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From: Terry Pannkuk
Sent: Friday, December 18, 2009 9:50 PM
Subject: [roots] Working on the Railroad-CBCT
Here's an interesting patient that presented on recall. The patient and her dentist are amalgam-phobes.
I really wanted to pack in an amalgam core after I treated the endo on #2 9 years ago. The crown was intact after
the endo treatment but it had been severely weakened by pins and other WMDD's (weapons of mass dentin destruction).
I wasn't allowed to follow up the endo with a build-up so I didn't. Predictably the crown fell off a year ago and
the patients dentist in an attempt to save the patient money made a hole through the occlusal surface, pounded a
couple of gold railroad spikes into the MB2 and P canals and recemented it back on, all with a rubber dam
I'm sure. :):):):):):):)
The patient presented a couple weeks ago with vague biting sensitivity in the area. It was not localized.
Both #2 and #3 tested equally sensitive (slightly) to percussion and biting. The PA was inconclusive although
I suspected a lesion on the MB root of #3. I prescribed a CBCT and these are the images I got.
#3 had been treated by some unknown clinician at some unknown time prior to 2000, Below is an additional coronal
section showing the MB1-MB2 area of the MB root of #2. - Terry