From: Mark Dreyer
To: ROOTS
Sent: Thursday, August 20, 2009 3:08 AM
Subject: [roots] Where to look for an mb2

Business is very slow this week (last week of summer vacation) so I had some extra time today.  I thought
this might be helpful in terms of where to look for an mb2.  I didn't find one in this particular case.
- Mark Dreyer, DMD















just curious mark, what obtura tip do you use for squirting; also what pluggers do you use and how far do
you normally get down the canal with the obtura tip? - brent

Brent, 20 guage tip, Dovgan niti condensors.  As for how down the canal the tip gets, usually about 1/3 of the
way down would be my guess.  It isn't really important if your canal is properly shaped and patent so I never
worry about how far it goes.  I just let it go as far as it can without wedging it - Mark

Mark:  wouldn’t you agree the proper sizing of the plugger (we use joey’s for squirting) is more important than
how far down the canal you insert the obtura or elements or hot shot tip?  As long as the hot soft stuff is ahead
of the plunger, it will get pushed apically - gary

Gary, Of all the things to consider in the process, the depth of the obtura tip in the canal is almost never on
my radar screen.  It just doesn't matter in a properly shaped canal.

Actually if you took a rad after squirting and before condensing, you'd see that the condensing doesn't do
anything that is evident on the radiograph.  Obviously you want to condense for other reasons.  My point is
getting the gp to the apex is more dependent on the shape of the canal and less so on depth of the obtura tip
or what condensor you use - Mark

Mark,  Do you always squirt or do you conefit, downpack and backfill as well?...Thanks!  Brad Winn

Other than in those cases with large diameter apices in which I place MTA, I always squirt.
The only use I have for cones is tracing sinus tracts - Mark

Mark, are these Carr tips on ultrasonic.  I’ve given my ultrasonic to endo in favor of Mounce burs.
Do these work better.  I’ve found the Mounce burs to allow much better vision - Guy

Guy, Do you like chocolate or vanilla better?  Same sort of question as to the preference between U/S vs.
Mounce burs.  And yes these are Carr Tips - Mark

Hi Guy, I disagree and agree at the same time.
For seeing what you are doing it is easier with ultrasonics but the dust is so small it covers every thing evenly
and it hard to see what you have to remove next.

Mounche burs leave a bit courser dust that settels in cracks and fins so it is a bit easier to see where to remove
the dentin.

Could be we use a different technique, what counts is result.
With US i can not use an airblow but with mounche burs i can, maybe you have an trick up your sleeve? - René Stevens

The most effective tool for identifying orifices is the Danville Microetcher.....all this discussion about burs,
tips et al.......very much goes out the window if you simply "satinize" the floor and interface with the axial wall
.......a drop of alcohol and the magnification effect is accentuated dramatically....no worry about dust, or chips
or whatever, the colour gradient distinction is dramatic.......it is the most invaluable and underutilized tool
in the endodontic armamentarium........Ken Serota

it's Munce,  not Mounce,  two different people.  www.cjmengineering.com - Bill Seddon

Thnx Ken,  will try this next time. See, even old discussions are good for 'new' guys like me - René

Hi, I first tried the Danville microetcher trick following Ken’s suggestion from several months ago and was absolutely
amazed with how well it works  it is one of the best tips I’ve picked up from this forum in the past 4-5 years.

The result is pinpoint accurate and there is minimal disturbance to the pulpal floor - Michael Moran

Oops, Munce, not Mounce...thanks Bill.  :-))

And Kendo, I use the micro-etcher to clean up before placing buildups but am always worried about sand getting onto
my scope lens.  I can't use a lens cover due to my ring flash - Mark

For me.....not know much about endo......ask me a C and B question....

But......using the air abrasion.........and then washing.....drying.........they seem to show up......but
air abrasion needs to be used very carefully.....ASK ME HOW I KNOW - Jeffrey

Ken, If I might play the role of nabob of negativity, I'll echo Jeff's admonition, only perhaps along a
different line -  vis a vis using caution with potentially introducing any form of compressed air
(let alone the >50 psi employed with the Danville particle abrasion product!), into a root canal system.

Attached is a pdf of a possible adverse sequela when introducing air alone past the relatively safe confines
of the canals. In the matter under discussion I would imagine the addition of 25-micron sized aluminum oxide
particles into the tissues would not help in any way either as I do not believe anyone uses sterile Al2O3 for
particle abrasion.

I'm not telling you or anyone else something you don't already know - just advising the employment of some
caution. Such a bad thing will never happen to your patient - until it does. Caveat dentors - Craig

Hi Ken, Can you explein what is  the Danville Microetcher.., how it works - Georgette

Hopefully this series of photos is helpful.  This is a canal which is very easy to miss if you don't know
where to look - Mark Dreyer




excellent photography Mark! - Abdul Parmar

Maybe the best set I’ve ever seen.  I’ve got to review my camera setup.
Your images are making mine look bad. - gary