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Case of middle mesial

From: unni krishnan To: roots Sent: Saturday, December 10, 2011 5:31 PM Subject: [roots] Middle mesial Sharing a case of middle mesial which was recently finished. Comments and criticisms are welcome as always - Unni Middle mesial

Middle mesial

Middle mesial

Middle mesial

Middle mesial Hello Unni, Nice case! About the last slide, what is the history of this tooth? Are you suggesting that the radiolucent area is caused by the presence of an unobturated mesiomedial canal? If so, are you planning to retreat? - Carlos Hi Carlos, Thanks for the response. Well, Iam in a predicament here.. I did the endo on that tooth 5 years back[ pre- magnification era!] I took a PA of that tooth just as a follow up. Its has always been asymptomatic. The entire joy of the MM discovery was watered down by this. Unfortunately I dont have previous radiographs as we moved to a new facility. But records show that the pulp was vital in the contra lateral one[ single sitting endo]. I have offered to retx it without charges, but when I told the crown may need replacement in case it chips off, patient didnt appear to be keen. Anyway he promised to come back for a cbct on that one. I will post it when he gets back. Regarding lit on bilateral occurence of MM , I couldnt find any. I need to go back and check the AMED presentation by Dr. Mahalexmi and see if there is any mention - Unni Keep us posted! I wonder if scattering/hardening will affect the CBCT here! - Carlos Aznar Hi Unni, Nice case! Regarding the contra lateral molar, I agree, I would retreat at no cost. I would just access/retreat through the crown, place an amalgam core, and then close the access with masking agent / opaquer and bonded composite. This should look very well, and the patient will be happy not to have to replace the crown - and not to have to pay for retreat! - Ken Heritage I have had occasions when the ceramic sort of peeled off when entered with diamond. what burs do you enter with? - Unni Unni, I sometimes use a small round diamond just to cut into the crown, or a small diamond fissure like a 541, then once I have any definite opening I use a long diamond fissure bur to open up and complete the access. I agree, the long diamond fissure bur alone is inclined to move about a bit so that's why I usually start with the round diamond................and a new bur works great! - Ken

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