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Complex roots with difficult access - 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: Wednesday, June 23, 2010 11:18 AM
Subject: [roots] Super-long curved, complex roots with difficult access-CBCT

This patient was very difficult to treat; just finished him a few minutes ago.  
The CBCT was helpful just so I could validate what I did at the end and make 
sure I didnít miss any major systems (I didnítí charge because it was mainly
for my personal interest). There wasnít really a separate MB2 orifice but I 
felt some action apically as I went through numerous recapitulations with 
precurved K-files.    Same with the palatal.  My EAL estimate was 2mm short
(as usual I trusted the RT more.good thing).  The MB had an apical trifurcation 
which can be seen on the transverse sections.  It also had a prominent furcation 
accessory at midroot. Wild case, good demo CT, almost cone-cut the
palatal root on the CT.  The patient was very tall -  Terry

Hmmm, the thickening of the sinus membrane adjacent to the palatal root looks suspiciously familiar. Was this a necrotic tooth? Please make a note to CBCT this tooth again in 6 months to assess the change (or not) of the sinus post-RCT. - michael p LOL....it was necrotic and this was the second visit. The palatal root was 28 mm long, DB 26mm and the MB short branch 23.5mm and the MB long branch 25.5mm. The CBCT simply showed what I did and did not help me do it; hence the free charge. There was no COD with the CBCT for this case - Terry

Protaper flaring

6 yr old Empress

Cvek pulpotomy

Middle mesial

Endo misdiagnosis

MTA retrofill

Resin core

BW importance

Bicuspid tooth

Necrotic #8 treatment

Finding MB2 / MB3

Deep in a canal

Broken file retrieval

Molar cases

Pushed over apex

MB2 and palatal canal

Long lower third

Veneer cases

CT Implant surgury

Weird Anatomy

Apical trifurcation

Canal and Ultrasonics

Cotton stuffed chamber

Pulp floor sandblasting

Silver point removal

Difficult acute curve

Marked swelling

5 canaled premolar

Sealer overextension

Complex anatomy

Secondary caries

Zygomatic arch

Confluent mesials

LL 1st molar (#19)

Shaping vs Cleaning

First bicuspid

In Vivo mesial view

Inaccesible canals

Premolar 45

Ortho and implant

Radioluscency

Lateral incisor

Obturation

Churning irrigant

Cold lateral

Tipped to lingual

Acute pulpitis images

Middle distal canal

Silver point

Crown preparation

Epiphany healing

Weird anatomy

Dual Xenon

Looking for MB2

Upper molar resorption

Acute apical abcess

Finding MB2

Gingival inflammation

Irreversible pulpitis

AG BU ortho band

TF Files

using TF files

Broken bur

Warm technique

Restorative prognosis

Tooth # 20 and #30

Apical third

3 canal premolar

Severe curvature

Interesting anatomy

Chamber floor

Zirconia crown

Dycal matrix

Cracked tooth

Tooth structure loss

Multiplanar curves