for the sarcasm - Thomas

When I hear that Universities are teaching that microscopes don't make a difference,  and that finding all the canals
isn't important I really wonder what we have come to.  In a way I'm glad that not everyone finds all the canals,
it at least provides me with some work - Bill

Bill, here in the u.s. the univ of Maryland just put in 16 scopes, and 7 or 8 of them are NOT dedicated to endo.
Two of the guys with me this past weekend were instructors at the university of Virginia, they are putting one in
for the residents, and are going to have their residents rotate over to wayne’s office for instruction.  Progress
is being made, albeit S-L-O-W! - Bill