Monday, February 13, 2012

Root Canals


Well folks, as you can see, or probably have already figured out, I didn’t get the Miami Dolphin gig. They picked “the tall guy,” which I’m cool with. They just have to realize that they had a true dol-fan that they passed on. Honestly, I thought I would get a call for maybe an assistant position. I guess it was the “west coast” offense they wanted to install (which I know nothing about).

So, I was driving back home to Ocala from the Panhandle of Florida this weekend. I-10 seems to go on forever (I think it was just a coincidence that the air smelled funny as I went through Tallahassee, hehe), and it gives a person a lot of time to think.

One of our reps was in our office last week helping us organize our endo armamentarium. Now, through the years, I have had several different endo kits. After dental school, I was told that the way we were taught is outdated and this is the way I need to do it. I bought all of this new equipment: files, motors, gutta percha, etc. A year went by before I was told that there was a better way to do endo.

Evidently, someone had done some research somewhere and the results showed that what I was doing didn’t work. Well, I didn’t want that! I did some exchanging and buy-back deals and then I was set with the “right system.” Ah, finally I was doing something right.

Time went by, and guess what. You can see where I am going. Today I am on my 8th “right system.” I agree that it’s a little confusing. Constant taper, different tip size, same tip size, different taper, single cone, lateral condensation, continuous wave, vertical condensation, back fill, biogeneric cement, and on and on.

I have realized that (I know I am slow), for the last 17 years, I have been maintaining teeth that have been endodontically treated by people other than me. For instance, many patients in their 80s have a mouth full of silver points. Sure, some of them had to be retreated. The root canals I performed using all the other 7 systems before the one I’m using now seem to be surviving. I didn’t think they were good and yes, some of those had to be retreated.

My endodontists have had to retreat some of their own endo over time as well. I see radiographs sometimes that make me wonder how that worked, but it was done 20 years ago and its fine. I’ve seen hundreds of endodontically treated teeth that look like they were filled with a 15 accessory point, and they seem to be fine.

I’m beginning to believe that identifying the canals is 90 percent of it, and almost everything else is pretty forgiving. Now, granted, doing tooth number 15 that distally inclined on a patient that gags takes amazing skill and talent; I am thankful for my specialists. Am I off on this?

Have a great week.


Anonymous said...

this message is for Dr Scott...

Hey Dr Scott
i understand what you mean about the various and changing endo techniques....
i use a reciprocating contra angle and hand instruments for canal prep and shaping and then paste injects from medidenta to fill the canals, followed up with gutta percha.
i would sure like to consider one of the newer/better techniques but the cost and learning curve have dissuaded me.
question for you.....r u super happy with your technique??
and what exactly do YOU use??


Marshall S. Dicker DMD, FAGD

Anonymous said...

I don't think you are off. You are pretty close to being dead on

ibdrillin said...

I cant say I am super happy, but I am using Brasseler right now and it seems to be working. But then again, they all worked.


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