High Pulp Horn - Courtesy ROOTS
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From: Sashi Nallapati
Sent: Friday, June 25, 2010 12:19 PM
Subject: [roots] Fwd: High pulp horn
When this tooth was referred to me for RCT in 4, i was positive that the
tooth was cracked. and that's why it got infected. she had a done a
filling in 4 a few years ago. as you can see from the BW, the
restoration is quite far from the pulp. when i removed the amalgam,
I didnt see any cracks which got me wondering why did the pulp become
necrotic. as you can see, right below the amalgam there was a pin point
pulp expsoure. the expsosure came about due to a very high pulp horn
just about 3 mm below the occlusal surface. these sort of exposures go
unnoticed to the naked eye since one doesnt expect the pulp horn to be
that high up. any way RCT was completed in one visit.
i was expecting a lot of lateral canals seeing the spread of the lesion
around the tooth. You can see a good bit of lateral anatomy got filled.
I did recommend cuspal protection for this tooth. all in all interesting
to see the high pulp horn in this case. that's why BW are important to
assess the proximity of the pulp horn to the occlusal surface.
comments are welcome - Sashi Nallapati
beautiful obturation Sashi! Its very humbling to see the great work
posted here on roots.
Could it have been a possible dens evaginatus? The lower second premolar
also seems to have the pulp horn extending high up coronally on the
Absolutely could be a DE. particularly looking at 29. thanks Imran - Sashi
Beautiful work. Do you expect lasering the pin point exposure followed by
GIC could have helped keeping the pulp alive longer - Henry
if it was an iatrogenic exposure, at the time of the filling, placing MTA
and then GIC over it, may have worked. If it was carious, then very little
chance of pulp cap working. pulp capping in general is an unpredictable
procedure in adults - Sashi
great job , by the way , it is 5 not 4 . - Magdel
thanks american system, its 4 - Sashi
Sashi, Sorry for the late reply on this thread. Just got back from hol
in Mallorca. I wanted to say that I really enjoyed your talk on
complicated premolars in Barcelona. V inspiring :)
In this case, I'm guessing that it didn't take you too long to shape the
canal. I'd like to know, typically how long you have irrigant (hypochlorite)
flowing through the canal before obturation.
I'd also like to ask you and the other Rooters too which brand of K-Flex
files you use to create the glidepath. I have been taught that K-Flexofiles
are good in severely curved canals.- Nik
NIkhil you are right, shaping took me little time.
after the shaping and gauging is complete, i irrigated with hypo at least
10mls and then used a fine ultrasonic tip to agitate the hypo while
irrigating the canal about 5 mnts. then EDTA and ultrasonics
about 2-3 mts and final rinse with hypo. then dry and obturate.
I like flexo files as well. - Sashi