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Deep probing defects at the distal - 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: Mark Dreyer
To: ROOTS
Sent: Friday, January 27, 2006 10:05 PM
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



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 A LOT 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

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 caries 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

Did it! - Mark
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