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LL 1st molar (#19):irreversible pulpitis :Ca(OH)2 dressing - Courtesy ROOTS

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From: Ahmad Tehrani
Sent: Wednesday, April 18, 2007 6:02 AM
Subject: [roots] Maintaining the curve

LL 1st molar (#19) irreversible pulpitis ,Ca(OH)2 dressing. 
No symptoms or discomfort at obturation  appt.
Only used pre-curved hand files, not to transport or perf 
the delicate mesial roots. flowable composite over the 
orifice and Core paste for bulk buildup - ahmad

Very nice work Ahmad - as usual :-) You could have probably get away with rotaries, just not to the terminus. I also don't have the nerve to use them in hard cases, sometimes I used them just to get some faster body shape. - Thomas Very nice handling of a tough tough case. Did I mention that was a tough case? :-)) - Mark But as an endodontist you know these aren't really hard cases if you study the pre-op x-rays carefully and have a plan of atach before you pick up an instrument. The hardest thing is to do is resist the temptation to stick a rotary file down these roots. Once I had the canal patent to a size 25, I saw no need to roto rooter it. Took a page from our friend Terry P. and started enlarging with pre-curved K-files. Then the shapes were pretty much done. Throw in couple of GG burs to accomodate the Obtura tip and Voila. Now the 2nd molar is totally asymptomatic, even with uninstumented canals, poor fill and open disegard what i said because despite all of mental gymnastics we excercise on line, the body and biology is the ultimate equalizer. I just wish I had that mojo in some of my cases...)) - ahmad Amen to the rotary comment. I'm actually glad you posted your case yesterday. I have a similar case coming up, and when I looked at it I immediately thought of yours and came to the same conclusion of no rotaries in the mesials. I'll post it when I'm done. - gary WHAT A CURVES... NICE JOB CONGRATULATIONS...DR. ALEXANDER GARCIA J. Thanks Dr, Garcia. The curves wee maintained from the very first handfile ( #6) I placed in the canal to the last. My asst. duplicated the curves in the rest of the files she was handing me. She is my eyes and sight while I have my head stuck in the scope. Our clinical asistant is one of the intangible (which makes or breaks us) we seldom mention in our case presentations. - ahmad

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