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Endo tips    Better Endo    Endo abstracts    Endo discussions

The opinions within this web page are not ours. Authors have been credited
for the individual posts where they are. Photos courtesy Terry Pannkuk - ROOTS

From: Terry Pannkuk
Sent: Thursday, January 19, 2006 12:00 PM
Subject: [roots] Fracture Exploration and Dissection of a Pulp Stone

I spent quite a bit of time on this case today.  It was either an endo or 
an extraction setting up for a two-stage implant.  I took multiple pictures 
for a routine access lecture series.  I needed something basic for 
maxillary molar demonstration.  I spend quite a bit of time dissecting the 
entire pulp stone out of the chamber.  I rarely if ever have seen that a 
previous clinician would perform a complete access and stone removal when 
I retreat molars of this type.  It takes quite a bit of extra time, but 
itís inconceivable to me that someone can make an appropriate assessment 
of crack extension without doing this and composite finishing burs are 
the only way I know that one can polish the floor smooth
enough to completely see the extent of the cracks - Terry

Terry, Nice case and nice pics. You've been using the scope longer than I have so maybe you have already tried this and can give me some feedback. I have been using an acid etch of either liquid EDTA or a gel etchant on the pulp chamber to remove the smear layer created by using burs and have found that isthmuses, cracks and canal orifices seem to be more obvious. I use the little fuzzy, plastic micro-brush applicators to scrub around the chamber with etchant for about 20-30s and rinse with a Stropko. What has been your experience? - Randy Hedrick Randy, I do the same, but also have a chairside microetcher and sandblast it before the chemical etch. Iím extremely paranoid of dentin-debonding; the reason Iím so skeptical of hype of Resilon. - Terry Dear Dr. Terry, why did you leave the crack on the buccal side untouched? did you feel that it will not create any problem in the future if it is left without a crown? - Vipin

Protaper flaring

6 yr old Empress

Cvek pulpotomy

Middle mesial

Endo misdiagnosis

MTA retrofill

Resin core

BW importance

Bicuspid tooth

Necrotic #8 treatment

Finding MB2 / MB3

Deep in a canal

Broken file retrieval

Molar cases

Pushed over apex

MB2 and palatal canal

Long lower third

Veneer cases

CT Implant surgury

Weird Anatomy

Apical trifurcation

Canal and Ultrasonics

Cotton stuffed chamber

Pulp floor sandblasting

Silver point removal

Difficult acute curve

Marked swelling

5 canaled premolar

Sealer overextension

Complex anatomy

Secondary caries

Zygomatic arch

Confluent mesials

LL 1st molar (#19)

Shaping vs Cleaning

First bicuspid

In Vivo mesial view

Inaccesible canals

Premolar 45

Ortho and implant


Lateral incisor


Churning irrigant

Cold lateral

Tipped to lingual

Acute pulpitis images

Middle distal canal

Silver point

Crown preparation

Epiphany healing

Weird anatomy

Dual Xenon

Looking for MB2

Upper molar resorption

Acute apical abcess

Finding MB2

Gingival inflammation

Irreversible pulpitis

AG BU ortho band

TF Files

using TF files

Broken bur

Warm technique

Restorative prognosis

Tooth # 20 and #30

Apical third

3 canal premolar

Severe curvature

Interesting anatomy

Chamber floor

Zirconia crown

Dycal matrix

Cracked tooth

Tooth structure loss

Multiplanar curves