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

image 6


6 months pic (nikon950)

image 7

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