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- Photos courtesy Ahmed Tehrani
From: Ahmad Tehrani
Sent: Saturday, August 06, 2005 1:36 AM
Subject: [roots] Necrotic
haven't posted a case in a while, so here is a boring one.
This patient completed his ortho treatment last year. #10 started to
turn color and despite of several attempts at bleaching it still didn't
whiten. Pulp testing last year was unremarkable. Starting 6 months ago
the pulp testing leaned toward a necrotic pulp. today Ice/heat test
no response and EPT ~80.
Still not really convinced decided to do a test cavity and was able
to access the pulp w/out any pain or discomfort.
CH after shaping the canal to Light-Speed 140....just kidding.
closed access with composite.
I have never done a cavity test before and I have to admit that I was
more nervous than he was. After giving Rob K. hell about it for years,
it worked out great in this case. Just hope I don't have to do it
ever again..)) - ahmad
From: Ahmad Tehrani
Sent: Friday, August 26, 2005 10:24 AM
Subject: [roots] necrotic and long
25 year old male... post ortho patient. #10 discolored. mild percussion
sensitivity. Pulp testing indicated a necrotic tooth. No thermal response
with hot or cold. EPT non-responsive until 80+. tissue normal ( NO ST ),
perio probing < 3mm . Accessed the tooth and sure enough the pulp had
turned literally to dust. CH for 30 days. Tooth totally asymptomatic
and comfortable at obturation appt.
Root ZX and pp measurement both had measured the length at 25.5 mm
previously....wire file at 22 mm...too short. reshaped the canals and
fitted a #50 cone....Chloroform dip seated it to length. I wish I had
taken a photo of the GP cone impression of canal anatomy...way too cool.
The apical part is strictly series of bent hand files to capture the
distal curvature of the root which exists in all laterals.
I like to thank Gary Carr for giving me this tip. I guess most laterals
fail because either this anatomy is ignored or destroyed with rotary files.
Not having fitted a cone in a long time decided to System S the case to
make sure all the anatomy is 3 dimensionally filled, usually not
addressed with other "warm" obturation techniques...))
Still, my danged B/U voids irritate the heck out me....no charge to
the patient - ahmad