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Caries bonding labial porcelain veneer - Courtesy ROOTS

The opinions and photographs within this web page are not ours. Authors have been
credited for the individual posts where they are - www.rxroots.com
From: Terry Pannkuk
To: ROOTS
Sent: Thursday, May 06, 2010 1:56 PM
Subject: [roots] Coulda Used a Laser, but didn't

Typical Depression Era Dentistry:  I got a call from a referral yesterday.  
He saw this elderly woman, struggled doing the endo on #27 and when he was 
finished didnít have time to do #26 which he had planned at the same time.  
She was distressed by the experience so he sent her to me.  He told me 
there was a lot of decay and that I might want to use the electrosurg to 
perform crown-lengthening.   He also told me if I felt it wasní't restorable 
to extract it.   I was already thinking of all the cool Canadian crap that 
could be used on this case: lasers..Isolites..bioceramics.medical grade pot. 
but I decided to just go mainstream.

I was also told I didnít have to worry about protecting the porcelain veneer 
which Immediately fell off when I started probing with the explorer 
(Good thing I didnít have to worry about that.

I placed a dam with multiple holes second bi to second bi and clamped #26 
deep on the gingiva.  In about 5 seconds zipped the lingual gingiva down 
with the electrosurg exposing circumferential dentin.  Thank God there 
wasn'ít an amalgam in #25 or the pulp would have been cured beef jerky!

The root canal procedure was routine.   I bonded a fiber post; maybe it
should have been metal; especially if the prep is going to have a shoulder 
instead of a long bevel.  I figured the occlusion would be protected, 
sheí's very petite, and besides the labial porcelain veneer had stayed on 
for years with just caries bonding.   A copper band matrix was used, 
contoured it down, replaced a small labial pothole with RelyX cement, 
and contoured it down to look like a tooth.

At the end of the procedure she asked me if I did crowns too;  
I said, No, your general dentist should do the
hard stuff like that -  Terry


Missed canal

Hyperaemic distals

NHS and dreadful teeth

Occlusal interferences

Unable to find MM canal

Cracked tooth

Calcified canal

Core versus hole

Fiberglass post

Necrotic retreat

Percussion and palpation

Premolar variations

Severe tooth pain

Necrosis and pulpal

Deep apical split

Broken left incisor

Single implant

Broken files

Periodontitis & Endo

Race shaping

Laser with fistula

Rosenberg technique

Carious exposure

Tougher than molar

Endo and Perio

ML joined with MB

Interesting anatomy

Lateral canal

Chamber Floor Split

Apical ledges

Pulpal digestion

Determine working length

Pulp chamber floor

Split root

9 year recall

Weeping lesion

Three furs

Bleach and treat

Alveolar fracture

Root resorption

Sandblasting role

3 rooted molar

Dental douche

Internal resorption

Titanium implants

Lesion on mesial root

Sealer track

Pretty tooth

Munce burs

Wide open apices

Three anomaly cases

Defects at the distal

Lesion on PAs

Root anatomy

Search for MB2

Lateral canal

Post space in P canal

Molar with long roots

TF use limitations

Tobacco ravages

Additional orifice

Crack and pulpal floor

Marginal ridges

Deeply buried implant

Ag Posts

Resorption repair

÷gram System

Curves in mesial canal

Lateral Crown movement

Lesion on MB root

4 canals,4 apexes

Retained root

Owes of NHS

Buccal query

Funky case

Direct pulp capping

Irreversible pulpitis

Serious pathosis

MSDO and Endo tx

Retreatment CBCT