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Photos courtesy Terry Pannkuk - ROOTS
From: Terry Pannkuk
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
itís 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. Iím extremely paranoid of dentin-debonding;
the reason Iím 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