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From: Marga Ree
To: ROOTS
Sent: Sunday, November 30, 2008 5:21 PM
Subject: [roots] Tough 3 canaled lower premolar
A difficult lower premolar, not only because the lack of sufficient
tooth structure. I made a pre-endo BU, after which I was able to put
a clamp on the tooth. DB and lingual were not difficult to find, but
mb was located very eccentric, it took me 2 long sessions to
complete it. Patient is scheduled for a crown - Marga
Great case, Marga. What post did you use? - Guy
Thanks Guy, I used the smallest post I have in my drawer, Fibrekleer
tapered post 1,25 mm by Pentron. The canals were so narrow, that I
had to remove some tooth structure to accomodate the post. Usually,
I use the existing space to insert a post passively. - Marga
Hi Marga! Thank you for sharing such a great case... what do you
consider a "long session"? - Chris
Hi Marga, well the immune system doesn't know the level of this
filling! Turned out well.
awesome, thanks for sharing! - Abdul
Thanks Chris. 2 sessions of 2 hours each......that's long, no??
....:-)) Not for me, I can do a 4 hour session without any problem
if needed, as long as there is good music on the radio, but for
the patient, I think 2 hours is max - Marga
Marga , this is a wonderfully treated endodontic case but I wonder
about the restorative prognosis of a tooth like this. There appears
to be limited tooth structure remaining and the restorative material
is very close to the osseous level clinically.
What do you think of how to best restore this, on these I hate using
a resin post but in my hands most times these fracture away after
crown placement. Great endo though.....yikes tough too! - Glenn
Glenn, You are right, the tooth is compromised because lack of tooth
structure. This was a dilemma. If is wasn't my husband who is going
to do the crown prep, I would for sure have recommended extraction.
I considered using more than one post, but the canals were so narrow,
that I had to remove tooth structure in the widest canal to accomodate
the smallest post I have in my drawer.
Anyhow, Paul will do a crown lengthening before prepping the crown.
- Marga
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