To pull or not to pull? | Endodontic insights
View online | November 5, 2015 | Forward to a Friend

Think again before you write that prescription, pull those teeth, or fill that canal . . .

Just recently, a local medical colleague of mine was arrested for two patient deaths and 398 felonies related to his prescription-happy hand. Eye-opener? Oh, yeah. So I ask these questions: Are we REALLY aware of all that goes on in the wide world of drugs? Are we thorough with our health histories and aware of potential drug cocktail interactions? Do we understand the recent changes to hydrocodone drug classification? Drug seekers . . . can you spot them? Do we have good, solid relationships with our local pharmacists? A pharmacist’s perspective is quite different from ours, which is why this article by pharmacist Corey Heffernan is such a good read and review for anyone who has a DEA number.

We have even more for you to mull over this month: To pull or not to pull? Should maxillary bicuspids in an adult be removed to acquire more space to achieve a favorable orthodontic outcome?

We have an endodontic insights article … and a pathology case, and it’s a fun one! Let me know what you think!

—Stacey L. Simmons, DDS, Editorial Director

Original Articles from Breakthrough Clinical

Pharmacology update: Reclassification and guidelines for controlled medications

$subtitles.get($x) When you were aspiring to become a health-care professional, the thought of playing cop probably never crossed your mind. Unfortunately it is a part of all of our jobs. Keeping a vigilant eye and having good prescribing habits can go a long way in preventing prescription drug abuse. So many changes have occurred in drug reclassification over the past year that the basic rules are not as simple as they should be. Corey Heffernan, PharmD, covers the highlights of common questions about prescribing controlled medications.

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Maxillary expansion or bicuspid extraction: A case study in orthodontics

$subtitles.get($x) To pull or not to pull? . . . the decision to extract permanent teeth in an adult patient is not always an easy one. When an adult patient presents with severe crowding and a posterior crossbite, will dental and skeletal expansion create sufficient space to resolve the crowding, or will teeth need to be extracted as well? Dr. Tyler Pritchard presents a case study as he goes through the process of making this decision.

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Endodontic Insights

Endodontic insight: Maximizing canal cleansing with minimal dentinal weakening

$subtitles.get($x) With regard to root canal therapy, it is often accurately stated that “what we take out of the root canal is far more important than what we put in.” What we take out is based on a combination of mechanical instrumentation and chemical irrigation. Conventional irrigants used in conjunction with instrumentation can impact the integrity of the remaining tooth structure both in a positive and negative fashion. Endodontics expert Dr. Barry Musikant offers his credible advice along with a suggested irrigation protocol.

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My Picks from the DentistryIQ Network

After a tooth extraction, are you guilty of chucking the tissue?

$subtitles.get($x) There are many etiologies behind the development of a radiolucent lesion at the apex of a tooth root. What clinicians are most familiar with are lesions of endodontic origin. But what happens when that lesion is of nonendodontic origin? What happens when the clinician proceeds with business as usual and performs an apicoectomy or extraction with subsequent implant placement because of a perceived root canal failure down the line? Perio-Implant Advisory Editorial Director Scott Froum, DDS, and Dr. Naomi Ramer, chief of oral pathology at Mt. Sinai Hospital, offer advice on how to handle these situations.

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‘Pearls’ Enhanced: Joshua Austin, DDS, FAGD, demonstrates interproximal reduction with the ContacEZ IPR Strip System (VIDEO)

$subtitles.get($x) In this monthly feature, Dr. Joshua Austin enhances one of his "Pearls for Your Practice" from his column in Dental Economics. This month, he demonstrates interproximal reduction using the ContacEZ IPR Strip System.

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3 denture products this prosthodontist can't live without

$subtitles.get($x) Prosthodontist Pamela Maragliano-Muniz, DMD, loves making dentures. But she didn't always feel that way. In this article from The Product Navigator, she identifies three products that are integral to her success—find out what they are!

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Implants, TMJ, ortho—why choose? The case for CBCT and the multidisciplinary dental practice

$subtitles.get($x) Dr. Kaveh Ghaboussi says, “I became a dentist by accident. An off-hand invitation from my childhood dentist—to shadow him in the office, see what he does, and maybe even buy his practice one day—was an unforeseen opportunity to reconsider my best-laid postcollege plans. I applied to dental school on a whim, but found myself drawn to the prospect of working with my hands, working with people, and—most importantly—helping those people improve their health.” In this article from Dental Economics, Dr. Ghaboussi explains how he and his multidisciplinary practice have embraced technology for practice success and patient well-being.

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Pathology and Diagnosis

Breakthrough Clinical pathology case: No. 10

$subtitles.get($x) In Breakthrough Clinical’s pathology case No. 10, healthy 11- and 14-year-old males present to the office for new-patient exams. Clinically, it was noted that the eruption patterns were not as they typically would be, primarily for the 2nd molars in the 14-year-old. A panoramic radiograph was taken, which revealed large radiopacities around the 2nd molars on the right side . . .

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Diagnosis and treatment for Breakthrough Clinical pathology case: No. 9

$subtitles.get($x) A 62-year-old male presents to the office with the chief complaint that for the last nine days, he has had a severe burning feeling on his tongue and the insides of his cheeks, accompanied by “white patches all over.” Breakthrough Clinical Editorial Director Dr. Stacey Simmons gives her diagnosis and recommended treatment in this month’s conclusion of pathology case No. 9.

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Visit Breakthrough Clinical’s Facebook Group

$subtitles.get($x) To network with your colleagues and share information about cases, visit our growing Facebook group. Here we have a place where we can freely share and discuss cases, treatment, clinical outcomes, and more. Come join us!

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CE and Our Sponsors

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CE: Diagnosis and Management of Pre-, Intra- and Post-Operative Complications for Sinus Augmentation Surgery (3 CE credits)

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SPONSORED INFORMATION: Irrigate, clean, and rapidly disinfect the root canal in one step!

$subtitles.get($x) Irritrol from Essential Dental Systems is a single-step disinfecting endodontic irrigation solution, used as a final rinse after sodium hypochlorite. It effectively disinfects, removes the smear layer, and is gentle on dentin. Irritrol efficiently removes the smear layer less aggressively than conventional irrigants, therefore causing less demineralization of the dentin. By incorporating this single-step solution into your practice, you will work faster, smarter, and more cost effectively.

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SPONSORED INFORMATION: Advanced Invisalign technology is designed to help your practice thrive and grow

$subtitles.get($x) As an Invisalign provider, you can stay on the leading edge of dental technology—a great way to position your practice for long-term growth and success. Register to become an Invisalign provider by December 31, 2015, and SAVE two ways. Learn more from Align Technology.

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