The opinions within this web page are not ours. Authors have been given due credit|
Sent: Monday, July 06, 2009 3:32 AM
Subject: [roots] Uh oh.........the smell of napalm Part I
What I would like is your thoughts. I'm not a scientist, I'm barely an
endodontist some of the time................ however, I'd ask you and
others who publish to read this over............
it's a collaboration of ROOTS people's contributions, thoughts imagery
and the footer will indicate that...... this is the beta submission for
approval..............I only wish I could do the science that you do so
well, At the end of the day, the greatest contribution in my opinion is
to just put it out there.......... Kendo (Kenneth S Serota)
|Figs 1a, 1b Previous endodontic therapy on tooth #2.6 (14) had failed;
the clinician chose to correct the problem with a microsurgical procedure on the MB root.
This procedure failed over time as well (sinus tract). Radiographic and clinical evidence
demonstrate the developing apical lesion. The root canal system was re-accessed, the untreated
canal identified, the entire system debrided, disinfected and after interim calcium hydroxide
therapy, obturated. One year later, the lesion has healed. While the retrograde amalgam remained
in the root end, its presumed ability to effectively seal a complex apical terminal configuration
was ill-considered. Everything leaks in time; retreatment is always the first choice for resolution
of an unsuccessful endodontic procedure where possible.|
|Fig 1c Listening to both sides of a story will convince you that there
is more to a story than both sides [Frank Tyger]. The endodontic implant algorithm ensures that philosophy does not
obscure pragmatism and expediency does not denigrate adaptive capacity.|
|Figs 2a, 2b Tooth #1.5 (4) was determined to be non-salvageable. It was removed, the socket stimulated to regenerate
and in four month’s time an ANKYLOS® implant inserted, a sulcus former placed and the tissue closed over the site to
allow for osseo-integration to occur |
|Figs 2c, 2d The choice of a natural tooth versus an orthobiologic
replacement will increasingly be a powerful force in dental treatment plans. The temptation to choose one or the other
based on expediency versus complexity, on marketing versus science is going to be the sine qua non of the standard of
|Fig 3 The degree of complexity of the root canal system has been
understood for most of the past century. The failure to negotiate the labyrinthine ramifications of the root canal
system has purportedly been a function of technical limitation rather than comprehension and yet, it took until the
mid 70’s to appreciate that thermolabile condensation of an obturating material could demonstrate a greater occlusive
degree of the system than any other modality.|
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