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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,Gary - ROOTS |
Maxillary left lateral incisor
From: Rob Kaufmann Sent: Tuesday, June 23, 2009 5:40 PM Sent: Wednesday, June 24, 2009 3:34 AM Subject: [roots] cbCT Case #2 Here's another unusual case we solved with cbCT. 38 year old female patient had seen me before for examination of symptoms associated with the maxillary left lateral incisor. The tooth had a history of possible trauma and was sore to labial pressure. ( Note the retained primary cuspid.) What was unusual about the case was while the PAs showed a horizontal crack, the pulp was testing vital and there was no evidence of PAR. Radiography clearly showed two horizontal lines at the bone crest. What was VERY odd was that this tooth had virtually no mobility of the apparently cracked coronal segment. It was firm to pressure. We decide that a sagittal section would tell us more and you can see from the cbCT that there is a clearly discernable area of "dislocation" between the apical and coronal pulp. Although the resolution of the web downloaded images may not lend itslef to see it, you CAN see the fracture clearly in several of the sagittal sections. Thsi tooth will need to be replaced with an implant. We will also have to see how we can work in replacement of the promary cuspid whiel we are in the area. Score another one for the Kodak 9000! Fred, you're gonna love it! - Rob Kaufmann DMD MS(Endo)would you consider ortho extrusion as part of the plan? (whether as a means of saving the tooth or to optimize implant placement? cool images Rob, congrats! i now have 3-d image envy - KendelG Here’s my contribution from today. Patient presented with pain in ul 2nd molar. Looked like a well done single canal molar on periapical, but something didn’t seem right. Took a scan, and you can see clearly that a buccal canal was never touched. Patient set up to retreat, implant is back in the drawer. Just got back from the 3d conference in Chicago, and we had for the first time an endodude do an hour presentation on using cbct for endo. Think his name is wang. Fred, you probably know him, he went through kim’s program at penn. Practices in California now. He has the same unit I have, the gendex 500 - gary
Really nice!! - Gustavo
