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Fracture Exploration and Dissection of a Pulp Stone - Courtesy ROOTS

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The opinions within this web page are not ours. Authors have been credited for the individual posts where they are. Photos courtesy Terry Pannkuk - ROOTS

From: Terry Pannkuk
To: ROOTS
Sent: Thursday, January 19, 2006 12:00 PM
Subject: [roots] Fracture Exploration and Dissection of a Pulp Stone

I spent quite a bit of time on this case today.  It was either an endo or an extraction setting up for a two-stage
implant.  I took multiple pictures for a routine access lecture series.  I needed something basic for maxillary molar
demonstration.  I spend quite a bit of time dissecting the entire pulp stone out of the chamber.  I rarely if ever have
seen that a previous clinician would perform a complete access and stone removal when I retreat molars of this type.  It
takes quite a bit of extra time, but it’s inconceivable to me that someone can make an appropriate assessment of crack
extension without doing this and composite finishing burs are the only way I know that one can polish the floor smooth
enough to completely see the extent of the cracks - Terry






Terry,  Nice case and nice pics.  You've been using the scope longer than I have so maybe you have already tried this and
can give me some feedback.  I have been using an acid etch of either liquid EDTA or a gel etchant on the pulp chamber to
remove the smear layer created by using burs and have found that isthmuses, cracks and canal orifices seem to be more
obvious.  I use the little fuzzy, plastic micro-brush applicators to scrub around the chamber with etchant for about
20-30s and rinse with a Stropko.  What has been your experience? - Randy Hedrick

Randy, I do the same, but also have a chairside microetcher and sandblast it before the chemical etch. I’m extremely
paranoid of dentin-debonding; the reason I’m so skeptical of hype of Resilon. - Terry

Dear Dr. Terry, why did you leave the crack on the buccal side untouched? did you feel
that it will not create any problem in the future if it is left without a crown? - Vipin