Maxillary left lateral incisor
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Photos courtesy Rob Kaufmann,Gary - ROOTS
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 while
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
cool images Rob, congrats! i now have 3-d image envy - KendelG
Hereís my contribution from today. Patient presented with pain in
ul 2nd molar. Looked like a well done single canal molar on
periapical, but something didnít 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 kimís program at penn. Practices in California now.
He has the same unit I have, the gendex 500 - gary
Really nice!! - Gustavo