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You’re emergency slot fills with a patient in pain. You find a tooth with irreversible pulpitis and need to extipate to get the patient out of pain. Yet on the PA, the canal is almost unrecognisable!
This episode Dr Omar Ikram leads us on a discussion about finding these elusive canals and shares a few tips and techniques that will help you locate, navgvate and extirpate!
Caries into the pulp. Clearly, endo is indicated, but how do you build up you temporary prior to extirpation and canal preparation?
One method is to pop a little cavit in the chamber then restore as normal and reaccess through the restoration. This works fine when you feel confident you can easily reproduce the access cavity with little risk of deviation.
To be honest, endo access for calcified or thin teeth makes my cortisol spike. So when there is clear caries to the pulp chamber and I’ve got access, I prefer not to completely close it, only to need to reaccess again.
To keep patency, try placing a large paper point in the Canal. Then your free to get a well sealed temporary in, easily maintaining your conservative access. Once the temp is done, ensure your isolation is still ideal and get on with the endo without wasting time finding that access again!
For most graduates, Endodontics can send a chill through the spine. It’s a challenging thing, done mostly by feel and when our experience is limited there are plenty of unknowns.
For this episode we have a social media dental titan. You’ve probably heard of him, he’s probably taught you a thing or two on Facebook. Dr Omar Ikram is a Specialist Endodontist, practice owner at Specialist Endo Crows Nest (based in Sydney’s lower North Shore), Specialist Endodontist at Sydney Dental Hospital and is a prolific teacher on Facebook.
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