As I pointed out during the late master class, you have to define WORK.
We are happy, happy, happy with our clinical endpoints. No pain, no swelling;
rads look OK, no drainage, fever, discoloration. All that tumor, rubor, calor,
dolor type stuff.
BUT, just 'cuz everything's feeling or looking fine tells us absolutely ZIP
about live bacteria or, for that matter, their stinking necrotic wasteproducts
slowly oozing off the tooth, but doing it subclinically.
Take out the tooth, biopsy the stuff around the root and you may well get an
entirely different and quite disturbing story, as Boyd Haley has done in the
past.
We're working at 19th Century levels of evaluation. This is more than pitiful
when we have DNA tests and chemical probes that can go far beyond these ancient
endpoints.
We can and should do better than this.
PIPs is looking promising, at least from what I'm seeing so far, but I have not
had data on immunostimulatory cleaning yet. That means going beyond removing
live bacteria from root canal systems and especially tubules. That antigenic
garbage may well be much harder on the system than the live bugs. Dead bugs,
dead bug parts, lipopolysaccharides, toxins, necrotic debris from human
cells...it's all nasty and way beyond the apex on the leaky tubules covering
the entire root.
regards
bill domb
-----Original Message-----
From: Gregory Sawyer
Sent: Monday, February 11, 2013 3:43 PM
To: riccoker@gmail.com ; arunnayyardmd@gmail.com
Cc: gkodish@gmail.com ; toothpick44@gmail.com ; ACEsthetics@googlegroups.com
Subject: Re: [ACEsthetics] Get that Panorex on everyone!
That is not alarmist. That is the state of endodontics without PIPS or
ozone. Our Thursday morning ozone lecture was from an endodontist from
Brazil. Remember the cadaver study done at USC about ten years ago.
51% of the apparently successful root canaled teeth had peri-apical
infections present. That doesn't count the ones that were extracted
because they became symptomatic. There are not canals but canal
systems, which no amount of NaOCL will reach so deep into the tubules.
Then we think we can seal in the bacteria, but they still have access
to the cementum at the outside. It amazes me that so many root canals
work at all.
Greg Sawyer
-----Original Message-----
From: Rick Coker <riccoker@gmail.com>
To: ARUN NAYYAR <arunnayyardmd@gmail.com>
Cc: Gary Kodish <gkodish@gmail.com>; Guy Moorman
<toothpick44@gmail.com>; ACEsthetics group
<ACEsthetics@googlegroups.com>
Sent: Mon, Feb 11, 2013 4:49 am
Subject: Re: [ACEsthetics] Get that Panorex on everyone!
It would really be interesting to do a survey of endodontically treated
teeth, teeth done 10 years or more ago, and do those CBCT's on them. I
predict that a very large percentage of them will show signs of cysts
or underfilled canals and potential reinfection sites, and then what.
How good does an endo have to be to be safe? Long term, not short term.
The real answer is that we don't know, and how much do we want to know?
If that were to happen, it could be most troublesome- more sinus grafts
and implants, or upper partial dentures or upper posterior
edentulousness.
Hopefully, I am being a little bit alarmist here.
Rick
On Mon, Feb 11, 2013 at 6:20 AM, <arunnayyardmd@gmail.com> wrote:
Diagnostic interpretations from a ct scan of carious lesions can fool
us. when we first started with ct scans our thought was it was
exclusive for all diagnostic needs. We quickly learned that some of
the dark areas were not caries but artifacts? Cause bitewings and
visual exam did not show any!! So validate your findings with other
diagnostic tools and experience. Sent via BlackBerry from T-Mobile
From: Gary Kodish <gkodish@gmail.com>
Sender: acesthetics@googlegroups.com
Date: Mon, 11 Feb 2013 07:13:47 -0500
To: <toothpick44@gmail.com>
ReplyTo: gkodish@gmail.com
Cc: ACEsthetics group<ACEsthetics@googlegroups.com>
Subject: Re: [ACEsthetics] Get that Panorex on everyone!
Kind of along the same train of thought, we had our training on
Thursday and Friday for our new cone bean machine. We had 2 patients
come in on Thurday and four on Fri. Out of the six I referred 4 to the
endodontist because of what we saw on the images that does not readily
show up on radiographs.. In addition when we looked at all of the
images you could see interproximal bone loss that does not show up
either. It was a mind opening experiance to be able to see all the
detail that was not available before. The trainor told us that she
knows of some periodontist's who are now regularly taking the cone beam
images on all of their patients because of the detail they see and then
they show them to the patients who now understand the problem. I can
see that because when I showed the images to my patients there was no
hesitation for them to get the problems fixed. I am wondering if this
may not eventually be standard of care.
On Sat, Feb 9, 2013 at 7:41 AM, Guy Moorman
<toothpick44@gmail.com> wrote:
My frond office just called yesterday and told me that we had another
subpoena from the coroner for radiographs. Seems one of our patients
was a drug dealer and someone threw hin down a dry well with 100
gallons plue of gasoline. They did not remember him but I've been
seeing him off and on for 30 plus years. Had a lot of dentistry so
they ID'd him immediately...xrayed him at the hospital...now crime lab
has him. Take that panorex and you want be embarrassed with they come
and you have to tell them you have no radiographs.
When I was in the military in 1969 we had a panorex at the clinic and
everyone got a pan, including the dental officers. The quality was
horrendously bad compared to today's machines but all they wanted them
for was to ID bodies. It was gruesome but functional. Guy
--
Guy W. Moorman
The Swamp
Douglas, Georgia
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954-462-5252
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www.ftlauderdaleheadachecenter.com
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Dr. Rick Coker, DDS, FACE
Director, Academy of Comprehensive Esthetics
www.tyler-smiles.com, www.tylersleep.com
http://www.google.com/profiles/riccoker.
903-581-1777
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