I feel so bad about my patient

[TSDentSurg]

I missed a hairline root canal when I RCT'd my patient. If I could've seen it, the endodontic infection would've been cured, and my patient would've kept her tooth. Instead, she got osteomyelitis of her brand new bone graft, and had to have a radical alveolectomy and an ICU admission. Now she needs a much larger bone graft, probably from her hip or tibia, plus an implant.

I guess this indicates why surgical microscopes are imperative for RCT. Why do so many GPs try to do them with only loupes?

Feeling really bad

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[jeffity]

I missed a hairline root canal when I RCT'd my patient. If I could've seen it, the endodontic infection would've been cured, and my patient would've kept her tooth. Instead, she got osteomyelitis of her brand new bone graft, and had to have a radical alveolectomy and an ICU admission. Now she needs a much larger bone graft, probably from her hip or tibia, plus an implant.

I guess this indicates why surgical microscopes are imperative for RCT. Why do so many GPs try to do them with only loupes?

Feeling really bad

Expense? I have no idea what they cost. What mag loupes? Just curious. I have no idea what it's like yet. Hope I get to play with the scopes at school when the time comes. I hear it takes dentistry to a new level.

 

[TSDentSurg]

Expense? I have no idea what they cost. What mag loupes? Just curious. I have no idea what it's like yet. Hope I get to play with the scopes at school when the time comes. I hear it takes dentistry to a new level.

Surgical microscopes cost $$$$$$. I was using 5x loupes.

Microsurgical dentistry is awesome...great for endo and perio. And oral-maxillofacial surgical oncology.

 

[Shunwei]

I missed a hairline root canal when I RCT'd my patient. If I could've seen it, the endodontic infection would've been cured, and my patient would've kept her tooth. Instead, she got osteomyelitis of her brand new bone graft, and had to have a radical alveolectomy and an ICU admission. Now she needs a much larger bone graft, probably from her hip or tibia, plus an implant.

I guess this indicates why surgical microscopes are imperative for RCT. Why do so many GPs try to do them with only loupes?

Feeling really bad

I would respectfully disagree. Surgical microscopes are certainly useful but I have been doing hundreds of root canals since last year without even using loupes (i used to use one but after it broke i have gone without it and never never looked back, I just use protective eyewear and take good care of my vision)). Once you have done enough RCTs, you get a good idea of number of canals, canal configurations, and morphology. Endo explorer and caries indicator dyes are also useful to identify canals. If I see a tooth with strange morphology I always have the luxury to refer out (like what you would see in Native American patients), but so far I have done hundreds of RCTs (mostly molars) and have not had a single flare up or relapse. Microscopes are useful but not a necessity.

 

[Contach]

I would respectfully disagree. Surgical microscopes are certainly useful but I have been doing hundreds of root canals since last year without even using loupes (i used to use one but after it broke i have gone without it and never never looked back, I just use protective eyewear and take good care of my vision)). Once you have done enough RCTs, you get a good idea of number of canals, canal configurations, and morphology. Endo explorer and caries indicator dyes are also useful to identify canals. If I see a tooth with strange morphology I always have the luxury to refer out (like what you would see in Native American patients), but so far I have done hundreds of RCTs (mostly molars) and have not had a single flare up or relapse. Microscopes are useful but not a necessity.

Are you doing necrotic teeth?

 

[sacapuntas]

I would respectfully disagree. Surgical microscopes are certainly useful but I have been doing hundreds of root canals since last year without even using loupes (i used to use one but after it broke i have gone without it and never never looked back, I just use protective eyewear and take good care of my vision)). Once you have done enough RCTs, you get a good idea of number of canals, canal configurations, and morphology. Endo explorer and caries indicator dyes are also useful to identify canals. If I see a tooth with strange morphology I always have the luxury to refer out (like what you would see in Native American patients), but so far I have done hundreds of RCTs (mostly molars) and have not had a single flare up or relapse. Microscopes are useful but not a necessity.

Can you expand on this at all? Am I understanding you right that Native Americans are more likely to have atypical morphology? Are there specific teeth you are most likely to see this in?

 

[yggdrasila]

Can you expand on this at all? Am I understanding you right that Native Americans are more likely to have atypical morphology? Are there specific teeth you are most likely to see this in?

Google "Native American shovel teeth"