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Lower Bi : CaOH2

From: Jörg Schröder To: ROOTS Sent: Friday, January 06, 2006 5:25 AM Subject: [roots] Lower Bi Necrotic case, two visits, CaOH2 in between. When I first saw the preop-xray I thought, that this would be a easy one. I then had a second look ( thank you Winfried!) and recognized that the canal seems to disappear after 10-11 mm. So I planned the next appointments for two canals. But after getting access I did not see a lingual canal. So I cleaned and shaped the buccal and was very disappointed not to find another one. I started troughing on the lingual canal wall but did not find a orifice even with prebended handfiles and microopener. Afraid of "creating" a artificial canalsystem I decided to fill the buccal one. After drying I saw a very little wet point on the lingual wall (just a reflex of the scopelight) Took a ISO 10 microopener and there it was. Buccal 10/45 with handfiles an stepback after VTVT with Flexmaster. Lingual FM 06/35. No off angeled x-ray because I could not place the Kodak XL sensor deep enough. So I was happy to get the apex on the film. The thing I learned today: Always have a last look. - Jörg Schröder

very cool. it's crazy learning to "see" with the scope. it isn't just as simple as "looking", we have got to learn to read some subte clues sometimes. It helps when we Know the canal must be there, as you can see from your pre-op eval. Awesome work as always. For this tooth the easiest angled shot would be to swing the tube head to the mesial, shoot toward the distal. i have one assistant i work with that is fairly good at these, but i find it's better to just shoot them myself (the radiograph, not the assistant) - Kendel Kendel, I always shoot them myself. Had a lot of new assistants last year as endo became a bigger part of my dental life ;))). As long as here in germany a lot of patients (and sometimes collegues) are very concerned about taking two radigraphs from the same tooth the same day (i.e. off-angled films ) I will "shoot" them myself , trying to avoid discussions.- Jörg Excellent work, superb documentation, I really like this one - Thomas

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