Good points Guy. I have a small office but access to pans if needed. I had a patient with what I suspected was a sinus problem. The oral surgeons prefer radiographs with referrals so I sent her to the orthodontist so she could go to the consult all prepared. Strange lady, got a call from her “You sent me for treatment and he did nothing just took a radiograph.” I had explained that the idea was to go to the surgeons with a pan. She said “You don’t care if I live or die” The surgeon said she was a wacko…sometimes you win. She always was late for appointments, haughty etc. She had a down syndrome son, we treated him very well and he liked us but she changed dentists…
But if people only get a pan for the bottom line…that would be sad….dentistry has changed hasn’t it J
Michael Pilon DDS
www.drmichaelpilon.com
www.40countries.com
From: acesthetics@googlegroups.com [mailto:acesthetics@googlegroups.com] On Behalf Of Guy Moorman
Sent: Tuesday, February 12, 2013 7:23 AM
To: riccoker@gmail.com; 'ARUN NAYYAR'
Cc: 'Gary Kodish'; 'Guy Moorman'; 'ACEsthetics group'
Subject: RE: [ACEsthetics] Get that Panorex on everyone!
We’ll find that, Rick, but we’ll also find some awfully good endo done by some of the best with “lesions”. The question is going to be as, Arun, says, what the hell is it. This things are being sold like crazy to people who have no need for them and a huge responsibility comes with owning one. You’d better be able to read the damned thing right or you could get your ass sued off. People get focused on finding apical lesions and placing implants and miss that metastatic breast cancer in the mandible and you are sued. Every one of these CTs should be read by a qualified radiologist and all of these new CBCTs are going to show a need for radiologists who specialize in just reading these head and neck shots. We have an ENT here who uses one and every single one of his is sent to Texas somewhere to be read by a radiology group that he knows one of the guys in. He’s covering his ass. How many dentists you think are going to do this and how many teeth are going to be retreated when there is no need? Too damned many.
Guy W. Moorman, Jr., D.D.S.
The Swamp
Douglas, GA 31533
912-384-7400
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From: acesthetics@googlegroups.com [mailto:acesthetics@googlegroups.com] On Behalf Of Rick Coker
Sent: Monday, February 11, 2013 7:49 AM
To: ARUN NAYYAR
Cc: Gary Kodish; Guy Moorman; ACEsthetics group
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
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Guy W. Moorman
The Swamp
Douglas, Georgia
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Dr. Rick Coker, DDS, FACE
Director, Academy of Comprehensive Esthetics
www.tyler-smiles.com, www.tylersleep.com
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