Endodontics

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Unbelievable ! - Courtesy ROOTS
The opinions within this web page are not ours. Authors have been credited for the individual posts and photographs where they are. Photo courtesy: Scott Simpson - www.rxroots.com
From: Scott Simpson
Sent: Thursday, September 14, 2006 3:54 PM
To: ROOTS
Subject: [roots] Unbelievable

This patient came to me for a consultation today seeking a second opinion. He reports having had #8 recrowned relatively recently. Now they are recommending extraction and fixed bridge - Just unbelievable! - Scott Simpson

Scott Ö Did you get any photos? Both of these should be retreated in my humble opinion, IF they arenít fractured. Terry Periodontically they looked good - no significant pocketing (2-3mm) and the tissue was surprisingly healthy around this crap - the patient is in his 20's and is healthy We will know more once they are dismantled. I suspect they can be restored still. I agree about getting rid of the evidence... sorry no photo's yet - Scott Simpson Nice fit on those crowns - Guy Scott, I call this "Get rid of the evidence". I'm surprised they didn't recommend Ext of both centrals... It's obvious that both of these teeth should be Retx'd and new restorations made that actually are ON tooth structure with some possible crown lengthing....either soft tissue or bony if needed..but this presumes the perio is in good shape. Scott, how hard would it be to put 2 implants in...your obvsiously gonna be fighting the "black triangle" since you don't get papilla in. I could also see putting in one implant and cantalevering...but it's a central..so I'm not too sure about the longevity here - Joey D Scott, Miserable work. This guy shouldn't be doing endo, posts, crowns or any type of dentistry! The apex of #8 is grossly underprepared( you can see the thin master cone outlined by the real diameter of the apical canal) and the cone in #9 is buckled in the apical 3-4mm. They do have a nice shape and taper though. I don't blame this poor work on the technique, Terry or anyone else. It's the clinicians fault. It's important to distinguish between the failings of the clinician and the technique. I won't seize this opportunity to trash a tapered instument technique in this easy straight canal but it could have been done much better with LightSpeed/Simplifil but in someone elses hands - Randy Ortho extrusion may be an option but temporization would be a problem. Be sure to check the position of the lower incisal edge to see if you have enough room. If you extrude them too far the cervical of the crown on maxillary centrals often gets narrow real quick due to the taper of the root. These particular teeth look like they have 2-3mm of extrusion to work with before the narrowing becomes a problem - Randy