HOPELESS PROGNOSIS?: Based on the pre-operative PA, many dentists would suggest to their patients that this tooth has a poor or hopeless prognosis. Clinically it had a 12 mm probing to the apex and radiographically it has a large apical lesion that was confirmed to extend around the entire MB root on CBCT. Even more concerning was that the lesion was not well centered around the root apex and was localized around the lateral root surface. Frequently patients like this are told “This tooth is fractured, it has to come out” without even attempting endodontic treatment. This case presents a great […]
Tag: PA
HOPELESS PROGNOSIS?
Proper Diagnosis of Non-restorable Tooth Fractures
PROPER DIAGNOSIS OF NON-RESTORABLE TOOTH FRACTURES
PROPER DIAGNOSIS OF NON-RESTORABLE TOOTH FRACTURES: This patient presents to our office with attempted excavation of an existing restoration and to evaluate the extent of a fracture in the crown (the patient had an MOD composite restoration). It was known by the restorative dentist that the tooth was necrotic (Note MB root lesion). For whatever reason, the dentist decided at this point to temporize and send to us for case management. BEFORE clinical exam and considering CBCT, we had noted several key factors in the PA and BW radiographs; the most important facto was the presence of bone loss on […]
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Why Does My Endodontist Sometimes Fill Short?
WHY DOES MY ENDODONTIST SOMETIMES FILL SHORT???
WHY DOES MY ENDODONTIST SOMETIMES FILL SHORT??? As endodontists, we attempt to fill to the anatomic constriction in every case. Sometimes this portal of exit can be quite far from the ‘radiographic apex’ due to dilacerations, a tooth’s anatomy, or angulation of the radiation source with respect to the tooth. This is why we heavily rely on electronic apex locators which are considerably more accurate than conventional PA images. Carefully inspect the images below. The pre-operative PA looks like the length control is nearly perfect; however, when the tooth is extracted, you can note that the thermafil carriers are actually […]
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CBCT PRE-SURGICAL ASSESSMENT
CBCT PRE-SURGICAL ASSESSMENT
