Calcified Molar

From: Sashi Nallapati
To: ROOTS
Sent: Monday, April 16, 2007 7:56 AM
Subject: [roots] calcified molar

This is the first time I had to 'drill' through the calcified palatal canal 19mm  from the occlusal reference to find
the patent canal. I had done it in anteriors but never in a palatal root of a molar.

I was always looking for the best documentation of the 'radial dentin effect' and the genuine look of a calcified canal
in the radicular dentin for years and this is probably is the 'closest- to- perfect' documentation that I could do
epicting the 'look' of this phenomenon.

At no time was I stressed going down the canal as i was following the 'spot'...Mb2 was a like an extension of the Mb1
and I wasn't too comfortable extending the palatal aspect of the Mb1 way too much after a few mm down the root -
Dr. Sashi Nallapati

 

 

 

 


Great case and documentation sashi!  Munce burs? Question: I've read an article of yours where you used ophthalmic
dyes. when would you recommend using them? - Siju

Sashi: great documentation and execution.
only a scope user can trough down 19mm and say: " at no time was i stressed going down the canal as i was following
the spot"...))))

This is an extensive calcification..just wondering how old is the pt and the crown? - Ahmad Tehrani

Patient is 45 and got a pulpotomy with arsenic (i believe) 15 years ago. there was cotton in the chamber - Sashi

Nice case Sashi, very cool how you can see with the scope with confidence (when you know what you are looking at) what you are doing.
The Mounce burs and ultrasonics allow you to careful watch (when dry) the progress as you cut.

great documentation and teaching cases.- Glenn

hi glenn, the key to this is the recognition of the calcified radial anatomy through the scope
and when it is presented, be able to recognise the differences in the normal and reactionary dentin.
its quite possible that sometimes it is difficult to recognise this subtle change. and of course at that moment,
we shall recognise our limitations and stop while still ahead of the game. its actually Munce burs..- Sashi

Only a very talented scope user with a lot of guts!  I know I never would have gone that far.- Gary

Hi Gary, this has nothing much to do with guts.
I had a sign I could follow with out deviation and I went for it. the moment
It disappeared, I would have stopped.
Its all about 'control' in these cases.
Viewing through the scope, line the munce/ultrasonics while not losing the
vision, know the anatomical differences in calcifications, color
differences, followup periodically the progress with radiographs and finally
and most importantly knowing when to STOP ;-))  - Sashif