The likelihood of this case type failing and this patient extracting this tooth in the future isn’t from recurring infection or what we think of as a true Endodontic failure. It’s from tooth fracture, specifically cervical snap off; a restorative failure. These tend to happen down the road and the small details for long term success are often overlooked. – If the only intercuspal coronal tooth structure remaining after interproximal caries removal is directly over the root canal, you can preserve this tooth structure by changing “ideal access” to a caries-directed access. Convenience form has no role here. – A fiber post is used to help retain the restoration and to some degree minimize the risk for cervical snap off. A fiber post can be placed here without developing the root-cracking high stress concentration that a short off axis metal post would, due to its modulus of elasticity being comparable to dentin. – Another tip: whenever this referring dentist has a various pulp exposure, she temporize with IRM directly over the pulp and none of the patients develop pain

September 26th, 2019 | By admin | | Comments Off on The likelihood of this case type failing and this patient extracting this tooth in the future isn’t from recurring infection or what we think of as a true Endodontic failure. It’s from tooth fracture, specifically cervical snap off; a restorative failure. These tend to happen down the road and the small details for long term success are often overlooked. – If the only intercuspal coronal tooth structure remaining after interproximal caries removal is directly over the root canal, you can preserve this tooth structure by changing “ideal access” to a caries-directed access. Convenience form has no role here. – A fiber post is used to help retain the restoration and to some degree minimize the risk for cervical snap off. A fiber post can be placed here without developing the root-cracking high stress concentration that a short off axis metal post would, due to its modulus of elasticity being comparable to dentin. – Another tip: whenever this referring dentist has a various pulp exposure, she temporize with IRM directly over the pulp and none of the patients develop pain