Argon Laser to reflect tissue on tough tooth

This topic is empty.

Viewing 5 posts - 1 through 5 (of 5 total)

Author

Posts
June 3, 2003 at 6:08 am #3313 Reply

Glenn van As
Spectator

Hi Folks: This was a weird case. Nice lady came in and needed two endos so she went to my local endodontist and his associate took on the case. This fellow just joined the practice but is an experienced clinician from back east. He had alot of trouble with both endos.
Only able to find 2 canals on both teeth….well I know more are there.

The lady came in today with both temps almost all out (happened on the weekend) and a large crack asymptomatic in the 2nd molar and a badly broken down tooth on the first molar. It needs osseous and also lots of work to save it but first I need to temporize it and also find the 3rd canal on the mesiobuccal.

I troughed a little with ultrasonics and wham down it went. APex locator showed it wasnt a perf and that it was in the canal. At that point I wanted to isolate so I quickly built up by hand the case with Point 4 in the base which is a very plastic flowable. I used the Argon laser to reflect the tissue on the buccal at 1.0 watts CW and then quickly did a caries control type buildup to keep the saliva out.

Opened up the canal and put a temp. I am thinking seriously about going back and finding the second canal on the mesial root of the 2nd molar .

It has a big crack but its not symptomatic.

Cool case and on its way to endo, osseous, posts cores and eventually some crowns.

Only had 45 minutes ( less actually) to do something today so this is what we accoplished.

Hope you like it and you can see what a HUGE help the scope is……

I was proud of myself for this one today.

Glenn

June 4, 2003 at 2:45 am #10119 Reply

ASI
Spectator

Nice treatment, Glenn. I guess had the Cl V amalgam been removed enough in the access, the orifice may be located by the endodontist.

How do you deal with the fee in a situation like this?

Andrew

June 4, 2003 at 6:15 am #10120 Reply

Glenn van As
Spectator

Hi Andrew………the amalgam fell out and still they werent able to locate the MB canal but we all have those days.

I am picking up the tab as the endodontist has done a ton of things for me……..its the least I can do.

Cya

Glenn

June 4, 2003 at 7:18 am #10122 Reply

Lee Allen
Spectator

Glenn,

Nice case and service to your patient. I love seeing those pictures you get ! Especially the one with the crack in the second molar. My experience has been dismal with those in the long run. I would expect in the near future to see a perio lesion (small chimney-like defect) develope at the least and at worse have it split in 2 causing much discomfort.

If you really want to keep it, since the last molar has the greatest occlusal stresses, I would put an immediate ortho band on it to splint the tooth before you get the crown in place so Murphy does not get busy with your plans.

Good luck. You always come up with the most interesting cases. I started using the Tetrac flowable in class I preps after seeing one of your posts and it has been wonderful. Thanks for the tip.

June 5, 2003 at 5:25 am #10121 Reply

Glenn van As
Spectator

Lee ……thanks.

I try different things……am willing to put my neck out and am fortunate to be able to take photos through the scope easily ……..

The flowable for small lesions works nicely. I like Point 4 flowable for the Class Vs and it is very plasticky…….works nicely.

I hope that with time we can all get a chance to meet……..

I enjoy this forum for what I learn…..I have to redo the endo on the 2nd molar and will try to get a temp crown or an ortho band on the tooth………

Thanks for the advice………

Cya

Glenn
Author

Posts

Viewing 5 posts - 1 through 5 (of 5 total)