drricoshort drricoshort

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Dr Rico Short  The Root Canal Specialist To The Stars! Motivational Speaker Author / Professor / Lecturer ❤️Jesus #GraceLife

The SHORT Case Of The Day!
Tooth #19 Relax or Extract?
Patient came in with pain on tooth #19. The dx was a necrotic pulp with acute apical periodontitis and PAP causing oseous breakdown. There was a lot of decay present and many dentists would have recommended an extraction and implant due to close proximity of bone. Patient did not want to have the tooth extracted. I always take a bitewing on cases with deep decay for restorative reasons. There was enough biological width for restoration and if not crown lengthening could be performed. Endodontic treatment was done in one visit. There were a total of 5 canals (3 mesials with separate POE's and 2 distals that joined). Conefit looked great. Obturation had some overextension especially on the distal root. This used to keep me up at night worrying about healing. But not anymore. I explained it to the patient and the referring dentist that we will monitor the case. If intervention is necessary we will do a retreat or surgery. A 6 month recall shows nice healing and patient was asymptomatic. The restorative dentist did a nice job with the crown. Sometimes the x-ray or final result will not be perfect. Overextensions happens to the best of us. I'm not perfect and I don't mind showing cases of my imperfections. Thank God the body is an amazing healer after we remove the critical mass of bacteria (Seltzer and Bender). Nothing special. Just understanding root canal anatomy and biological principles.
#RelaxDontExtract
#WatchAndWait

Dr. Rico D. Short
Board Certified Endodontist
Apex Endodontics P.C / Atlanta

MEMORIAL DAY SALE!
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#CelebrityEndodontist
#RootCanalSpecialistToTheStars

The SHORT Case Of The Day!
Teeth #5 and #31 ~ Using Different File Systems
(Edge Endo X7 vs Brasseler USA New Scout)
As an independent lecturer and product evaluator I get to "play" with a lot of new technology. I love evaluating Ni-Ti files. I treated 2 endo cases recently ~ one on tooth #5 and tooth #31. On tooth #5 I used Edge Endo X7/.04 taper files and on tooth #31 I used Brasseler USA Endosequence .04 Scout files. What difference do you see in the final shapes?

They are both heat-treated files. Both felt very similar in my hands. I ran both at 500 RPMs/2 NcmTorque. I really like the efficency in cutting, pre-bending and flexibility, and tight flute structure on the new Scout Files. In addition, you can look at the files and see an area "flattening out" before it separates which is a cool safety feature on both files. The Scout File has a smaller flute diameter than Edge Endo X7 (.73mm) making it perhaps a bit more flexible. In addition, the Scout file has a size 17 (purple) making the transition smoother form the size 20 to the size 10. Furthermore, the Scout Files have individual sterile blister packaging which is a nice feature. However, I don't like the small Tip Size ID on the Scout File. It makes it hard to see when transitioning to the next file and the red stripe signifiying tip size is a little confusing at first.
At the endo of the day, I would definitely give the new Scout File an "A" so far. It is more expensive than the Edge Endo X7. Maybe Brasseler USA can work on that. I'm waiting for more independent research to come out dealing with cyclic fatigue and torsional stress compared to Edge Endo X7 and other files then I'll give my final verdict.
Dr. Rico D. Short
Board Certified Endodontist
Apex Endodontics P.C / Atlanta

Get over the invisible barrier. #drricoshort #gracelife

Jesus was a rebel. He was against the #culture. 🤷🏾‍♂️💪🏾🤔

🔑👑🙏🏾

#GraceLife @robertmadu God will blow your freaking minds with his generosity towards you!!!

Endo News You Can Use!
What can you do to help get a good block for that hot lower molar prior to root canal treatment? Tell the patient to take 600mg Ibuprofen 1 hr prior to root canal treatment. Encourage them NOT to take it until the diagnosis is confirmed. It may cloud the diagnosis. A new study in the JOE by Venkateshbabu Nagendrababu, BDS, MDS, PhD et al shows oral premedication with NSAIDs and ibuprofen (>400 mg/d) increased the anesthetic success of IANBs in patients with irreversible pulpitis.
https://www.jendodon.com/article/S0099-2399(18)30130-4/fulltext?dgcid=raven_jbs_etoc_email#.WwQbDMxW6dQ.facebook

and my kids said they don't have anything good to eat at school. they cra cra. Spoiler Alert.🤷🏾‍♂️

So I’m enjoying my backyard with no furniture. #gracelife

The SHORT Case Of The Day!
Tooth #30~ Retrx or Extract?
A 33 year old male patient had a previous root canal on tooth #30 about 10 years ago. He started having biting sensitivity. The dx was previous treatment with acute apical periodontitis. The pre-op x-ray looks pretty good with the previous root canal. Patient decided to retreat the tooth. A retreatment was performed in one visit. There was a missed mid-mesial canal located with the microscope. According to Norsat et al in JOE 2015, the incidence of MM canals is 32.1% in patients ≤20 years old, 23.8% in patients 21–40 years old, and 3.8% in patients >40 years. This retreatment case was performed in 2008. I just saw him for a 10 year recall and he's still asymptomatic. Look at the large shapes. These were "in style then" .06 and .08 taper was the "bomb.com!" Greater Taper files by my buddy Dr. Steve Buchanan were a HOT item! Deep shape and large coronal flare was preached heavily ~ Mostly because we were doing warm vertical condensation or continuous wave and needed to get the heat within 5mm of the apex. Now we have heat treated ni-ti files (narrow and flexible) and bioceramic sealers (no heat required) so we don't have to open the apex so large or increase the taper. Fortunately, no crack or root fracture and it's been 10 years since retreatment (20 years in all). A CBCT would have helped figure out there was a missed canal. On cases like these I offer patients to get a CBCT before treatment. Some do and some don't. Today I would much rather see smaller shapes and less flare. We are now back to conservative shapes and tapers .02 and .04 max. It's crazy to see styles go out and come back. Does that mean I'm getting old?..lol
Living and Learning.
#RelaxDontExtract

Dr. Rico D. Short
Board Certified Endodontist
Apex Endodontics P.C / Atlanta

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