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Extremely dangerous mesial root curve - Courtesy ROOTS
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for the individual posts and images where they are.

From: Terry Pannkuk
Sent: Thursday, November 09, 2006 9:40 PM
Subject: [roots] Extremely dangerous mesial root curve

This is a case I finished yesterday .  I was sweating bullets making 
sure I handled it carefully. The curvature, patientís huge tongue, difficult 
isolation, limited jaw opening, and long, narrow roots made it an extreme 
challenge. It had a borderline restorable crack - Terry

Very nice, Terry. Doing a tough case like this in front of an audience is even more of a challenge. - Mark 3 crummy canals! Nice result - gary I understand the tongue, length, and limited jaw opening making this case challenging. The curve doesn't look nearly as threatening as implied in the subject line of the thread... unless I am missing something... ;) - David Prusakowski To get apical shape that truly cleans the canal system requires flaring that risks perforation on the outside of the last apical curve. If you settle for sepsis; you are right, itís not that challenging - Terry Dave, The curve you see on the film is not usually the one that breaks your file, in my experience. there was probably a buccal-lingual curvature here as well. I am willing to bet that Terry did a lot of coronal flaring to provide straight line access to the apical curves. The cases where I have broken files have almost withour exception been those where I wished I had done more coronal flaring. You can provide visual access to the broken file to try and get it out, or you can provide the same acess to the apical curve before you break the file - Dan Shalkey >> You can provide visual access to the broken file to try and get it out, or you can provide the same access to the apical curve before you break the file. Nice line I like that - Simon Dan, you said: "You can provide visual access to the broken file to try and get it out, or you can provide the same acess to the apical curve before you break the file". If I had any left, I would give you at least R100 [100 Rootsuros] for such a wise sentence - Dan To be honest, most of the rotaries I've fractured have been because of limited access, inadvertently running the instrument with flex instead of straightline in upper second molars, mb and mb2's of firsts. I wish my nsk hp had the ability of my m4, which is to attach it with the file in place in the canal. The latch makes it a pia to do. Even with bite blocks, hovering a 25mm instrument above the tooth before plunging inward can be a challenge. That's one of the reasons I've become a firm believer in one of the tips john khademi offered in his presentation at amed; whack the tooth down BEFORE beginning access prep. It's going to be crowned in any event, we have better visibility, I have better lighting for vision and photography, and I've gained a couple of mm for access - gary

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