From: Terry Pannkuk
To: 'roots@ls.rxdentistry.com'
Sent: Thursday, October 06, 2011 1:21 AM
Subject: [roots] Uninterrupted Long Term Recall #'s 245 and 246 from today

I treated these two adjacent maxillary bicuspids in 1995, both single visits (note the majority of long term recalls
are single visits because I didn’t start phasing into two visits for all necrotic pulps and retreatment cases until
2001-2004.  Both delayed cores, both with posts placed by the referring dentist.  Patient is asymptomatic with no
clinical signs of disease.  She came in for treatment of #10.

The data table should probably have column which designates why the patient came back for a recall:  1.  Routine
scheduled (extremely rare, these patients are very difficult to get back for long term recalls)  2. Coincidental
need to treat a different tooth (very common), and 3. Came back with a problem regarding the recalled tooth
(less common than #2 but more common than #1).  I’m positive these designations skew the outcome data in different ways.

#1 probably being most representative of true outcome percentages.

#2 probably skewing my outcome slightly more favorably given the fact these patients likely had a reasonably positive
experience or they wouldn’t come back, but they also could have a chronic asymptomatic lesion they don’t know about
(net effect probably skewing the outcome slightly more in my favor).

#3  probably a more drastic skewing of outcome in a negative/unfavorable direction

An interesting test hypothesis for these 3 presumptions would be to spend a period of time requiring patients
to come back for recall giving them a huge discount for motivation, then see how the prospective outcome percentages
with an excellent recall rate in the future compares to the retrospective one I’m performing now.

The problem is that I simply cannot afford to pay for that patient recall motivation out of my pocket and a great
majority of my patients would need quite an economic incentive not to be inconvenienced.

This patient was extremely nice and enjoyed the special attention she got with my performing the extra recall exam.
I’m getting better at communicating the value of a recall CBCT, and the vast majority of my patients are letting me
take the CBCT recall exams, especially the last 6 months, nearly all long term recalls are CBCT recalls.

Terry

 Current List:  74%  (65/246)  are teeth that remain with no hint of problems (i.e. no suspicious radiolucencies,
 no signs/symptoms suggesting potential recurrent endo disease)  Teeth lost or failed for any reason (not necessarily endo)
 represent the F/Extracted. Many of the columns like Thermafil, Fracture, Pin, Paste, and etc. need to be filled
 in meaning I need to go back through the records and radiographs to check chart text to find ones I didn’t catch
 putting the basic outcome data in