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 Post removal case
The opinions within this web page are not ours.Authors have been credited for the individual posts where they are. - photographs courtesy: Randy

I'm forwarding this case to roots from randy Hedrick, who most of you will recall participated with roots
until recently.  Randy did this very difficult double post removal, has placed it in powerpoint format,
and has included a narrative to explain how he accomplished treatment.  Note the additional use of
mounce's discovery burs - Gary

From: Randy Hedrick
Sent: Wednesday, January 10, 2007 4:19 PM
To: gary l. henkel d.d.s.
Subject: Case

Here is the case and narrative.  I could not have done this case without a microscope - Randy

Gary, You can relay to Randy that this is very nice endodontic management of a difficult case. "I could not have done this case without a microscope." Randy and I have ground gears since day one. Five years ago he would have argued me blue about the need for a microscope, just as he argues with me now about other things. I think he is teaching somewhere in FL. See kendos "Life or Death" post about educators. Anyway, I know this, because five years ago he did not have a microscope. You would think people would be able to put two and two together when people like Pannkuk, Carr, Ruddle, Clark, vanAs and countless others are saying the exact same thing. This case is not done, however, and returning it to a clinician who cannot execute the restorative as well as the endodontics was done will doom this tooth. The only hope here is an endo/restorative casting. I don't recall if I posted this one from last month. The restorative managment of these compromised cases will dictate the outcome. I am recalling over 100 of my burliest, stupidist, nastiest cases from my first year of practice (2001). We have lost two teeth so far. One made it at least 2.5 years on an Altzheimers pt before extraction. It was never restored. The other was a bicuspid PBU bridge abutment. The RD who made the bridge is a clown who I no longer work with. It took several phone calls to their office to even get the extracted/not extracted story straight. I'm still not sure. As endodontists, we have lost control of these most difficult cases to the world of 7th generation sloppy crappy bonding. The microscope equipped, restoratively versed endodontist should be the guy restoring these teeth. Do you think I would have tried to "drill out" the gold post and place a stupid SS post? Who did that? Do you think they had a scope? :-)) This case below generated some controversy on DT. Of course, basically no one posted any cases to contradict what David Clark has taught me, or posted cases to show how it could be improved. One of the guys complaining about the casting limiting his restorative materials options did post a nicely done lateral incisor crown. I then asked him to post his radiograph. He THEN told me it was a vital case - John A Khademy DDS hey, five years ago i didn't have a scope either. as far as i'm concerned, that is all in the past and not relevant. he did a nice job on the case, documented it extraordinarily well, and was good enough to share it. that's good enough for me. He's been to amed, and as listed here is a strong advocate of the scope, as are we all. nuff said about that as far as the arguement about it not being done, no arguement there. it has to be restored well or randy's efforts go down the porcelain commode. and i share your concern about the double poster being the one to whom the case is returned. as you well know, this has been an issue for the endodontist since the beginning of endo, who does the buildup. i've stated many times i have an advantage over a lot of endodudes in that I have to make that decision only with myself, and i'm usually a very agreeable kind of guy. and i agree that endo as most rooters and tdo'ers see it does not end until the core goes on. - Gary