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The opinions within this web page are not ours. Authors have been credited for the individual posts and photographs where they are. - www.rxroots.com

Problem with MB root

From: Dmitri Ruzanov
To: roots
Sent: Friday, October 14, 2011 4:58 PM
Subject: [roots] Today's case

Just finished this one...
Nothing special... i had to send the report to referral and thought i might send it to ROOTS as well :-)

Referral started endo (deep caries, exposure) but couldn't get the patient comfortable. Sent the case over to me
guessing i might find and "accessory" canal... hmmm...

In the referral letter it was stated that canals were already completely instrumented to size ProTaper F3 in all canals (yikes!)

I pretty much believe there is a problem with MB root... most probably apical transportation with perforation.
Gonna follow up the case in one year to decide if any surgical intervention is needed.

Oh, and yes, there was an MB2 (surprise! LOL!) which has merged into MB1... nothing fancy.
What worries me is that it is not routinely thought that there has to be MB2... and if one doesn't find it
- express referral to endo is warranted. Guess, if the patient were symptom-free he would have packed the case :-(

BTW, is there a way to polically correctly tell referring GPs that F3 is very bad idea in virgin canals,
especially in MB system???! - Dmitri

Problem with MB root

Problem with MB root

Problem with MB root

BTW, is there a way to polically correctly tell referring GPs that F3 is very bad idea in virgin canals, especially in MB system???! You could try it this way: Dear Doctor X, I noticed you used Protaper F3 in a case you recently referred to me. Although the preparation with Protaper F3 results in a good shaping of the canals, it might be a little too big for smaller root canals. What I prefer is to shape those canals to a Protaper F1 or F2 and then I finish it apically with a Profile 30.06 or 35.06. This results in adequate apical shaping like Protaper F3, but it will preserve more cervical dentin. I hope this suggestion, might be helpful. Sincerely, Dmitri Ruzanov BTW nice restoration you made, Dmitri! - Grtz, Rafael Rafael, thanks for the example! :-9 However i doubt it will make any difference - it is way too polite. And, you know, all this about cervical dentin preservation - who the hell needs that???! I mean people will look at me like i've got three heads and a tail...LOL! Terry, John K - i'm fishing for your suggestion :-) Re: restoration This was a quickie build-up i placed immediately after the completion of endo. As a courtesy to the referring dentist. Took me 3 minutes - i used Injectafil for this - miracle material, works wonders. Normally (if were doing the case for myself or for my A class referral) i would have place White Opaque core to make it easier to prep afterwards... This doc doesn't refer much to me, it is like two or three cases a year. And i'm not sure he would place a core with proper isolation... Dmitri

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