Thursday, June 23, 2011

The Endo Blog Welcomes a New Contributing Author - Dr. Justin M. Parente

We would like introduce and welcome a new contributing author to The Endo Blog, Dr. Justin M. Parente of Alpharetta Endodontics (Alpharetta, GA).

Dr. Justin M. Parente is from Alpharetta, GA. After undergraduate studies the University of Georgia, he attended dental school at the Medical College of Georgia. While at dental school, he earned awards for clinical excellence in both periodontics and endodontics, as well as awards for academic achievement and the highest score on the national boards. Dr. Parente was recognized as distinguished Hinman scholar and was inducted into OKU dental honors society upon graduation. He then completed the two year endodontic specialty program at the Medical College of Georgia. At the annual meeting of the American Association of Endodontists, Dr. Parente presented and won an award for his research on endodontic irrigation. Dr. Parente lectures and mentors students in endodontics at the Medical College of Georgia. He lives in Alpharetta, GA and enjoys playing guitar, reading books, and drawing art.

Dr. Parente has presented at the American Association of Endodontists annual meeting and at his local chapter of the Seattle Study Club. He serves as a scientific advisor for the Journal of Endodontics, peer reviewing research submissions.

He is a member of the American Association of Endodontists, the Georgia Association of Endodontists, the American Dental Association, the Georgia Dental Association, the Hinman Dental Association, the Northern District Dental Society, Southern Endodontic Study Group, the Alpha Omega Dental Society and the Seattle Study Club.

Welcome Dr. Parente!

Tuesday, June 7, 2011

To Scan or Not to Scan?

This patient had RCT #2 done about 8 yrs ago in the military. She is reporting pain of several days duration. Today it is percussion sensitive, normal perio probings, no swelling or palpation tenderness. Adjacent teeth are WNL.

Radiographs reveal peripical radiolucency and conical shaped root. Two canals have been filled. My assumption is that this is likely a c-shaped canal that was incompletely treated. We decided to take a CBCT to evaluate the root form to determine if there is a missed canal or c-shaped canal. If a canal is missed, then retreatment will be recommended. If all the canals were found, then we might consider a surgical approach.

I was surprised to see a large resorptive defect on the DB root surface. This defect has destroyed most of what was once a DB root. Non-surgical retreatment of this tooth would result in perforation and extrusion of RCT material, and likely failure. It was determined that surgical treatment of this tooth would also have a poor prognosis as well. Extraction has been recommended.

Also noted was a perforation in the floor of the Mx sinus, with adjacent sinus inflammation. This tooth is also causing a sinusitis of dental origin. Removal of this tooth should help clear up some of the chronic sinus issues the patient has been experiencing.

Another example of CBCT showing what you cannot see in a traditional radiographic image. Neither of these problems were identifiable with regular imaging and were not the purpose were were taking the scan. However, identifying the root resorption and the sinus perforation had a significant impact on the diagnosis and treatment plan for this patient. The CBCT is a valuable tool for case selection which improves the rate of successful of endodontic treatment at Superstition Springs Endodontics.