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 don’t use it, or  it has to be gel acid - Rob Kroese

Thank you Mark, I have never have used it and didn’t 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’t 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