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Minor carious lesion:Cracked tooth
The opinions within this web page are not ours. Authors have been credited for the individual posts where they are
From: gary l. henkel d.d.s.
To: ROOTS
Sent: Thursday, November 06, 2008 8:52 PM
Subject: [roots] why I need to stop using drugs!

Iím posting this as a lesson to not get tunnel vision as yours truly did.
This 60 y/o white male, who happens to be a good friend, presented 2 weeks ago
with cc of ďsensitivity on and off on the upper left.Ē  No biggy, right?
So the genius doctor (aka yours truly)  finds a minor carious lesion on the
mesial of #14, takes a quick look with his 2x loupes at 15, finds nothing
wrong, problem solved.  Wrong!  Patient comes back today, says everything
is as before.  This time, genius doctor thinks letís look for a cracked tooth.
This time, he decides to use the microscope he has hanging from the ceiling,
and with a little effort and an explorer is able to create the separation
seen here.  I actually missed this the first time around.  Sometimes I wonder
if I should be doing something else for a living!

Good news is patient is finally willing to place the implant at the #13 position where I extracted an over retained deciduous molar about 2 years ago. So are treatment plan is we are going to extract #15 and immediately place one of the new ultra wide implants in the #15 Position, and then place a standard fixture in the #13 position. I will document and post the case as it moves along. - Gary L Henkel Gary, I wouldn't jump to conclusions. You may have made the same mistake even if you were sober. Giving up on the drugs may be a bit drastic! - Kendel Hey, drugs keep me alive and walking around. Donít knock it. You are nearly as old as me GaryÖget ready for moreÖthat little seven day pill thing. I see more of these things today that I want to. Surely there are some older guys or ladies out there who can answer this question. Donít we see a heck of a lot more of these things than we did when we started. Clenching seems to be on a epidemic scale. Iíve got two or three patients who could bite a 20 penny nail in pieces. Question on the implant Gary. Are you using Nobel or other. I had three replaced with a fat boy great 6 mm implant. It was a massive process. About five mms of sinus floor came out with the palatal root and my calm easy going perio guy almost used a curse word and that would have caused a ten minute prayer meeting great surgeon. He packed enough bone up there to plug Hoover Dam and we waited. He tried a sinus lift and found no membrane so we waited. 18 months later we did the sinus lift and place the Nobel implant. It uncovered immediately so I just put a healing screw on it that I like hate those straight ones. Need to do the restoration but canít find the time. I do them myself with an assistant. Get my hygienist to check margins but if it comes from Ultimate Styles it fits sometimes too damned well. Iíve threatened to send them a gallon of die spacer very anal retentive Japanese techs. We used a fat boy on #19 in my mouth and it worked like a charm but I left it in too much lateral occlusion and my clinching vibrated the screw loose. We cut it off and then I read on here that you simply drill a little hole in the top and change the screw never use the same one because it has been stretched. I love those wide implants solid feels like cement blocks holding the crown and abutment in. Guy

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