Home page
Bone regeneration
Root fracture
Filing buccals
Apical periodontitis
Off angle xray
Lower Bi
5 canals
Sinus tract #13
Perio endo lesion
Calculus formation
Antibiotics in periodontitis
POE for MB2
Balloon sinus elevation
Confluent MB system
Lasers in endo
Endo cases
Molar case # 17
Dark color dentin
Gum pain
Ortho reabsorption
Strange anatomy
Tooth abscess
Dens case Tx options
Deep bifurcation
Buildups in RCT
Smoking /dental health
Immediate implant
Fractured US tip
Silver cone removal
Dental trauma
Post and core
Apico # 19
Irreversible pulpitis
MB, DB and P
Extra anatomy

Top 25    New additions    Useful links    X-ray discussions
Endo tips    Better Endo    New additions    Endo abstracts    Endo discussions
Web discussions    MB 1,2,3    Bleeding    New Case studies    Back to home page    MB2

  "C" shape case

The opinions within this web page are not ours. Authors have been credited for the individual posts and images where they are. Photos courtesy Terry Pannkuk

From: Terry Pannkuk
Sent: Saturday, September 02, 2006 2:33 AM
Subject: [roots] Smoothing out some previous "monkeying" around wih the access

I completed this “C” shape case today.  I decided to take some sequence pics of the cone-fit and two-handed compaction.
The referral had previously accessed the tooth and went a little wide at the MB line angle.  I sandblasted the pulp chamber
and placed a bonded core at the end.  All three systems were confluent with the ML smoothing into the D after coronal
flaring - Terry

Terry: very nice ...your obturation flow always looks so smooth. I noticed that you removed the mesial isthmus connector, so why not remove the thin wall between the merging canals for better cleaning? Is that unnecessary and leads to weakening the tooth more? But I understand about keeping it there, so they don't ask for discount since you only did "one" canal???...))) Thanks for the kudos on my pictures, but yours are much better than mine. I am working on it. - Ahmad
You don’t want to get carried away on a “C” shape. The furcation invaginates into the “C” and getting carried way with troughing the thin isthmus can lead to big trouble (i.e. perforation). When I visualize the confluence apically and note that it is clearly flowing and clean in the apical third I leave the isthmus (….and well enough) alone - Terry
I couldn’t agree more with that philosophy Terry. The isthmus is a bacterial harbor, but mechanical removal, although tempting at times when we’re armed with high mag and an U/S, could weaken or even be catastrophic to the structural integrity of the tooth. Here’s a case I did a couple weeks ago. - Rod Tatayn

Middle distal connected a common isthmus from buccal to lingual

Tempting to open up the entire fin, but WL films show apical confluence of canals to a single distal POE.

Cleaned and shaped canals individually focusing on cleansing the confluent apical third pack

Awesome pictures! I agree, coronal flaring facilitates apical enlargement ;-)) - Fred
Nice curves in mesial canal
Apical periodontits
Type III dens case
5 canaled molar
necrosis periradicular..
Triple paste pulpectomy
Endo cases - Marcia
"C" shaped canal anatomy
Psycho molar
routine case
straight lingual
Doomed tooth
another molar
Tooth #36
Instrument removal
Tooth #27
Mark Dreyer cases
Troughing case
6 year recall
9 clinical cases
Flareup after best treatment
Fred Barnett cases
Cases by Marga Ree
Glenn Van As cases
Sashi Nallapati cases
Cases by Jorg
Terry Pannkuk cases
New dental products II
New dental products
Difficult retreatment
Canal anatomy 46
Freak case
huge lateral canal
Separate MB canal
Crown infraction
5 year recall
Palatal canals
TF retreatment
Fiber cone
Bio race cases

Check Page Ranking