Toothache and extreme cold sensitivity - Courtesy ROOTS
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From: Rob Kaufmann
Sent: Tuesday, December 23, 2003 5:05 PM
Subject: [roots] Whats up with this molar?
Here’s a weird one I did this morning. 18 year old female with history of recent
composite on lower left 2nd molar. No history of Ortho. Current complaint is
toothache and extreme cold sensitivity. Referral says he had near exposure.
(Translated: He’s exposed it no doubt.) Vital case, obviously. No periapical symptoms.
Pre-op film looks very average. Looks like a slam dunk. I get into the tooth and the
MB canal reads 14 mm with an apex locator while the ML is closer to 19 ! That MB file
is a #25 as while I’m expecting some resistance as it goes around the mesial root
S curvature there is none. Where’s it going? Something fishy is going on here.
I take the WL film and I’m seriously LONG in the MB. It’s straight out the Mesial
almost. I check the access again for possible MB perf NO way.
I treat the ML and D and leave the MB to last. The foramen size ends up as a #55.
ML and D done with ProTapers, hand S files and K reamers. MB, done with hand
instruments only. Dried with paper points and got exactly the same WL. Custom cone fit
the MB with chloroform dip and packed with Warm Vertical BU style. You can see the
sealer track from the hole I poked in the PDL with the original WL file. It looks
VERY much like a perforated case but it isn’t. Anyone else ever see one of these?
- Robert M. Kaufmann DMD MS(Endo)
Dear Rob, Look at the pre op film that you are going to see a lesion there prior your
treatment. That is why I like to take at least 3 pre op films.
It can be a root resorption? - Carlos Murgel
Nice Carlos!!!! Very nice!
I always talk about this in my courses! I like to discuss this with colleagues.3pre op
films (periapical)!!! Ortho, mesio and distal! Our challenge: three dimentionality!!!!
So I think it is necessary to do an anatomical observation (SLOB rule).
It can be an anatomical variation????? - Márcia Valéria (Brasil)