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 didn’t 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 wasn’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 didn’t have to worry about protecting the porcelain veneer which Immediately fell off when
I started probing with the explorer (Good thing I didn’t 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’t 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, she’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