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Endodontics |
| The opinions within this web page are not ours. Authors have been credited for the individual posts where they are. Photos courtesy Rob Kaufmann - ROOTS |
Occasional palatal swelling: Resorption mapping
From: Rob Kaufmann
Sent: Tuesday, June 23, 2009 5:40 PM
To: ROOTS
Subject: [roots] 1st cbCT case
Here's the first one we did with our new Kodak 9000. We installed on Thursday the 11th and it just so happened
that this patient walked in that morning. We offered her a free cbCT ( supervised by the Kodak rep) as a test case.
49 year old female in good health had a history of occasional palatal swelling at the gingival margin of the
maxillary left central incisor. She had previous Ortho treatment as you can tell by the blunting of the apices.
Although she was not in any acute discomfort, there was some doubt as to whether an exploratory Palatal flap was
worth the effort. I consulted with the Periodontists in the building ( who were kind enough to locate teh cbCT
in their office ) and they were also insterested to see what it would show.
The scan showed that the palatal ECIR was larger than we had anticipated and that it was not worth flapping
the case to try to determine the extent of the resorption. The patient was scheduled for implant treatment plan
to include extraction and replacement by my periodontist friend. The use of the cbCT had one added bonus -
by NOT flapping the palatal area in between the 2 centrals we preserve the papilla for optimal implnat aesthetics.
IN teh past, we may have done teh exploratory surgery and lost this important soft tissue aethetics. So, by
(normally) charging the patient a few hundred dollars for the scan we:
(1) get a much better assessment of the area
(2) avoid costly surgical procedures
(3) preserve important soft tissue anatomy in the aesthetic zone
(4) Steer the patient in teh direction of a treatment that has less guesswork, higher predictability and that
works....the first time.
Still working on getting report formats/images in teh proper places so please excuse the mish mash of images.
I can see me now ROUTINELY charging the patient another couple hundred bucks in the diagnosis/exam of retreatment
cases with LEOs. I will tell em that if tehy want me to dissassemble/reTx - I gotta know what I'm getting into....
THIS is the best way to know that.
The Kodak 9000 is one VERY cool machine. I can see me using more and more...even though I DON'T do implants
Rob Kaufmann DMD MS(Endo)
