Monday, February 27, 2006 10:31 AMMonday, February 27, 2006 10:31 AMFrom Dr. Keneth SerotaFrom Dr. Keneth Serota

...axial dentin has a ...axial dentin has a different chromatic (colour) tonedifferent chromatic (colour) tone than dentin and orifices that are present within the than dentin and orifices that are present within the root trunk.....that dentin is root trunk.....that dentin is much darkermuch darker and just and just keeping it wet magnifies the chromatic keeping it wet magnifies the chromatic distinctiondistinction.......Fred's point about troughing the line in .......Fred's point about troughing the line in conjunction with any combination of NaOCl, etch and conjunction with any combination of NaOCl, etch and a DG 16 endo explorer can assist one in finding the a DG 16 endo explorer can assist one in finding the middle mesial canalmiddle mesial canal............................access openingsaccess openings that truly that truly allow light inallow light in, , beveled cavo surface line anglesbeveled cavo surface line angles obviate obviate shadowing in the same way they enhance optics for shadowing in the same way they enhance optics for photography..............each root canal system has a photography..............each root canal system has a distinct anatomy, however, distinct anatomy, however, the map of the floorthe map of the floor, , the the chromatic topographical outline is always in evidencechromatic topographical outline is always in evidence regardless of the magnification or ocular apparatusregardless of the magnification or ocular apparatus. .

Middle MesialsMiddle Mesials::Connect the dotsConnect the dotsTrough the LineTrough the Line

NO MM’sNO MM’s

On 2/26/06On 2/26/06AAhmad hmad TTehrani ehrani

Is there anything that alerts you to look for MM other than Is there anything that alerts you to look for MM other than troughing?troughing?

SShould we take in to consideration,  how far apart the MB hould we take in to consideration,  how far apart the MB & ML canals are for& ML canals are for instance?instance?

Is this anatomy discernable on the pre op x-ray? wire film? Is this anatomy discernable on the pre op x-ray? wire film? post op?post op?

HoHow would you recommend filing this canal so it doesn't w would you recommend filing this canal so it doesn't getget blocked or ledged? blocked or ledged?

On 02/27/06 On 02/27/06 Fred BarnettFred Barnett

I connect the dots and trough a few mm's on every case.  On the angled pre-ops, if the mesial root looks especially wide, I may be a bit more aggressive....but I always stay on the line and I am always cognizant of the furca.  When you look at Hess's work from 1928, I am humbled by the simple white lines that appear on my post-op radiographs.   

Hess's work from 1928Hess's work from 1928

A strategy on creating pathways to the canals is A strategy on creating pathways to the canals is required in order to debride and disifect them.required in order to debride and disifect them.

Proper magnification and illumination to see the Proper magnification and illumination to see the subtle color changes of the "Road Map" is mandatory. subtle color changes of the "Road Map" is mandatory.

Monday, February 27, 2006 2:18 PMMonday, February 27, 2006 2:18 PMFred Barnett Fred Barnett

Terry Pannkuk ‘s contributionTerry Pannkuk ‘s contribution

““Anatomy can be wild but even the wildest can be overcome with an Anatomy can be wild but even the wildest can be overcome with an understanding of shape, access, and development of a thoughtful strategy understanding of shape, access, and development of a thoughtful strategy that allows debridement and obturation of the clinically significant space that allows debridement and obturation of the clinically significant space leaving only the most minute entombed crypts remaining and unlikely to leaving only the most minute entombed crypts remaining and unlikely to cause recurrent pathosis. “cause recurrent pathosis. “

(T. Pannkuk, 2006; ROOTS(T. Pannkuk, 2006; ROOTS))

II would add that using an etchant on one of the would add that using an etchant on one of the little round microbrushes helps remove the smear little round microbrushes helps remove the smear layer and makes the "grain" or calcification patterns layer and makes the "grain" or calcification patterns of the dentin stand out more.of the dentin stand out more.

Put a little etchant on the microbrush and scrub Put a little etchant on the microbrush and scrub around the chamber for 20-30s and rinse thoroughly around the chamber for 20-30s and rinse thoroughly and dry with a Stropko irrigator to help locate and dry with a Stropko irrigator to help locate additional landmarks on the walls and floor of the additional landmarks on the walls and floor of the chamber.chamber.  

Monday, February 27, 2006 5:54 PMMonday, February 27, 2006 5:54 PMRandy Hedrick contribution:Randy Hedrick contribution:

Thursday, March 02, 2006 1:57 AMThursday, March 02, 2006 1:57 AMvijayalakshmi girish kumarvijayalakshmi girish kumar

Can I suggest another way to do what Randy has Can I suggest another way to do what Randy has suggested?suggested?

using ultrasonics to clean the access cavity after doing all the troughing, will do the same thing as etching the cavity.

sashi nallapatisashi nallapatiNSU endo, FLNSU endo, FL

Saturday, February 04, 2006 4:41 PMSaturday, February 04, 2006 4:41 PMRajiv PatelRajiv Patel

Just another Middle MesialJust another Middle Mesial

Rajiv PatelRajiv Patel

Rajiv PatelRajiv Patel

Rajiv PatelRajiv Patel

Rajiv PatelRajiv Patel

Rajiv PatelRajiv Patel

Rajiv PatelRajiv Patel

Rajiv PatelRajiv Patel

Rajiv PatelRajiv Patel

Rajiv PatelRajiv Patel

Rajiv PatelRajiv Patel

Rajiv PatelRajiv Patel

Rajiv PatelRajiv Patel

Rajiv PatelRajiv Patel

Rajiv PatelRajiv Patel

Rajiv PatelRajiv Patel

Clinical case from Clinical case from Márcia Valéria Boussada Vieira Márcia Valéria Boussada Vieira toto

As I learned on Roots from my coleagues. “Follow the As I learned on Roots from my coleagues. “Follow the MAP!”MAP!”www.rxroots.comwww.rxroots.com

Middle mesial from Brasil