MB 1, 2 and 3
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From: Marga Ree
Sent: Wednesday, August 30, 2006 10:25 PM
aSubject: [roots] Mb1, 2 and 3
Retreatment of a thermafil case. Mb1 and 2 had separate POE's, Mb3 merged with Mb2.
Patient was not very satisfied with the result, because his initial complaint, sensitivity when tapping against the tooth
with his fingernail, didn't resolve completely....:-(( - Marga
Wonderful, I had several like this as well. This week I had 2 upper 6'th with 5 canals. One or two appointments ?
I know that fingernail tapping, I had several complains like that on front teeth. Sometimes going beyond apex helped,
sometimes not. Anyone has idea what to do ? - Thomas
Thanks Thomas. Two appointments, usually I wait till the patient is symptomfree to finish treatment. But, he wanted me to
fill the tooth, because he planned a business trip. I thought the fingernail tapping sensitivity might be due to a crack,
or maybe to the extruded thermafil carrier sticking out the palatal. Unfortunately, his complant didn't subside - Marga
Marga, You probably already know this but sometimes when a patient taps on their tooth with their fingernail and says
it is sensitive what they mean is, "I don't think you got all the nerve out of my tooth because I can still feel it when I
tap on it." They often think that because if you "took the nerve out", it shouldn't have any feeling at all.
At that point I explain that we take a temperature sensitive nerve out of the center of the tooth but there are still
nerves all over the outside of the root were it is attached to the bone and they will always be able to feel it when they
tap on the tooth with their fingernail. Sometimes that is enough to satisfy their questions and they will forget about it.
Of course this explanation is only used in the absence of all other signs and symptoms - Randy
You guys are too kind. I simply have their fingertips amputated and the fingernail tapping sensitivity goes away
immediately. J but you are correct, that is usually what I get. Patients think after endo the tooth is completely dead,
that no matter what stimulus is applied there should be zero sensation. The presence of innervation in the pdl does
require explanation - Gary
marga do a fibrotomy..Sashi Nallapati