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

From: John A Khademi, DDS MS
Sent: Tuesday, November 22, 2005 9:06 AM
Subject: [roots] Why your endodontist is an elitist (fill in the blank)

Not from the archives. This is last Thursday and 1/2 of Friday..days I do not do consultations. A consult day would be
worse. Much worse. This is in support of Terry's Post about "abuse after abuse, day after day." If there is interest, I'll
dig up the consult day I posted to TDO. Case#1: Pics 1-5. Ann came in with Nec/AAP #19, secondary to the RD placing a huge
monoblob of composite for the BU, failing to take into account polymerization shrinkage, and then failing to get the crown
margin down there. We grossly overextended the access to the distal to remove the DK, placed geristore, then finished with
bonded amalgam. Case #2: Pic6. 13 y/o Charley (who is very cute) took a digger and avulsed #9 a year ago. On an emergency,
a dentist replanted the tooth, placed an archwire and told her and her mom to see his regular dentist and get a root canal
in no uncertain terms. Her regular dentist (who happens to be an idiot) took the archwire off and..that's all folks. I
called him and he said "everything looked fine" Her orthodontist is in a panic. I told him we could almost certainly keep
the tooth for the duration of ortho, and maybe do a forced eruption when her jaw growth stabilized. Case #3: Page2 Pic1-4.
The brutality should be obvious and need no further explanation. Fourth one in a row from this RD. Time for the "phone
call" :-(( Case #4: Page2 Pic5. George came in complaining of pain LLQ. Pulp and periapical tests revealed Nec/AAP #18
secondary to a fx. A bad fx. A very, very bad fx. RD #1 wanted to crown the tooth. RD #2 knew something was not right, but
was not sure what, or which tooth, so he referred the case. No one bothered to detect the 9+mm narrow defect on the distal
of #18. No one looked at #31,or any of the other teeth in his othewise healthy mouth that had fractures. Sorry - John

John: I guess my questions are how many of the problems are: 1. Dentists who just dont know any better 2. Dentists who just cant see any better 3. Dentists who just do care to see or know any better...... Its one of the three in my opinion. Category 1 and 2 can still be helped if the person wants to learn and if the endodontist is open to helping..... Category 3 is a write off. Dump them if they are a referral and deal with those who can be educated. Gary Carr has alot of disciples from TDO and I seem to remember that he has 6 dentists only who refer almost everything to him. He has created his practice.........you could do the same. Remember the old saying......If its meant to be.......its up to me - Glenn

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