From: Terry Pannkuk
To: ROOTS
Sent: Sunday, September 05, 2010 4:32 AM
Subject: [roots] FW: Crapped up Retreatment Recall 7 years with CBCT

I retreated this crappy case in 2003.  The dentin was stained, soft throughout the pulp chamber with a
small strip perf of the furcation in the MB.  I filled the entire MB with MTA.  Bonded the floor and
orifices with flowable then a macrofil composite core.  A perplexing decision was made in 2008 when
he returned with a cracked tooth on #4, the mesial abutment for the crappy bridge.  The prosthodontist
he was seeing at the time wanted me to assure him that #2 was ok after I extracted #4..  He felt that
if #2 was going to eventually fail, he would want an implant in the #2 position and the #4 position
to make an implant supported bridge. The oral surgeon who placed the implants was unavailable so
I took the #4 tooth out after communicating with him.  No crap was placed in the socket. The oral
surgeon took an ICAT in 2008 before he and the prosthodontist planned out the implants.
I found #2 to show no recurrent lesions from what I could tell on the PA’s and the ICAT images which
had crappier resolution compared to the Kodak.  He came back last week to have a different tooth treated.
I still don’t see any areas of concern after taking the CBCT today. So far it looks like a good decision
to keep this crappy tooth. I figure even if it cracks, develops recurrent caries, and fails a few years
down the road, a single implant can be placed in the #2 site.  The implants look like they were positioned
beautifully by the oral surgeon.   - Terry