Perforating internal resorption case - Courtesy ROOTS
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From: Terry Pannkuk
Sent: Tuesday, December 29, 2009 6:38 AM
Subject: [roots] Done now?
Here's the surgery on the perforating internal resorption case I
treated today. Originally treated in 2006. - Terry
What kind of endodontic filling technic was used in this case?
I suppose, that used material is MTA, didn't it?
Infiltrated with Lido 1/50 Thanks - Terry
Wow! Not too easy on a lower second molar. Nicely performed and
documented, as usual. How did you control bleeding from the PDL?
Thx for sharing - Maarten
Actually the access was pretty easy with this guy. He was about
6' 8" with a minimal buccal shelf. Case selection is everything.
If there had been poor attached gingiva, poor access, involvement
of the furcation/interproximals, I would have extracted the tooth.
Knowing what you can and cannot do is more important than actual
clinical expertise. You wouldn't believe the number of cases I
don't treat simply because I have a "bad feeling" about how it's
going to turn out. :) Back in 2006, I remember thinking to myself,
"Jeez, this guy is tall with a great big mouth and wonderful
anatomy for a potential failure". You wouldn't have seen that
delicate little Tedvek suture at the tip of the mesial papilla if
I had been fighting a pudgy wide cheek the size of Jaaba the Hut.
:):):) - Terry
"Knowing what you can and cannot do is more important than actual
Isn't 'knowing what you can and cannot do' exactly the definition
of clinical expertise? Before you know what you can and cannot however,
you need to try these things. A lot of stuff isn't thaught at
dental school or postgraduate programme, and you learn just by doing
it. The first time might not result in a satisfactory outcome, the
second time will be better, until you reach an acceptable level and
are comfortable in offering it to your patients and execute it.
Attached is a similar case I treated recently. Haven't done a lot of
them. Young lady with a couple of strange carious lesions
(all class V lesions) in an otherwise healthy dention. In order to
save tooth 46, I started removing the (vital) pulp, then reflected a
small flap and restored with Fuji II (resin modified GIC).
Calcium hydroxide and a temporary sealing were placed. Two weeks later,
the orthograde RCT was finished.
Not as perfect as yours, but not as easy as yours, at least from
the perspective of the size of the defect... - Maarten