Just wanted to thank you for your videos, they have been a huge help and influence on my career. Your content exposing me to more endo was part of the drive for me to pursue endo, and I am happy to say I was just accepted into a program to begin as a resident next year
☝🏻💁🏻♀️As I have 35+ years of dentistry experience chairside in this case scenario...I hope this explanation is understandable and helps with decisions regarding the delicate procedures involving dental root canal therapy and its complete treatment possibilities😁👍🏻 #1...a "pulpectomy" MUST be followed through completely to shape the canals to fill the vacant space(s) #2...lower molars can have up to 4 canals AND ANY TOOTH MAY HAVE THEM PESKY "ACCESSORY CANALS #3...ALL root canal procedures REQUIRE a basic buildup AND a crown to maintain the remaining tooth structure as to, as best as possible (there are absolutely NO GUARANTEES in dentistry and/or medical procedures/patient care) prevent further fracturing of what tooth structure remains #4...it is EXTREMELY WISE to finish these procedures in a timely manner because once started, the tooth remains in jeopardy of losing the entire tooth and with medical/dental procedures, many times can be cost prohibited whereas in this case, the cost of 1) the root canal (a pulpectomy is ONLY the start of a root canal treatment); 2) buildup; 3) full coverage crown...so IF you lose the tooth itself after going through at least 2/3 of the "NON REFUNDABLE" treatment, the loss requires replacing the lost tooth (necessary because without the tooth that was there, teeth WILL shift and change positions, AND the tooth directly opposing the missing tooth can and USUALLY does super erupt (continue to grow beyond/into the newly opened area) which limits further treatment of that area #5...losing that treated tooth requires 1 of 2 options...A) a 2-3 unit bridge (2 unit bridges have always been limited...cantilever bridge or even a butterfly bridge) depending on what remains to work with as for which the teeth on each side of where the missing tooth was which creates a break in tooth structure from its smooth uninterrupted surface exposing teeth to microscopic organisms thrive on the enamel (surface you can see) and the dentin (layer of the tooth structure visible only when the enamel has been removed) layers which can possibly cause a loss to either of the teeth used for the bridge if you do not take diligent care of the restoration (one should ALWAYS care for their teeth by brushing AND flossing the teeth you want to keep!!!), really floss underneath the bridge (you should be instructed/taught exactly how to care for your new restoration); B) a loss of the treated tooth can also be replaced by a single tooth implant (sometimes placed at the time of the extraction of the failed tooth depending on any damage to the remaining bone that supported that tooth) also needing a bit of time of healing to ensure the implant is stable for the final restoration (implants behave much like a real tooth which also can be affected by periodontal disease) HOWEVER, a dental implant properly taken care of can be used as an anchor for future dental restorative needs when/if the need arises
That mms was literally worked blindfolded 👏👏👏…. Makes me think when struggling on these cases: despite all our preparation and research on the subject, how it kills me when patients gets frustrated and just want to end the torment of coming back and beg me for extraction of the damn tooth. I do understand them, I really feel their torment, still makes me think I failed them because I made them wait too long.
Congratulations for making it to the end of the road! If I could give you a gold star, I would. Thank you for your comment and I’m grateful you’re here.
Thank you for your comment. For me, it was the temperature change sensitivity the patient experienced that tweaked my curiosity. Hopefully you can use this in your own practice in the future.
hello! thank you for the video. one quick comment that could have made your life easier and helps you not to lose as many canals. All the white matter at the floor of the pulp cavity is a calcification and not the true floor of it!
I appreciate you pointing that out! When I was editing the video, i didn’t really notice the pulpal floor - but when I rewatch it - that calcification glows!
I am dental student in my third year and a big fan of your work and videos! I'm curious about how you videotape these procedures? I think it would be a game changer to video tape myself to be able to analyse my mistakes and to teach others. Very grateful for your work! Best regards from germany!
You have to have a microscope, these videos show the same perspective he has. Most modern endo scopes will have the ability to record with a camera. Expensive, cumbersome to learn working with, but I really would like to have one some day myself
was it a deep split when you started and found the mm? gosh, that's difficult even with a scope, and much more difficult on the mesials of lower molars. most difficult preps are for me third lower molars with type 1-2 of mesials when I have to dig down with ultrasonics and use old school hand files for the first part of prep. I enjoy your videos
I value your statement. There is actually a little bit of excess BC sealer that is use beyond the tip of the cone as per what you noted. Interestingly, I keep that in the back of my mind, especially when I am treating large resorbed apices
Thank you so much for being a part of this community. I hope this video can help you scout out those middle mesial canals!
Just wanted to thank you for your videos, they have been a huge help and influence on my career. Your content exposing me to more endo was part of the drive for me to pursue endo, and I am happy to say I was just accepted into a program to begin as a resident next year
☝🏻💁🏻♀️As I have 35+ years of dentistry experience chairside in this case scenario...I hope this explanation is understandable and helps with decisions regarding the delicate procedures involving dental root canal therapy and its complete treatment possibilities😁👍🏻
#1...a "pulpectomy" MUST be followed through completely to shape the canals to fill the vacant space(s)
#2...lower molars can have up to 4 canals AND ANY TOOTH MAY HAVE THEM PESKY "ACCESSORY CANALS
#3...ALL root canal procedures REQUIRE a basic buildup AND a crown to maintain the remaining tooth structure as to, as best as possible (there are absolutely NO GUARANTEES in dentistry and/or medical procedures/patient care) prevent further fracturing of what tooth structure remains
#4...it is EXTREMELY WISE to finish these procedures in a timely manner because once started, the tooth remains in jeopardy of losing the entire tooth and with medical/dental procedures, many times can be cost prohibited whereas in this case, the cost of 1) the root canal (a pulpectomy is ONLY the start of a root canal treatment); 2) buildup; 3) full coverage crown...so IF you lose the tooth itself after going through at least 2/3 of the "NON REFUNDABLE" treatment, the loss requires replacing the lost tooth (necessary because without the tooth that was there, teeth WILL shift and change positions, AND the tooth directly opposing the missing tooth can and USUALLY does super erupt (continue to grow beyond/into the newly opened area) which limits further treatment of that area
#5...losing that treated tooth requires 1 of 2 options...A) a 2-3 unit bridge (2 unit bridges have always been limited...cantilever bridge or even a butterfly bridge) depending on what remains to work with as for which the teeth on each side of where the missing tooth was which creates a break in tooth structure from its smooth uninterrupted surface exposing teeth to microscopic organisms thrive on the enamel (surface you can see) and the dentin (layer of the tooth structure visible only when the enamel has been removed) layers which can possibly cause a loss to either of the teeth used for the bridge if you do not take diligent care of the restoration (one should ALWAYS care for their teeth by brushing AND flossing the teeth you want to keep!!!), really floss underneath the bridge (you should be instructed/taught exactly how to care for your new restoration); B) a loss of the treated tooth can also be replaced by a single tooth implant (sometimes placed at the time of the extraction of the failed tooth depending on any damage to the remaining bone that supported that tooth) also needing a bit of time of healing to ensure the implant is stable for the final restoration (implants behave much like a real tooth which also can be affected by periodontal disease) HOWEVER, a dental implant properly taken care of can be used as an anchor for future dental restorative needs when/if the need arises
How many minimum canals can a mandibular first molar have ? Is it possible that the first molar has only 2
That mms was literally worked blindfolded 👏👏👏…. Makes me think when struggling on these cases: despite all our preparation and research on the subject, how it kills me when patients gets frustrated and just want to end the torment of coming back and beg me for extraction of the damn tooth. I do understand them, I really feel their torment, still makes me think I failed them because I made them wait too long.
I made it till the end. Thanks for sharing your endo tips
Congratulations for making it to the end of the road! If I could give you a gold star, I would. Thank you for your comment and I’m grateful you’re here.
Prepping Middle mesial canal with large taper can lead to strip perforation. I would prepare the canal with a small taper like 17.04
Thank you so much for this video
Thanks for Yours videos. I used isopropyl alcohol on the tip of the brush to remove the sealant from the cavity and then rinsed it off with water.
How many minimum canals can a mandibular first molar have ?
I did watch up to the last min thanks it’s interesting to watch advance cases like this appreciate it thanks
Really great video, nice job! Thanks for posting these videos, they are very helpful
Thanks for sharing this experience ❤
Thank you for your comment. For me, it was the temperature change sensitivity the patient experienced that tweaked my curiosity. Hopefully you can use this in your own practice in the future.
I always makes it to the end since many years ago, even the longest vids!
22:56 irrigation hu.. We need that king of video 😊
hello! thank you for the video. one quick comment that could have made your life easier and helps you not to lose as many canals. All the white matter at the floor of the pulp cavity is a calcification and not the true floor of it!
I appreciate you pointing that out! When I was editing the video, i didn’t really notice the pulpal floor - but when I rewatch it - that calcification glows!
I am dental student in my third year and a big fan of your work and videos! I'm curious about how you videotape these procedures? I think it would be a game changer to video tape myself to be able to analyse my mistakes and to teach others. Very grateful for your work! Best regards from germany!
You have to have a microscope, these videos show the same perspective he has. Most modern endo scopes will have the ability to record with a camera. Expensive, cumbersome to learn working with, but I really would like to have one some day myself
Thanks for your reply!@@RoshDroz
was it a deep split when you started and found the mm? gosh, that's difficult even with a scope, and much more difficult on the mesials of lower molars. most difficult preps are for me third lower molars with type 1-2 of mesials when I have to dig down with ultrasonics and use old school hand files for the first part of prep. I enjoy your videos
Great video. Thank you. What did you use to cut or burn off the GP? It looked like an ultrasonic?
do explain the toilet bowl analogy please :D
Made it to the end.
THanks Ash, please post more molar endo videos
Great 👍
You are so lucky that you have those Munce burs. They are such an effective tool when it comes to opening up tight orifices.
Very good video thank you Dr
My question is what is name of white material which is like the liquidam around the clamp?
Great question. It is called oraseal.
i'm still here.
❤❤
45 04 quit large u should obturate with mta ya bc putty dr teruchi technique
I value your statement. There is actually a little bit of excess BC sealer that is use beyond the tip of the cone as per what you noted. Interestingly, I keep that in the back of my mind, especially when I am treating large resorbed apices
Great 👍