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Hi there folks: A while back Dr. Carr showed us some tremendous results with
nonvital bleaching in his TDO program.
Today I had this lady who presented with a lower right central incisor which had
endo (see the digital images where I took the radiograph, put it on a view box,
took my 990 Nikon of the microscope, put it in MACRO ( tulip setting) and then
turned off the lights in the operatory and left the viewbox on and took the shot).
The tooth was done 15 years ago and is asymptomatic despite the short fill.
THe photographs show that I removed some Gutta percha to get it out of the coronal
section of the of the crown.
I place some Etch , Bond and a flowable resin overtop. Then used a walking bleach
of 35% Peroxide ( Superoxyl) and used the laser to heat it up ( Argon). I then put
a temporary in with the very dry pellet in place and will see her in 3 weeks.
I didnt have enough time to get a shade guide out so the pics are as good as you
will get. I will send you them next time when she comes back.
As an aside, if she isnt 100% happy I am gonna put the dedicated bleach for the
laser ( has red crystals in it which absorb the green argon wavelength) to see if
this will help.
I used the Argon for around 40 seconds at 0.6 watts tonight on green wavelength.
Photos courtesy of Glenn - www.rxroots.com
R2 with Radiograph
Pre-Op with Dam
prepped tooth with gutta percha
is for etch
H2 flowable layer 2
Argon ready to fire
Temp in place
Facial view done
N4 Lowest Power
From: Glenn van As
Sent: Saturday, April 28, 2001 6:34 PM
Uzi et al: I apppreciate your constructive criticism regarding my bleaching case.
As a teacher at the University of British Columbia for 10 years in the faculty of
dentistry, I always tried to find something positive first to say about someones
dentistry and then afterwards tried to spend some time discussing how things might
have been improved.
At times I had to stretch with the students by saying things such as...........
"that was a very nice rubber dam"
" the anesthetic was very good in that case".
In dealing with the items I thought could be improved, I always dealt with it in a
professional manner and yet at times I let something slip that I didnt have a chance
to retract. The internet is wonderful in that you can proof your comments prior to
Having said this, the internet can be a wonderful place to hide. Criticism can be
levied without second thoughts, and some people chose to say things that they would
never say to another person face to face.
I have always mentioned that I am here to learn, am willing to take constructive
criticism and am happy to post my cases for review, and I even like it better when
someone criticizes my case and supports their argument with clinical cases. I think
we always should strive to be positive in our dealings with eachother, otherwise it
will become a situation where soon, few will post any cases unless they are absolutely
sure that their case is beyond reproach. I love for instance that Dr. Rick Swartz who
is a marvellous practitioner, posts a case where he asks for help (CaOH case) and
shows us a case in which things didnt work out as anticipated ( regardless of why).
I wont point fingers at anyone but the choice of words in a post should keep in mind
that we are all students here, willing to learn and improve and that all of us have
varying skill levels.
I appreciated your choice of words Uzi and how you approached the discussion choosing
your words carefully.
I wish everyone was so careful in their posts.........
From: Benjamin Schein
Sent: Sunday, April 29, 2001 7:26 AM
Glenn, you are as gifted with words as you are with images. I assure you that
everybodys attempt to criticize is constructive. We some times may sound sharp or edgy
but it is with the best intentions. For example Fred and I are always
discussing different angles of the same issue, and to some people it may sound as
quarreling or bitter fighting. I do however like Fred a whole lot and respect him
more. I know he feels similarly about me. - Ben
Dear Glenn: many thanks for your comment. When I post a reply I always try to look
for the positive points in every case. You are very well right when you feel that
undue criticism may cut off the will to post cases unless, as you mention, beyond
reproach. However, the same as you, I feel that I am a privileged student to be
together with a group of such gifted endodontists and dentists who are general
practitioners or specialists in other areas. It is unbelievale the thrust that this
forum has given me in my practice, I have had the opportunity of viewing beatiful
cases that encompass every aspect of the dental profession, go back to my cases and
analyze them to find out why is it that some cases just dont seem to look right. I
have seen cases that otherwise would be hidden under the desk so nobody would point a
finger at us and making nasty comments about our ability. If you look at Sashi's cases
you can imagine also how his drive has induced him to post beautiful cases, very nice
photography etc, and he is practicing in an environment which most of us are asking
ourselves how the hell does he manage?
In any event. I hope to see your postings and may tell you that envy you a lot.
(In the good sense as Dr. Schein has mentioned). I wish I could have all the new
technology in my hands at least to be able to play with it and decide afterwards if it
is worth it or not, but still have a first hand impression.
My congratulations once again - Uzi