Crack stopped shy of pulpal floor - Courtesy ROOTS
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From: Mark Dreyer
Sent: Monday, August 07, 2006 11:59 PM
Subject: [roots] Crack
First case of the day. Crack stopped shy of the pulpal floor,
so we went for it - Mark
Hi Mark, This is a cracked tooth I have been treating for almost
6 months now. After listening to Carr, Schwartz and other pretty
smart guys, I am taking a more cautious approach to these cases.
I think given the predictability of dental implants, especially
in the posterior mandible, we need to leave no stone
unturned in these cracked tooth cases.
The pics show the fracture, which is a bit of an odd one, running
down the lingual surface of the tooth to the ML canal. I have been
staring at this thing every month since February (preop) and nothing
has changed. There was never a probing defect in this tooth.
He has been symptom free for over five months. While this
is no guarantee of success, we did due diligence and then some.
Pic4 is 1 month, pic5 is 4 months with evidence of healing, and
pic6 is the final from today.
We finished the case today without anesthetic at the patients request.
You can grumble about the mesials being short, but they are actually
about .25mm long. He could feel them just a little bit when I was
fitting cones. There were three distals, with two of them merging.
I thought there was an MM initially, but after troughing (pic3)-
-nothing. The tooth was restored with a bonded amalgam,
and remains out of occlusion. We recommended a crown ASAP, and
my recommendation would be for full coverage gold - John A Khademy
boy, where have you been stranger. are you still using that intraoral
camera thing for your photos? if so, which one are you using? those
are great shots, and i need something for my 2nd office - gary
Hi Gary, I am using both the intraoral camera, and a Sony DCR-PC100
(DV camera) with a memory stick on the scope. The images are low
resolution compared to Carlos' and others', but in print form you
The intraoral camera is cheap and really easy to use and give that
"fisheyed" view of the whole chamber as opposed to the "confusing
to some" mirror shots required by a scope mounted cam. The above
pics are intraoral camera pics.
Both have their purpose. Use what works for you. :-)))
- John A Khademy
What beautiful dentistry !!!!!!! I am sure you used a bonded
temporary, adjusted the tooth out of occlusion, and told the
patient not to bite on it. The patient could be offered a gold
crown or temporary Plastic crown from the beginning.
- Danny O'Keefe