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From: Mark Dreyer Sent: Friday, January 27, 2006 11:36 AM To: ROOTS Subject: [roots] Crack I wish I had a dime every time a naked eye dentist (NED) said a scope wasn't needed to dx a crack. Referring dentist sent me this guy for rct on 30. Patient was convinced the problem was 31, but the dentist didn't see anything wrong with that tooth and assumed the guy's pain was from 30, which actually responded normally to the cold today; 31 was non-responsive to the cold, had deep probing defects at the distal, and +++ to apical percussion and palpation. Off to the OS for this guy. - Mark Dreyer He must have missed the big area on the distal root as well ? Very convincing, but I think you would see it with loupes as well. - Thomas You might as well do 30. It is a short step away. Guy I prefer the old fashioned carries excavation first. If no pulp exposure, we usually try make a filling, most last a long time. It's true endo later is usually harder due to calcification. I am sure Terry will kill me ... Thomas Hmm. Looks like maybe this was an OED (one eyed dentist). Yikes! I see that 30 has issues but how could you miss 31? - Arturo Cool case Mark........ You think the PA with the radiolucency would give it away. There usually is occlusal decay on the surface of these to cause the weakness for the Mesial to distal crack to occur. I know so much more about cracks now that I have been using the scope for 8 years. It is actually so cool to see the cracks when you get the scope. Its one of the first two things you notice far more of with the scope. Cracks and decay. These mesial to distal cracks seem to happen ALOT on lower 2nd molars which are at the end of the fulcrum I guess. Great case and if I have a chance today I will post some recent cracks cases....... I LOVE DOCUMENTING THEM with the scope.......sooooooo cool. - Glenn
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