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Endo tips    Better Endo    Endo abstracts    Endo discussions

Mesial middles- Courtesy ROOTS
The opinions and photographs within this web page are not ours.
Authors have been credited
for the individual posts where they are. -

From: John A. Khademi, DDS MS
Date: Jul 19, 2005 1:57 PM
Subject: Re: For Benny, mesial middles from yesterday and today

Mesial middles from yesterday and this morning.

Colton I posted on the metal crown access post.  It is a retreatment case.

Edna is the second one.  I wrote about her earlier in Terry's diagnositic post.
Her lower second molar was necrotic, and was probably the only source of pain.
We are two stepping her.  I will probably fill the molar and prep out the bicuspid
(that did not need endo) and the anterior (that did) at her next visit.

Lori was an irreversible pulpitis and got one-stepped.

The fourth one is Rob.  He had irreversible pulpitis secondary to a cracked DL cusp
and got one-stepped.  He lives in Telluride, over 2 hours away.

The debate about mesial middles strikes me as somewhat like the debate about the
MB and MB2 joining.  Rather pointless.  I put in the pic of Rob's unprepared
mesial middle, and you can see the tissue in there.  Who care's if it is a 
separate canal, fin, isthmus whatever.  There is tissue in there if it is vital, 
and bugs if it is necrotic. How one can look at that tissue, (which actually bleed 
when I poked at it with the Maillfer micro-opener) and forumulate any argument 
for not getting it out that is congruent with the biologic basis of endodontic 
treatment is beyond me. :-)

Calling it "arbitrary" as long as the canals that you found were shaped nicely 
does not resonate when pus gushes up the "canal, fin, isthmus, whatever."  
However, if you have never seen this happen, then it must not be so. 
(The "I'll believe when I see it" mindset!) :-))).  You won't see it until you
believe it.  Right DanS? :-)))  - John A Khademy

Where are the money shots? finals? Access shots are the sizzle without steak. :) - Terry

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