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Tougher than a lower second molar - Courtesy ROOTS

The opinions and photographs within this web page are not ours. Authors have been
credited for the individual posts where they are - www.rxroots.com
From: Mark Dreyer
To: ROOTS
Sent: Thursday, January 14, 2010 10:10 PM
Subject: [roots] Hardest anatomy for me

I can't think of a root form that is tougher than a lower second 
molar like this. Vital case, however 2 visit case due to 
complexity/inability to get ideal result in time I had allocated 
for single visit - Mark Dreyer

Great case, great photos.....do you ever worry about numbness on lower 7s if you puff..... I know I do. Its a very very nice case - Glenn Thanks, Glenn. Sure I worry about the proximity of IAN to these teeth, but I worry less than I used to being that I've done so many of them with only one temporary paresthesia, which was back in my cone/AH-26 days about 10 yrs ago. - Mark I like that Mark! Did you get any blockage with pulp stumps etc due to it being a vital case? - Bill Bill, I prefer liquid edta. Of course other than the concern for wax buildup, I suppose a product like rc prep would be ok also - Mark Mark, May be a silly question but what is the purple gel in the tooth? I see it more often but I donít use it, or it has to be gel acid - Rob Kroese Thank you Mark, I have never have used it and didnít know it as well. I try to convince the referring dentist that I am making a better buildup. But I will keep it in my mind - Rob Rob, When the referring doc isn't ok with me doing the buildup, I place orifice barriers with Ultra-dent purple Perma-flow - Mark Mark, Liquid EDTA not gel? I know EDTA should help break down the collagen plugs that we can get with vital cases. - Bill Bill, thanks, and no I didn't get a blockage. My routine is to have 17% edta in the canal when I'm first going for patency. Anecdotally I can tell you I seem to block myself out way less than if I have bleach in the canals - Mark And you squirted that thing? That is amazing apical control - gary Nice stuff Mark per usual. I did one about like that yesterday and didn'ít even know it until I did the fill and packed it. The measurements were short so I thought I had an easy one. Sometimes it is better to not know where the files are going. I think this is where the smaller diameter TFs shine 0.06 and 0.04 - Guy Dear Solly, May I ask why did you use the Munce Projectors here as I don't see any problem to do a pre-endontic buildup and working through it. Nice documentation, but I think the tooth has very poor prognosis - Thomas how do you do the build up without blocking out the canals,here I do a half hour soak while doing emergency and then at end start build-up I agree prognosis poor but I have many successful cracks still running after 5 years I think if it was my tooth I would take the chance and that's what I advise the patients chance to save difficult extraction,probable bone fill and implant - solly

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

Radioluscency

Lateral incisor

Obturation

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