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Tooth # 46 : Narrow escape - Courtesy ROOTS
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for the individual posts where they are. -

From: Marga Ree
Sent: Sunday, August 31, 2003 1:16 AM
Subject: [roots] Re: a blast from the past

I have encountered a similar situation: the crown on tooth 46 
had been made recently, and the patient developed symptoms, 
radiograph revealed AP. I accessed the tooth, but wanted
to keep the opening as small as possible. I wanted to try the 
new LA Axxess Burs of SybronEndo.... and found out that I was 
0,1 mm away from a furcal perforation, it was a very narrow 
escape.  It was 100% my fault, this patient was very cooperative, 
my assistant did an excellent job, as always, and I almost ruined 
the tooth. I covered the very, very thin furcal roof with composite, 
and with a lot of frustration and self-reproach, I finished the RCT. 
These situations make you feel very humble, and this happened not
4 years ago, but 2 months ago...........  Marga

Here is one of my first posts to Roots.i thought it should be fit to present it again hopefully, if not to stimulate some discussion but also if not for my own therapeutic purposes. There is benefit to reminding ourselves where we have come from and hope not to go to again. Hiding things under a rock is not the answer. At the summit meeting I think my favorite speaker was Cliff Ruddle. I liked him best not only because of the information he relayed but also because he purposefully mentioned that he makes inflammatory comments to people to throw them off balance. He said that he has found that in doing this that he can more quickly determine an individual’'s true character by their reaction. I agree with him 100%. We all eventually and repeatedly fall victim to this technique rather it being accidentally or purposefully used on us. Here is a case/patient that reminds me that ability can be over-run by poor management of self. Here is the case where I fell victim to being thrown off balance by the patient and my surroundings. This case reminds me of the tough times I had getting started right out of school. Times we all easily forget. At the end of the write up I mention that I continue to struggle on him the second case included is the root canal I did on the same patient right after I finished that bridge - Craig Barrington

CRAIG, If these things must happen (and probably they must, so that we learn from them more than we do from success), they´d better happen to the fellows that almost deserve it, like this Mr-Curious............Marcos Arenal MARGA, Thanks for sharing your own experience. As I said to CRAIG, we go 10 steps further in our learning when we err, and only 1 when we succeed - Marcos Arenal Marga, I now make the same access through a crown as an uncrowned tooth. Too great a chance of doing just this with an inadequate access - Guy Hi Marga ! Everything can happen, we say only the rabby doesn't have those problems. Anyway why did you put the rubber damn clamp on the distal tooth, in order not to chip the new crown ? I usually use #14 clamp and nothing happenes to the crowns. Does the tooth have bifurcation on the D canal or is it some small transportation ? - Thomas P.S Just finished another 3 rooted lower premolar, and it came out very nicely, hopefully I will not be lazy and scan it soon.

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