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Necrotic case
The opinions within this web page are not ours. Authors have been credited
for the individual posts where they are. - Photos courtesy Ahmed Tehrani

From: Ahmad Tehrani
To: ROOTS
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 To: ROOTS 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

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