Januari 05, 2017
first essential skill you need to knowis how to find the darn things. let's find them and i told you the answer yougotta have magnification and illumination simultaneously. you'll findsome but you aren't gonna find things to do not gonna find them all, i'm sorryit's a tool we've got to have and so just planning out there yes i'm gonna do that.now you got a plan, i don't care win just so you got a plan and notice theassistant this is my son jason, assistance there too so desiree whenshe's with me we're in the game together and desiree knows what's next if she can see it. she's giving meenergy it's a lonely being during root
canal is that it's lonely here in thathole by yourself nobody gives a rip, you're all by yourself, you have no helpsupport emotionally are used up because you can get down the canal, you can't findthat mb2 so this is another aspect of being able to see is have thenurse it's two people against one instead of one and then you say well idon't really need a microscope john this is for many years ago but look it's kindof a bad overfill there, but that's even worse that. then and you say to yourself,how could they possibly miss that bad? well on a maxillary front tooth are you going to perforate on the lingual or the facial facial if you're going to perforate? willalways give you the answer second house
that ok so the lingual or the facial?facial, so i knew that and has a one-year-old endodontist, one time i perforated on the lingual just to show it can be done. now ialways thought it would be kind of neat if we had a seminar and we've shared the onething that you did in dentistry and you haven't told anyone else about it. i'll tell you one of mine, i make an access and a panicone time stupid assistant. you know what, i learned, we learned not from our successis right we learn when we fall down and we learn how to get back up. so you knowwhat i do now, i actually check to make sure the rubber dams on the right toothand it was about a month ago i started
making access a new set was wrongbecause there shouldn't be a tooth behind the one i was making access to sure enough it was on the first molar and not the second molar. so i learned alifetime lesson and that's the value of these things is not to beat yourself upbut learn the lessons. so i told you about the x gates and its 4 gatesgliddens, which is useful you know less is more and i told youabout the accesses, i'm just reviewing here just to remind you. what percent ofthe lower interiors have two canals 40% so when i'm handing out to you is asheet that tells how many canals are in each tooth, so i have actually have thesea chair side cuz i can't remember, so ok,
front teeth cuspid to cuspid you've got triangle1 and 2, ok now most of you just watch me know most of you on a front toothmake your access is too wide when i'm looking it accesses you chalk off tomuch mesial distal and distal and not enough in sizable apical, turn it so now this is atriangle 2 upper tooth you're removing triangle 2, you have to come up a littlemore and triangle 1 even endodontist they see patients that they've treatedthey've gone around either triangle 1 and 2 or both. ok, so make sure you got the front teeththe triangles are gone. which canal on the top teeth has thehook on it
you treated, you screw it up, you refer tothe endodontist, you're always going to treat it, so you better remember whichone it is. which one has a hook? it is the which tooth lateral, exactly. and if you know that then yougot to preserve that turn otherwise you're going to be straight the hookwill still be there and cause an endo lesion gland perhaps. post terrial teeth also havetriangles so this is a molar but it could be any tooth. now if you look here,anybody can see that cause i'm up here i can look straight down but it can't lookin here unless i'm laying on the chamber floor, cuz there's a triangle here. how doyou remove those to find the canal. now remember we're finding the canal, so let'stake an example of maxillary molar and
little peephole i can't see down unlessthey were laying on the chamber floor, if you look closer you can see it better, sowe could use a x gates are distant gates glidden forward now i'm looking straight down it,now i own it and then i have a chance to shape it and packet in a controlled way.another maxillary molar finding the canal, so with the microscope you gonnabe able to see these color changes, when you're looking for a canal and in thetissue is white go away from that, it's not the rightspot.it will look like this, you'll be able to see. there's no hole there yet
pulps die coronal apically and they calcified coronal apicallyright so sometimes you can't find the canal where is it as another half amillimeter so you just gotta go another half a millimeter but you have to go inthe right spot cause you go over there that's the wrong spot, weaken the toothmake a hole. so one thing you do you get already put your long shank number oneround were in your high speed and you said ok let's go in and you can't see it because you asthe head of the hand pieces in the way so what do you do fired up and then look oh my god, have to go the other way fired up wrong way again now i'm good but pretty soon you got all these bur holes.in dentistry, we don't we are
self-selected. we are here because wewant to do best thing for the patient. you can't getaway from it. i can show you a new tool in the final analysis if it doesn't do abetter job you will discard it. it might be faster you, might make more money butin the heart of hearts eventually gonna say i can't do it. somepeople who use hand instrumentation still is because they've heard aboutbreaking something and the fear is just too great i can not possibly take thatrisk and i i you know, i applaud you for that. so we have to see and dosimultaneously then we feel safe.
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