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The opinions within this web page are not ours. Authors have been credited for the individual posts and photographs where they are. - www.rxroots.com

Not a trophy case

From: Mark Dreyer To: ROOTS Sent: Tuesday, August 30, 2011 11:39 PM Subject: [roots] Case just now It's been a while since I posted a case. I certainly don't think this is a "trophy case". My errors, include not certain I nailed the WL on the P root as my shapes are usually bigger than that apically. Also, I think the mb2 meets with mb1, but I could never get them to drain together, and I was at the point in my instrumentation that if I pushed much more, I felt I might create my own canal, so I left it as is. I think perhaps I could have preserved some more PCD, however I'm not convinced that I didn't do what I had to do given the extent of the caries. I'm sure stricter followers of the church of JKology will disagree. :-)) I figure I might be able to avoid dental purgatory since I did the buildup and as a bonus used rat poison! LOL I did send a note to the referring doc questioning the need for a crown on this tooth. Any opinions on that?

Mark, As a general dentist that does most of my own endodontics, I appreciate seeing what others more experienced and trained can do with difficult situations. As far as a crown for this tooth, I might suggest that I would do at least an onlay to cap the cusps, because I believe the chances for fracturing one or more of them is significantly increase from this treatment, but that is just personal opinion and I have no scientific backing. All that I can tell the patient is that faced with the same choice for myself or one of my family members, I would at least do an onlay. Of course, I would not use amalgam as a core build up, but again that is personal preference. I just donít want mercury in my office. It has more to do with the potential, but unproven to my knowledge, problems with working around dental amalgams. After 40 years of practice, much of what I do is just because. I do try to read and follow more learned colleagues; however, sometimes our illustrious colleagues on ROOTS talk way over my head. That isnít their problem, I know, but again at my age, I just hate having to spend hours trying to decipher the true meaning of some posts and decide upon who is taking whose high ground in the more effective and efficient endodontic treatment. Thanks again for the post. - J. Terry Frey DDS crown it! - Craig Barrington Mesial marginal ridge is already cracked and you don't want to crown? - Robby rabi

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