From: Mark Dreyer
To: ROOTS
Sent: Friday, August 28, 2009 6:47 PM
Subject: [roots] Good thing I used ZOE sealer instead of a leaking resin sealer!

This is for all of you that like to post a restorative failure in which the pdl is intact and the endo appears
to be successful, thus making the direct or implied claim that the reason for this is that superior sealing ability
of your resin sealer du jour.  In other words, single case anecdotes are worthless for making claims of this sort.

I did the endo and core buildup 2.5 yrs ago.  She's asymptomatic, but the crown came off and there is gross caries
on the buccal margin.  I can't help but wonder if I left decay?   This is disheartening.  I told her to go get an implant.
- Mark Dreyer





It's sad that after a wonderful endo the crown fell apart. Could you not put in a post and a resin core and crown it off again?
And I didn't get the import of your first paragraph - Sanjay Jamdade

I understand the first paragraph completely.
The point is that various new sealing materials are sold based on claims that the new sealers/obturants can achieve what
traditional time-tested materials cannot.  Mark is saying that any single case is not sufficient evidence to draw such
conclusions, as some have done, by showing a healthy attachment apparatus despite coronal leakage, and claiming "aha,
it's the new sealer (s) ", which implies that without the new materials, this would not be possible. Here we have gross
coronal leakage with ZOE/gp, yet an asymptomatic, healthy periodontium.

Mark, I'm not sure what caused the aggressive recurrence of decay.  Perhaps there was a problem with crown fit/cementation,
or perhaps this patient has an aggressive caries potential.  Disturbing nonetheless, I agree - Kendel

Kendel, can you be my ghost writer?  You are much clearer in you writing style than I!  :-)) - Mark

Mark: take a good look at the 2nd radiograph ....
the distal area is either prepared -->and not filled or there was decay present not removed or resorbed.
do you have a pre-op BW?  - ahmad

Ahmad, I'm not seeing it, (you are talking about the 2nd radiograph in attachment "page 1" right?)  but I'm sure I have
a pre-op BW. I'm going to check it out on Monday and post it - Mark