A brief description of management of calcified pulp chamber and canals is given here. References- Mamoun JS. The maxillary molar endodontic access opening: A microscope-based approach. Eur J Dent 2016;10:439-46.
Nice video. The illustration of the three ultra-sonic tips shows a long thin tip shaped like a hummingbird's beak. This tip is useful for breaking up large pulpal stones. General method is to first locate the easier to find palatal canal as a landmark. Then, use the hummingbird tip to scale around the outer perimeter of the pulp chamber calcification. Look for areas where the pulp chamber seems to "perforate," but it is not perforating into the alveolar bone, but rather it is "perforating" into the space between the calcified pulpal tissue and the hard floor of the pulp chamber. Using microscopes, a space might be observable between the undersurface of the pulp chamber stone, and the floor of the pulp chamber. This is a very tiny difference in height, requiring microscopes and co-axial illumination for optimal detection. Hopefully, after troughing the perimeter of the pulp chamber calcification with the hummingbird beak ultrasonic tip, parts of the pulp calcification will appear to lift or peel away from the pulp chamber floor. A #2 or #4 round bur in a slow speed handpiece can be used to break up the troughed pulp chamber material, with minimal risk of gouging the pulp chamber floor. The optimal scenario of identification is if there is a clear difference between the corrugated surface of the calcified pulpal tissue and the smooth pulp chamber floor. Note that the pulp chamber floor tends to be harder than the calcified pulpal tissue or pulp stone. This is one way of distinguishing the two, in that the scaler tip will tend to more easily chip away the calcified pulpal tissue, than the more hard pulp chamber floor. Microscopes and co-axial illumination help to facilitate such differentiation between what surfaces are being damaged by the scaler tip, and which surfaces are relatively resistant to the scaler tip.
Nice vdeo sir..as I'm having this until my second visit to.my dentist still she can not reach the stone on my root canal..can I not continue for it is their any pain after.un.succesfull operation
Today found a palatal canal blocked!!!! The orifice is clear but beyond orifice it's blocked, view it in microscope, looks like sclerosed dentin..tried to break with gd drill but no gain..any suggestions?
Try with an orifice shaper (Sx). Use a little stiff file to generate torque at tip of file, D finder is good option. To increase the torque, you can cut tip of #8 file (21 mm) around 2 mm and use shortened length🙏🙏🙏
Greetings sir. Even after canal location & BMP if pulp stones persist should we attempt to remove it? Or should we go ahead and obturate if the tooth is asymptomatic?
How are you sir? What is you opinion on dental practise post lockdown Plz make a video What will be the protocols What will going to change forever from now i
Hi.. I am good. There are a lot of senior dentists giving opinions about post lockdown practice. I am still in dilemma because there is no solution to aerosols produced during treatment. So dental procedures without aerosols (simple extractions, hand scaling, ortho treatment etc.) you can perform normally without much difficulty as in those procedures; you have to save yourself only. But in aerosol generating procedures, there are risk of cross infection to other patients as they will not be wearing N 95 mask during treatment. So, you can keep only 1 aerosol generating patient a day after all other consultations or without aerosol procedures and another method is go for covid test before treatment. Regards
hello sir hope you are in good health. sir I am a fresh dentist from westbengal currently doing houstafship I have encountered a RCT pt with calcified pulp chamber I have removed it as much as i can but when i put the files it doesn't going all the way in and apex locator is showing only upto white lines and can't force the files any further. plz give me your valuable suggestions.. or if you can provide your IG handle or other platforms in which i can contact you. thanks in advance
Hello dear doctor we are waiting from you videos please if possible 🙏 also what we can do if apex locator is not showing correct apex (ex: at 2/3 of canal showing as apex) thank you a lot
