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Endo tips    Better Endo    Endo abstracts    Endo discussions

Cracked Tooth Replacement - Courtesy ROOTS

The opinions and photographs within this web page are not ours. Authors have been
credited for the individual posts where they are -
From: Terry Pannkuk
Sent: Thursday, August 06, 2009 4:43 AM
Subject: [roots] Cracked Tooth Replacement

Here's an interesting example of why I like a surgical guide with a 
bit of flexibility.   There was a pneumatized coronally extending 
portion of the sinus on the distal.   Needing 1.5mm of bone from 
each adjacent natural tooth, an Astra 4.0 was planned.  The initial 
placement of the guide pin revealed that it was a bit shifted toward 
the distal pneumatized sinus area.  I simply tilted the angle of 
first penetration of the  precision drill a bit mesially and took a 
check radiograph.  I was happy with the alignment knowing it was 
nicely parallel to the root of the second bicuspid and pretty much 
parallel  to the wall of the pnematized sinus on the distal. The 2.5 
and 3.2 drills went to the  desired length with no need for sinus 
tapping. I then drilled half way down with the 3.7 drill and tapped 
the ledge down with the 2.5, 3.0, and 3.5 ostetomes.  I tapped 3/4 
of the way down with the 4.0 osteotome and screwed in a 4.0 x 9mm 
straight Astra.   Of course no taper. :)  I bury most of these 
implants without a healing cap figuring it  takes some additional 
slight risk out of the equation.  It's no big deal
to punch the tissue out and place the abutment later - Terry

Very nice terry !! Can you take a photo of the kind of surgical guide you used here - sergio

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


Lateral incisor


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