Yee Sang Dinner 2012

The Chinese New Year Reunion Dinner for my staff at Soo Dental Surgery this year was held at the Yuan Zuan Chinese Restaurant, One World Hotel. The restaurant captain was nice enough to give us a private room with a Monet-like painting. It was attended by my nurses, Banun and Asma and their respective families, and friends, Dalia and hubby and Shiamala.

It was a sumptuous nine-course meal, beginning with delicious fruit yee sang. The roast chicken was rather small but we had giant-size fish and prawns. Din, Dalia's husband commented intelligently that all seafood served has to be super-big because it is the year of the water dragon! The prawns were everyone's favorite and the meal was completed with chilled date dessert and deep fried 'nian gou'.

Modern dentistry with precision and comfort

Excellence under magnification

An upper first molar usually has three root and 3 to 4 canals, however, this case present here, tooth 26 only has two roots. The pre-operative periapical radiograph suggested that a mesiobuccal canal may be present in the buccal root because the canal was not in the centre of the root. Hence, the patient was sent to me for retreatment, although the tooth was asymtomatic. Under excellent magnification and illumination from the operating microscope, the MB canal was located. Buccal canal bifurcated into MB and DB canals at the apical one third. Canals were filled with the warm vertical technique.

Healing Power

Human being has excellent healing power. For a dento-aveolar infection, once bacteria is eliminated, soft tissue will heal and bone will regenerate. In this case, the post-op periapical radiograph was taken less than five months after initiation of the root canal treatment on the first molar. There is evidence of almost complete resolution of the periapical lesion.

Here, it takes five months, for Wolverine in X-Men, it's five seconds!

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!