Craig Wrote on Dec 14:
NICE WORK…… But Why remove the relatively "normal" looking distal root when you have a wicked curved mesial root like that? Although you got a white line to the end did mean you cleaned it and didn't mean you didn't have a lateral canal that was causing issues………….
Would seem logical to me that if that case were going to demo a failure, it would demo it straight in to the furcation like was seen……….………..
I would have don't apical surgery on the mesial root instead of a root amp on the DB root………… Thoughts? - Craig
OK Craig. Here's ther recall - taken today.
The Case was originally done in Oct of '02. This is 3+ years later. The DB root amp was done about 6 months after the initial treatment. I'm pretty sure if the problem was related to pathology in the MB root we would have seen more radiographically by now. This tooth was periodontally compromised from the get go. (The mobile wisdom tooth distal to it didn't help matters with food impaction!) Furca involvement is there - no doubt. But the patient's tooth is firm, he's doing a decent job of taking care of it - considering the altered buccal contour.
I get the impression that attempted surgical treatment of the mesial root would have been a disaster. It would have necessitated removal of a lot of the support for this tooth - especially if I wanted to resect to a point where I could get a good retroseal. Once I opened the area surgically and found the furca involvement, I probably would have amp'd the whole MB root - which would have likely doomed the tooth to Perio failure. Its not the prettiest case overall but I simply used it as an example of some wild anatomy that can be negotiated withe some perceverance and a bit of luck .- Rob
Thanks for holding a grudge….. ...you aren’t stalking me now are you???.....
It looks pretty nice. The xrays are a little hard to visualize all the details required to call it a 100% success but my thoughts are at least it hangs in the 99.9% bracket…
I agree with your comments about removing the MB root. Doing that would have led to a possible esthetic problem as well with the sinking in of the bone when healed…..
Thanks for following up the case! Interesting! - Craig