The MB2 challenge

For upper sixes, I usually spend half an hour preparing the three canals and the remaining time attending to the MB2. It is difficult locating its orifice most of the time and negotiating this fine canal is also a challenge. Working with an operating microscope is beneficial for this purpose. I have retreated many failed RCT of upper sixes due to neglected MB2.

The case above belongs to an uncle of the referring dentist, hence additional stress for me to produce good work, but I'm glad that it didn't take too much trouble treating the MB2.

Another C-shaped canal

Mostly seen on mandibular second molars among Chinese, incidence reported to be 27.5%, but I think it is higher than that. Fused roots, long pulp chamber with a C-shaped orifice are common characteristics. A single ML canal and a long oval extending from MB to D is a the most common configuration. ML canal is usually curved. High tendency to strip perforation due to thin lingual wall. Obturation technique used here is warm vertical. Post should be avoided as well.

Save the Root

To save or not to save?

This tooth is badly broken down, you can choose to extract and have an implant, option two is to keep it. Its kind of a borderline case because there is only minimal coronal tooth structure left. I supposed there is no right or wrong on whichever treatment option . It depends on how keen the patient is saving his tooth and what the dentist is comfortable doing, really. So, it also depends on who you seek the professional advice from.

I will choose to save if this is my own tooth. In order to restore this tooth, root canal treatment and crown is a must. To hold the crown, a post is placed into the palatal canal and an amalgam build-up is done.

The question is how long will this tooth last? I have been asked this question everyday! I honestly can't predict, I can offer data/statistics on success/failure of root canal treatment or longevity of root-treated teeth but then again, each tooth is different . What I can be sure is that this tooth is weakened but I can try my best to restore it. The rest is up to the patient and God.

Life is about making choices and I'm glad I'm a root saver!

New York New York!

This is during my endodontic attachment in USA. Dr Kim, my mentor runs a specialist in the Rockefeller Center in NYC, and I was about to witness the"guru" in surgical endodontics, performing an apical surgery. This is where the "rich and famous" fixed their teeth :) Apparently, the rental for this office unit at the Rockefeller Centre is USD10,000 per month, but it has got a fantastic view of the ice staking rink and the gigantic Christmas tree in December!

New York has became one of my favorite cities and if you ever visit there, don't miss the sushi at Hatsuhana Sushi Restaurant, http://www.hatsuhana.com/hatsuhana

The best that I ever had.

Back to the Grind and Drill!

My first patient in Petaling Jaya after being away in Philadelphia for more than a month. It did feel a bit awkward, trying to adapt to the environment at my own clinic again and at the same time, to apply and incorporate what I learned at UPenn into my daily practice. Retreated root canals on 37 and placed Ca(OH)2, three months ago. Its a C-shaped canal. The patient came back today symptom-free. Completed the canal obturation and felt satisfied with the resolution of the periapical lesion. I would say it was a good start to the week !

Ramadan Buffet @ Le Meridien 10th August, 2011