From: John A Khademi, DDS MS
To: ROOTS
Sent: Friday, December 07, 2005 12:08 AM
Subject: [roots] System B and Squirt backfill

Just completed today. Pic one is the preop before some idiot did an apico on this tooth about a year ago.
Apparently the root canal had been recently done by his general dentist, who said he found four canals and
some pressure was placed on the endodontist to manage the case surgically, so he complied. The apico (Pic3)
can be seen connecting the B/L width of the MB like a staple, and the DB also had apico/retro. Yet the
sinus tract persisted (Pic2). I entered the case, and indeed four canals were had gutta percha (Pic4),
but were far from "filled" (JHC look at the palatal--still pulp!) Additionally, the MB3 and DB2
(Pic5-files in them) were missed with tons of crud in them. The MTA fillings on the MB and DB roots held,
so I prepped the canals with a flattened off #2 GG apically and #3 coronally. Palatal prepped to a 50/.10
(Pic6 is prepped). CH change in August, another in September. No symptoms, no sinus tract, no nothing.
Squirted the MB/MB2/MB3 and DB/DB2. Conefit a .10 AutoFit, and laterally condensed about 5 more cones
before SysB and Squirt backfill. There was a big trough conecting the DB/DB2/P (Pic7). Oh, BTW, the idiot
who did the apico?..that woulda been me. :-) - John A Khademi



sweeeet.  thanks for sharing these - Kendel

Unbelievable teaching case!!!  This case deals with ethics, who is responsible for the ultimate decision
in treatment, and the technical aspects of endo - Fred

John, this case proves something else.  As we see more and more and more of these it proves that the majority
of GP's and some endodontists don't have a clue what the basic goals of endodontic treatment are.
I know four years ago, I didn't know what I should have to be doing molar endo.  Guy

Great case John ... and I LOL at the last line - Simon

Nice story John, Were you able to tell the GP what you found ? I am a GP and sent a case out that I was not
happy with after taking a final X-Ray after closing the case. I have asked my asst. to have the patient back
and retreat. I wonder if another dentist that saw the x-ray would call me and talk to me about it, would
they just tell the patient what a sorry dentist I was, would the patient get along for many years before
needing more treatment, ????????  - Dr. Danny O'Keefe

Beautiful case, thanks for posting.- Danny Chacko

honesty for the right reason (the patient), not for the not-so-right one (other dentist could see our work)
- Marcos Arenal

YES THE PATIENT HAS TO GT THE BEST AND HOW HE GETS  IT DOES NOT MATTER - Gurpreet