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Apex Locators in the diagnosis of perforations


 Importance of Lateral Canals







The opinions and photographs within this web page are not ours.
Authors have been credited  for the individual posts where they are.
- Photos courtesy of Yosef Nahmias - www.rxroots.com


      
From: Yosef Nahmias Sent: Tuesday, April 24, 2001 3:19 AM Looks good to me! For those who don't believe that lat canals are important! (Fred!!!). My man, this is what I think! Warm gutta percha people have no choice but to clean and shape following very strict guide lines. Therefore (and I think that we are speaking the same language, cause I am sure that we have more points in which we agree than disagree!) we tend to be a a bit more , how should I say it, meticulous when shaping. If the shape is not there (and we follow the 5 principles outlined by H Schilder) we can not pack the case! In my case, for example, I have to reach 4 objectives as far as the shape: A #40 (02 hand instrument) to within 1 mm of my WL, that is the RA, #2 A dovgan plugger #35 to within 3 to 5 mm from WL, #3 A Sys plugger to within 4 to 5 mm from WL, and I have to be able to fit a medium size GP cone to WL. If I don't fulfill all this objectives, I can not pack the case! This rules are my bible! When doing lat condensation, the rules are more , flexible , lets say it! Not everybody is the same, but I find that lateral condensation allows you to be a little less careful. So you may be right, maybe it is not as important how we pack them, but how we clean them. However, I think that it is in my opinion, as important the way you pack them as well as the way you clean them. For example, if you go the get an x ray of your stomach, you need to drink a dye to show with it what is going on, think about the gutta percha as the way to show up what the anatomy is like in each one of your cases! Like this case for example!
image 1
You may say, "so what!" But look at the next one! If I had not packed the canal with YTH I would have missed the ........
image 2
second canal, which I knew was there but could not see it (with scope and so on!). So I guess lateral condensation can do that??? Here is the next one
image 3
Now, a lateral canal! This case had been done by a pulp lover, now what to do, surgery ???? Sinus tract
image 4
Preop PA
image 5
Post op Pa after retx
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6 months pic (nikon950)
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Maybe, but a big maybe, this case (and I bet a lot of people in this forum have thousands of cases like this one!) would have healed with lateral. However, in my opinion, what if it had not (we will never know???). This way, I can see and visualize the problem, I can see the anatomy of the RC system. One picture says more than a thousand words. I hope I have gotten my point across, it is not that our cases look nicer (which they DO!), but because we are so proud of them, and because we BELIEVE in them, we have no choice except to do them as perfect as we can! No compromising! No short cuts! The x rays talk, and they tell you how much you put into it, they tell you about the skill of the individual (100% success - X). Not to say that all our cases look perfect (I wish they did!) but because of the way we treat them, success is more predictable! Our technique , as I said before, does not allow us to compromise! And for that, you need patency files, and a way to deliver the material in a thermoplastic stage! (you can pack it or squirt it as you wish!) So, we are not that far apart, we want to achieve the same goals,the only two differences that we have are, as barbarians : The RA is the only predictable anatomical landmark we can see on the PA and secondly, we use warm stuff! Our WL does not allow us for changes , when I was a pulp lover, 1 mm short meant I could be 1.5 mm short, or maybe 2 mm short (why bother then, maybe we should all do deep pulpotomies and done!) We do not like to leave any, did I say ANY, vital or dead tissues in the canal, and since I can not guess (or do not want to) where the canal ends on an x ray, I go for the RA (of course I use apex locators , and you know that!). My .02 cents of a peso! Yosi (got to go to see my accountant, probably bad news!) Yosef Nahmias, D.D.S., M.Sc. Chief Editor Endoweb From: Dr. Kenneth S. Serota Sent: Tuesday, April 24, 2001 2:33 AM "Dr. Kenneth S. Serota" wrote: Tougher cases with skinnier roots, I'm using the Schwed Easy Flow gutta percha and getting this Superfil effect recently which t'ain't making me happy. Still never 100% certainmente about flow in canals this small with Regular Flow. Comments Stropdude. Photos by Dr Kenneth S Serota