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Sinus tract 13 (US# 6):Crack

From: Winfried Zeppenfeld To: ROOTS Sent: Thursday, February 05, 2009 1:08 AM Subject: [roots] crack du jour New Patient showing up with sinus tract 13 (US# 6). Looking at the X-ry, Ithought it might be fractured, but probing was within normal limits, so I opened it. After removing the gutta percha, there was a clearly visible fracture, now also on the X-ray. This tooth looks like a compaction victim to me (because it's only fractured apically). What do you think? - Winfried

Winfried,This looks like a "thin walls" victim to me. The funny thing withendodontists is that they are the only guys that blame themselves for a problem. Our surgeons always blame everyone but themselves for a implantgone wrong and perio guys always blame the patients.That's probably the reason that at least in Israel we are the garbage binfor every other people mess. And I will better shut up about what we earn compared to those other guys. Any force on a tooth like that can cause a crack - Thomas Thomas, I don't blame myself, I didn't do the endo ;-) . But that's what I like about endo: no patient screws up my work with his oral hygiene, and no technician srews it up with poor margins despite a good impression, missing interproximal contacts, inadequate tooth shape or esthetics......Winfried I wish, My "good" referrals easily screw up my cases with a bad post&core anytime . That's the disadvantage of being a specialist and not doing your own post & cores - Thomas Thomas, I always do the adhesive buildup after my endo before I send the patient back to the referral. But I only do some work on a referral basis. Basically, I'm a GP who spends about 40% of his time with endo. Some patients refer themselves. The rest of my work is (adhesive) restorative, crown and bridgework, dentures and an increasing number of implants - Winfried Hi Winfried, are you doing the surgery phase as well? - Kendel Hi Thomas Some endodontists do make their "own" post & core. I think that in many cases this is beneficial not only for the patient but also for the referring dentist. Maybe we should include more training on these restaurations in post-graduate programs and try to "educate" the referring dentists that this is better. I know that in the Netherlands the referring dentists will usually won't mind, and in most cases will be pleased if I do the post & core. The situation in other countries may be different of course. - Hagay and my crack do jour:) (yesterdays) - Sergiu

Hi Winfried, I totaly agree with you - "looks like a compaction victim". I have the same case, but I now who made this compaction - it was me :( I'm always looking for your cases - your presentations and documentations are extremely good! - Ivan Yovchev

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