From: Terry Pannkuk
To: ROOTS
Sent: Thursday, June 18, 2009 11:04 PM
Subject: [roots] Stonehenge Case

This was like finding a large giant block placed by human hands without any explanation how the Hell it got there.

The patient had severe swelling and drainage and I'm sure I was getting mucous from the nasal cavity because the
fluid and snot just kept on coming from about 20 minutes when I wedged the purple microsuction tip into the canal.
This retired police officer is heading off to a remote region of Alaska by float plane on Saturday to go on a salmon
fishing trip he has been planning for a year.  He's in perfect systemic health, so I figured getting him on
Medrol Dospack would add a bit more insurance minimizing the chance of a flare up and ruining his trip.

The big question about this case is, "How did the broken bur get in the apical half of the root?  This cuspid was
24mm long and the bur was 20mm deep!

Why would it break?  What kind of bur is it? Why was this guy using it?  Why was it firmly lodged like it was
bonded yet it was bypassed?

The previous treating dentist was an old gp who passed away about 5 years ago.  The treatment was done about
7-8 years ago.

At the consultation I had guessed it was a separated silver point, when I initiall accessed it didn't reflect
like metal and I thought it might be a bonded broken zirconium post tip because it was so firmly attached to the wall,
when it was finally ultrasonically loosened and floated up, it was obviously a deep broken bur tip.  I plan to obturate
with MTA in one month assuming he's asymptomatic with no drainage. Goofy stuff. - Terry