my sequence is open the contact ,remove all decay ,file 10,15,s1,s2,sx till 2/3s ,apex locater ,file 10,15 ,s1,s2,sx,f1 ,gauging ,finishers , ultrasonic activation naocl , 1 min edta soaking and activation , another naocl and activation ,i use caoh if necrotic tooth
Save the epic music for something a little more..i don't know, life or death maybe? Great video, just a comment on a lot of dentistry videos, we can have music with a little more levity
Hey doc what's your opinion on removing all caries coronally, then accessing into pulp chamber, then placing rubber dam? I do it like this to help orient my bur while accessing and deroofing the pulp. I not as experienced as you are so that's why I do it like that
Why did you do it that way? Seems like you had good enough isolation before restoring the wall, and could have been even better if you just did the Oraseal by itself without the proximal restoration
This question is actually the reason why I did it this way. I will often finish the Endo and then place my restoration, however, I will have oraseal everywhere, and that ora seal seems to make its way into the restoration at a microscopic level. Even if I try to remove it perfectly. It actually drives me bananas. lol Over the years, I’ve had leakage of hypochlorite when I thought the dam was sealed (a secondary seal), so I rarely do Endo without a secondary seal. I learned something yesterday when a friend texted me about using blockout resin on dry teeth. I used to use Opal dam, but it always fell off halfway through my Endo. Maybe it was because they do surface was still moist.🤷🏻♂️
Hey doc! What microscope are you currently using? I love the fluorescent filter. I’m looking forward to upgrading from my Global a6 to maybe Extaro 300. What’s your opinion on that change?
If this patient was mine....I would have tried removing the decay...place dycal over the nerve area and permanent restoration....obviously this tooth was still vital...then I'd wait to see if the tooth abscesses...then do a root canal...explain to patient that there is a possibility tooth could abscess and it would be dealt with....patients have more respect for you for at least trying to avoid a root canal is my experience
But vital pulpectomy has much better prognosis than having the tooth all seized by bacteria. I also try to avoid RCT by all means but when it already has symptoms I go to RCT at once.
Aseptics weren't 100%. I don't think someone in a teaching/mentoring role for aspiring dentists should have the integrity of the rubber dam compromised.
nope i need your voice in the videos!
amazing as usual 🍏❤️
Lol
The purple rubber dam is iconic now
Lol
Well done doc 👍🏼
my sequence is open the contact ,remove all decay ,file 10,15,s1,s2,sx till 2/3s ,apex locater ,file 10,15 ,s1,s2,sx,f1 ,gauging ,finishers , ultrasonic activation naocl , 1 min edta soaking and activation , another naocl and activation ,i use caoh if necrotic tooth
Clean work doc well done
Thank you
I usually do IDS or whole restoration of the missing wall before going in with NaOCl. It helps adhesion later :)
Interesting
Many thanks I love the video
Very cool!
Save the epic music for something a little more..i don't know, life or death maybe? Great video, just a comment on a lot of dentistry videos, we can have music with a little more levity
Hey doc what's your opinion on removing all caries coronally, then accessing into pulp chamber, then placing rubber dam? I do it like this to help orient my bur while accessing and deroofing the pulp. I not as experienced as you are so that's why I do it like that
I think as long as there is a dam on the tooth before files are placed (safety) and hypochlorite (disinfection), you’re golden.
Why did you do it that way? Seems like you had good enough isolation before restoring the wall, and could have been even better if you just did the Oraseal by itself without the proximal restoration
This question is actually the reason why I did it this way. I will often finish the Endo and then place my restoration, however, I will have oraseal everywhere, and that ora seal seems to make its way into the restoration at a microscopic level.
Even if I try to remove it perfectly. It actually drives me bananas. lol
Over the years, I’ve had leakage of hypochlorite when I thought the dam was sealed (a secondary seal), so I rarely do Endo without a secondary seal.
I learned something yesterday when a friend texted me about using blockout resin on dry teeth. I used to use Opal dam, but it always fell off halfway through my Endo. Maybe it was because they do surface was still moist.🤷🏻♂️
Hey doc! What microscope are you currently using? I love the fluorescent filter. I’m looking forward to upgrading from my Global a6 to maybe Extaro 300. What’s your opinion on that change?
How much time does the whole procedure took.
About 45 mins
Nice. What was that white putty-like material that you placed on the gingiva?
That is oraseal.
do u stil use Dr Ricucci protocl for apex locator?
Hard to break old habits….i still go to one red bar. 🤦🏻♂️
what rotary files are u using doc?
I wonder if anyone would have removed all decay especially with the slow speed prior to opening the pulp chamber.
That’s a very great point.
I think I would
Why not ?
@@AllThingsDentistrystill awesome video, and a great way to generate discussion.
If this patient was mine....I would have tried removing the decay...place dycal over the nerve area and permanent restoration....obviously this tooth was still vital...then I'd wait to see if the tooth abscesses...then do a root canal...explain to patient that there is a possibility tooth could abscess and it would be dealt with....patients have more respect for you for at least trying to avoid a root canal is my experience
With symptomatic apical periodontitis? I used to try to avoid doing RCT but then those teeth ended up needing the Endo anyways
But vital pulpectomy has much better prognosis than having the tooth all seized by bacteria. I also try to avoid RCT by all means but when it already has symptoms I go to RCT at once.
Aseptics weren't 100%. I don't think someone in a teaching/mentoring role for aspiring dentists should have the integrity of the rubber dam compromised.