Tooth # 46 : Narrow escape - Courtesy ROOTS
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From: Marga Ree
Sent: Sunday, August 31, 2003 1:16 AM
Subject: [roots] Re: a blast from the past
I have encountered a similar situation: the crown on tooth 46
had been made recently, and the patient developed symptoms,
radiograph revealed AP. I accessed the tooth, but wanted
to keep the opening as small as possible. I wanted to try the
new LA Axxess Burs of SybronEndo.... and found out that I was
0,1 mm away from a furcal perforation, it was a very narrow
escape. It was 100% my fault, this patient was very cooperative,
my assistant did an excellent job, as always, and I almost ruined
the tooth. I covered the very, very thin furcal roof with composite,
and with a lot of frustration and self-reproach, I finished the RCT.
These situations make you feel very humble, and this happened not
4 years ago, but 2 months ago........... Marga
Here is one of my first posts to Roots.i thought it should
be fit to present it again hopefully, if not to stimulate
some discussion but also if not for my own therapeutic
purposes. There is benefit to reminding ourselves where
we have come from and hope not to go to again. Hiding things
under a rock is not the answer.
At the summit meeting I think my favorite speaker was
Cliff Ruddle. I liked him best not only because of the
information he relayed but also because he purposefully
mentioned that he makes inflammatory comments to people to
throw them off balance. He said that he has found that in
doing this that he can more quickly determine an individual’'s
true character by their reaction. I agree with him 100%.
We all eventually and repeatedly fall victim to this technique
rather it being accidentally or purposefully used on us.
Here is a case/patient that reminds me that ability can be
over-run by poor management of self. Here is the case where I
fell victim to being thrown off balance by the patient and my
surroundings. This case reminds me of the tough times I had
getting started right out of school. Times we all easily forget.
At the end of the write up I mention that I continue to struggle
on him the second case included is the root canal I did on the
same patient right after I finished that bridge - Craig Barrington
CRAIG, If these things must happen (and probably they must,
so that we learn from them more than we do from success),
they´d better happen to the fellows that almost deserve
it, like this Mr-Curious............Marcos Arenal
MARGA, Thanks for sharing your own experience.
As I said to CRAIG, we go 10 steps further in our learning when we err,
and only 1 when we succeed - Marcos Arenal
Marga, I now make the same access through a crown as an uncrowned tooth.
Too great a chance of doing just this with an inadequate access - Guy
Hi Marga ! Everything can happen, we say only the rabby doesn't have
those problems. Anyway why did you put the rubber damn clamp on the
distal tooth, in order not to chip the new crown ? I usually use #14
clamp and nothing happenes to the crowns. Does the tooth have
bifurcation on the D canal or is it some small transportation ? - Thomas
P.S Just finished another 3 rooted lower premolar, and it came out
very nicely, hopefully I will not be lazy and scan it soon.