Pt presented with persistent sinus tract on B. RCT’s done by another endodontist in town. They were suggesting to start endo in #26 followed by apico if that did not work. That’s when she decided to go for another opinion. I retreated #23 and 24, CaOH for at least 6 weeks, with no luck. Sinus tract just would not heal. Then I suggested decompression after final obturation. Irrigation was done for about 5 weeks.
This is an example of endodontics practiced at the highest level, in my view. From Diagnosis to Treatment: first rate the whole way.
Many endodontists would fumble the ball on this one…..
gbc
Thank you!
Wonderful case! How did you know that #26 didn’t need treatment?
#25 or #26?
Neither had any symptoms. Tooth #26 tested vital and #25 was non responsive but with the heavy calcification. I was not convinced that was the source. Pt had a persistent bucal sinus tract distal of #23.
Thank you. I was hoping this was a case in which the EPT was useful 🙂
Hehehe….I do not even own one!
Thank you. I was hoping this was a case in which the EPT was useful 🙂
:-))
Brandon,
Please post a case where you think the EPT test was necessary to make a smarter bet—-it’s been 4 years on TDO where the challenge has been made, yet only Rick Schwartz is the only one who submitted an example—and on that example there was much debate.
He brought up the same challenge in the AAE forum. I posted a case there but he wasn’t sold on it. I was hoping to show him this case as an example.
The first step in a journey to understanding tests and testing is to recognize that endodontists, and endodontics doesn’t understand tests and testing.
It’s complicated by the fact that, outside of the TDO community, there is almost universal opinion that endodontists do understand tests and testing. In fact, I do not believe I have ever met an endodontist that doesn’t think they don’t know very well how to evaluated the results of their tests.
In other words…They don’t know what they don’t know.
Sad.
@gbc…hehe…that was you a decade ago!
https://drive.google.com/file/d/0BxrQBZNFORlDTnFZTWE1ajdWSkk/view?usp=sharing
https://drive.google.com/file/d/0BxrQBZNFORlDVW8tQU9GcWZibUU/view?usp=sharing
The humbling thing about being a clinician, even with over 10 years experience, is that I continue to make errors in decision making…even when I know better. You add one extra variable (e.g. patient is in pain an leaving in 2 days for vacation) that seems important but is actually noise and it can throw off rational decision making.
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