Abscessed pulp on entry. Crown cemented within 6 months of visit to our office. 17/.04 V-Tapers. Three months of Calcium hydroxide with a change in between. Last Radiograph is a 3.5 year recall.
Online Endodontic Education
Online Endodontic Education
Abscessed pulp on entry. Crown cemented within 6 months of visit to our office. 17/.04 V-Tapers. Three months of Calcium hydroxide with a change in between. Last Radiograph is a 3.5 year recall.
It’s exactly this sort of case that I am hoping the GW tool will move from a multi-visit approach to a single visit approach.
Hope springs eternal….
gbc
Ah……the fact is almost every C-shaped anatomy has a “missed” canal. Let’s assume you are correct—but we have radiographic resolution—despite what must be billions of microorganisms still present. And trust me, they are still alive.
Hmm…how could that be? Since the patient-centered outcome and the disease-centered outcome appear optimal….well, maybe addressing all the anatomy—the process-centered outcome—isn’t all what it’s cracked up to be?
gbc
What you can say about this case is you have an optimal outcome at year 3.5. You can’t draw useful inferences from any one case or even any group of cases unless they follow strict CONSORT guidelines and you follow those cases over a longer time frame. Such guidelines are seldom, if ever, done in endodontics.
For many patients, an “optimal” result would be the outcome at 15 years…or even longer. Ever tried getting 15-20 year recalls into your office? Careful retrospective analysis of outcomes (using an ITT approach) shows that results with less than a minimum of 85% recall rates are subject to gross distortions and lead to erroneous inferences as to “what works and what doesn’t”.
So when evaluating retrospective outcome metrics over a 20 year period you want to ask a very pointed question: “What happened to all the cases you didn’t recall?”
What might help you in understanding better how to evaluate retrospective studies and how you need to be careful in drawing inferences from such studies is to spend some time in learning what the medical community has learned in studying this issue. At TDO we have spent 5 years studying these issues so we have a little different perspective on the topic than you do.
https://drive.google.com/file/d/0BxrQBZNFORlDWHo1dVVNTDVUdU0/view?usp=sharing
https://drive.google.com/file/d/0BxrQBZNFORlDQlZOdGFsRkxpMW8/view?usp=sharing
https://drive.google.com/file/d/0BxrQBZNFORlDb3hSZk5IWWNlYUk/view?usp=sharing
https://drive.google.com/file/d/0BxrQBZNFORlDMUlTWVg0OXYtYlE/view?usp=sharing
https://drive.google.com/file/d/0BxrQBZNFORlDZnI4TDdsV2d5U2M/view?usp=sharing
i understand what you are saying, but can you please answer my question? thanks
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