DentaltownUK May 2017 - 75
He's coming in around 2 p.m. Maybe I'll try to get in with cowhorn at first and then section
if it's not coming out. I'm never really sure if I'm using cowhorn right. From what I understand,
it's more like a pumping motion (up/down) instead of a buccal/lingual movement, correct? ■
Lil Toof
Member Since: 06/18/15
Post: 9 of 16
3/15/2017
Yes, get the tips in the furcation. Start with small figure 8 motion, lightly. Read the tooth
feedback, increase figure 8's distances as the tooth shows positive feedback, while also squeezing
the grips tighter and tighter into furcation lifting it out as you go.
Figure 8's, circles, squares, whatever you want. Just a constant controlled movement that
increases in magnitude as the tooth tells you it is OK to do so. ■
Jeromy Thornton DDS
Member Since: 06/15/11
Post: 10 of 16
3/15/2017
I've extracted hundreds and hundreds of teeth just like this. Radix paramolaris (or entomolaris, depending on B vs. L) is extremely common in the Yupik Eskimo population that I treated
for my first four years out of dental school.
These teeth will make you regret attempting them if you don't know what you're doing (or
have X-rays, which we didn't many times).
As Jeromy said, first thing is to get a cowhorn on it. Seventy-five percent of the time this
tooth is going to come right out and be looking good for a nice picture to show. Two-minute
EXT. You'll know if this is possible in about the first 30 seconds though. If you squeeze and
figure 8 the cowhorn and it's instantly loose, you're going to get it out whole. If it feels like it's
sitting in cement, drop the cowhorn and pick up the handpiece.
The other 25 percent you need to section M and D roots (B to L section) and then section
the two distal roots. Get the M root out first if you can. 301 and forceps extraction, usually
pretty easy. Use your B to L section to your advantage but putting a 301 in there and gently
luxating the M and D roots. You're just trying to get a little mobility on the D roots while the
M is still present. Then get your usual purchase on the M of the M root and remove (important
to purchase here so you don't break D roots). Then section the D roots. Your section is M to D.
Get down there to where you see the bone between the roots, don't hope to split it, you'll just
break that distal lingual root off way down there and then be digging for it.
Be aware, the DL root many times has a curve at the apex to the buccal, meaning it wants to
roll out buccally. You should remove the DB root first, then the DL root.
Straight forward, but I've watched these teeth crush even experience exodontists. Here's
your flow: 23 forceps for 30 seconds ---> section M and D roots ---> luxate M and D root gently
within the section you've created---> remove M root ---> section DB and DL roots --->remove
DB ---> remove DL
I think it's very unlikely, but that DL root looks a little shorter and usually that means its
curved. They just want to hold in there when they are like that. Or worse, you break off the last
3mm that's curved, look down the socket and see nothing.
Take X-ray, see there's still a piece in there, look in socket again and see nothing. You're like
what is going on here, then realize, "Oh yeah, it's a curve to the buccal and that little piece of
root is hiding under bone." You have to prep the "roof" of bone off to retrieve it. Probably going
to come out with a cowhorn, but be ready in case it doesn't. ■
HuntNFishNW
Member Since: 12/13/11
Posts: 11 and 13 of 16
Join this
discussion
online!
search:
"Third Root"
Curious to see how this
case turned out? What
would you have done in
this situation? Head to
dentaltown.com and
search the message
boards for "third root."
This thread will be the
top result.
3/15/2017
Lil Toof
Thank you both for your advice! I will update once I'm done. ■
3/15/2017
Member Since: 06/18/15
Post: 15 of 16
dentaltownuk.com \\ MAY 2017
75
http://www.dentaltown.com
http://www.dentaltownuk.com
Table of Contents for the Digital Edition of DentaltownUK May 2017
On Dentaltown.com
Mike Gow Editorial
Meet the Team
Howard Speaks
Dental Aid Network
Titanium vs. Zirconia Implants
NASDAL Goodwill
Golden Nuggets
Orthodontist Case Study
Poll—Pediatric Dentistry
Technology: The True Foundation of Your Practice
Continuing Education
Timeout: Chris Barrow
Progressive Bites
Walt Disney's Hollywood Smiles
Dental Imaging: Elaine Halley
MANAGING SYSTEMIC DISORDER: STEPHEN HUDSON
The Art of Diagnosis in Endodontics
MESSAGE BOARD: 2nd Distal Root on 36
Social Media Fails
Operation Smile
THROUGH THE KEYHOLE: SURGERY— HOME AND AWAY
Lifestyle Section
History of Dentistry
Student Section
Wish List
DentaltownUK May 2017 - 1
DentaltownUK May 2017 - 2
DentaltownUK May 2017 - 3
DentaltownUK May 2017 - 4
DentaltownUK May 2017 - On Dentaltown.com
DentaltownUK May 2017 - Mike Gow Editorial
DentaltownUK May 2017 - 7
DentaltownUK May 2017 - 8
DentaltownUK May 2017 - 9
DentaltownUK May 2017 - Meet the Team
DentaltownUK May 2017 - 11
DentaltownUK May 2017 - Howard Speaks
DentaltownUK May 2017 - 13
DentaltownUK May 2017 - Dental Aid Network
DentaltownUK May 2017 - 15
DentaltownUK May 2017 - 16
DentaltownUK May 2017 - 17
DentaltownUK May 2017 - 18
DentaltownUK May 2017 - 19
DentaltownUK May 2017 - 20
DentaltownUK May 2017 - 21
DentaltownUK May 2017 - Titanium vs. Zirconia Implants
DentaltownUK May 2017 - 23
DentaltownUK May 2017 - 24
DentaltownUK May 2017 - NASDAL Goodwill
DentaltownUK May 2017 - 26
DentaltownUK May 2017 - Golden Nuggets
DentaltownUK May 2017 - 28
DentaltownUK May 2017 - 29
DentaltownUK May 2017 - 30
DentaltownUK May 2017 - Orthodontist Case Study
DentaltownUK May 2017 - 32
DentaltownUK May 2017 - 33
DentaltownUK May 2017 - Poll—Pediatric Dentistry
DentaltownUK May 2017 - 35
DentaltownUK May 2017 - Technology: The True Foundation of Your Practice
DentaltownUK May 2017 - 37
DentaltownUK May 2017 - 38
DentaltownUK May 2017 - 39
DentaltownUK May 2017 - 40
DentaltownUK May 2017 - 41
DentaltownUK May 2017 - Continuing Education
DentaltownUK May 2017 - 43
DentaltownUK May 2017 - 44
DentaltownUK May 2017 - 45
DentaltownUK May 2017 - Timeout: Chris Barrow
DentaltownUK May 2017 - 47
DentaltownUK May 2017 - Progressive Bites
DentaltownUK May 2017 - 49
DentaltownUK May 2017 - 50
DentaltownUK May 2017 - 51
DentaltownUK May 2017 - 52
DentaltownUK May 2017 - 53
DentaltownUK May 2017 - Walt Disney's Hollywood Smiles
DentaltownUK May 2017 - 55
DentaltownUK May 2017 - 56
DentaltownUK May 2017 - 57
DentaltownUK May 2017 - 58
DentaltownUK May 2017 - 59
DentaltownUK May 2017 - 60
DentaltownUK May 2017 - 61
DentaltownUK May 2017 - Dental Imaging: Elaine Halley
DentaltownUK May 2017 - 63
DentaltownUK May 2017 - 64
DentaltownUK May 2017 - 65
DentaltownUK May 2017 - 66
DentaltownUK May 2017 - 67
DentaltownUK May 2017 - MANAGING SYSTEMIC DISORDER: STEPHEN HUDSON
DentaltownUK May 2017 - 69
DentaltownUK May 2017 - The Art of Diagnosis in Endodontics
DentaltownUK May 2017 - 71
DentaltownUK May 2017 - 72
DentaltownUK May 2017 - 73
DentaltownUK May 2017 - MESSAGE BOARD: 2nd Distal Root on 36
DentaltownUK May 2017 - 75
DentaltownUK May 2017 - Social Media Fails
DentaltownUK May 2017 - 77
DentaltownUK May 2017 - Operation Smile
DentaltownUK May 2017 - 79
DentaltownUK May 2017 - 80
DentaltownUK May 2017 - 81
DentaltownUK May 2017 - THROUGH THE KEYHOLE: SURGERY— HOME AND AWAY
DentaltownUK May 2017 - 83
DentaltownUK May 2017 - Lifestyle Section
DentaltownUK May 2017 - 85
DentaltownUK May 2017 - 86
DentaltownUK May 2017 - 87
DentaltownUK May 2017 - 88
DentaltownUK May 2017 - 89
DentaltownUK May 2017 - 90
DentaltownUK May 2017 - 91
DentaltownUK May 2017 - 92
DentaltownUK May 2017 - 93
DentaltownUK May 2017 - 94
DentaltownUK May 2017 - History of Dentistry
DentaltownUK May 2017 - Student Section
DentaltownUK May 2017 - 97
DentaltownUK May 2017 - 98
DentaltownUK May 2017 - 99
DentaltownUK May 2017 - 100
DentaltownUK May 2017 - 101
DentaltownUK May 2017 - 102
DentaltownUK May 2017 - 103
DentaltownUK May 2017 - Wish List
DentaltownUK May 2017 - 105
DentaltownUK May 2017 - 106
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2025
https://www.nxtbook.com/farran/dentaltown/dentaltown-january-2025
https://www.nxtbook.com/farran/dentaltown/dentaltown-december-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-november-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-october-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-september-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-august-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-july-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-june-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-may-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-january-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-december-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-november-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-new-grad-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-october-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-september-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-august-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-july-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-june-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-may-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-january-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-december-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-november-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-october-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-new-grad-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-september-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-august-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-july-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-june-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-may-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-january-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-december-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-november-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-new-grad-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-october-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-september-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-august-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-july-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-june-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-may-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2021
https://www.nxtbook.com/farran/dentaltown/2021January
https://www.nxtbook.com/farran/dentaltown/2020December
https://www.nxtbook.com/farran/dentaltown/2020November
https://www.nxtbook.com/farran/dentaltown/2020NewGrad
https://www.nxtbook.com/farran/dentaltown/2020October
https://www.nxtbook.com/farran/dentaltown/2020September
https://www.nxtbook.com/farran/dentaltown/2020August
https://www.nxtbook.com/farran/dentaltown/2020July
https://www.nxtbook.com/farran/dentaltown/2020June
https://www.nxtbook.com/farran/dentaltown/2020May
https://www.nxtbook.com/farran/dentaltown/2020April
https://www.nxtbook.com/farran/dentaltown/2020March
https://www.nxtbook.com/farran/dentaltown/2020February
https://www.nxtbook.com/farran/dentaltown/2020January
https://www.nxtbook.com/farran/dentaltown/2019December
https://www.nxtbook.com/farran/dentaltown/2019November
https://www.nxtbook.com/farran/dentaltownuk/2019OctoberNovember
https://www.nxtbook.com/farran/dentaltown/2019October
https://www.nxtbook.com/farran/dentaltown/2019NewGrad
https://www.nxtbook.com/farran/dentaltown/2019September
https://www.nxtbook.com/farran/dentaltown/2019August
https://www.nxtbook.com/farran/dentaltown/2019July
https://www.nxtbook.com/farran/dentaltownuk/2019JuneJuly
https://www.nxtbook.com/farran/dentaltown/2019June
https://www.nxtbook.com/farran/dentaltown/2019May
https://www.nxtbook.com/farran/dentaltownuk/2019AprilMay
https://www.nxtbook.com/farran/dentaltown/2019April
https://www.nxtbook.com/farran/dentaltown/2019March
https://www.nxtbook.com/farran/dentaltown/2019February
https://www.nxtbook.com/farran/dentaltownuk/2019FebruaryMarch
https://www.nxtbook.com/farran/dentaltown/2019January
https://www.nxtbook.com/farran/dentaltownuk/2018Winter
https://www.nxtbook.com/farran/dentaltown/2018December
https://www.nxtbook.com/farran/dentaltown/2018November
https://www.nxtbook.com/farran/dentaltownuk/2018November
https://www.nxtbook.com/farran/dentaltown/2018October
https://www.nxtbook.com/farran/dentaltownuk/2018October
https://www.nxtbook.com/farran/dentaltown/2018NewGrad
https://www.nxtbook.com/farran/dentaltown/2018September
https://www.nxtbook.com/farran/dentaltownuk/2018September
https://www.nxtbook.com/farran/dentaltown/2018August
https://www.nxtbook.com/farran/dentaltownuk/2018July
https://www.nxtbook.com/farran/dentaltown/2018July
https://www.nxtbook.com/farran/dentaltownuk/2018June
https://www.nxtbook.com/farran/dentaltown/2018June
https://www.nxtbook.com/farran/dentaltownuk/2018May
https://www.nxtbook.com/farran/dentaltown/2018May
https://www.nxtbook.com/farran/dentaltownuk/2018April
https://www.nxtbook.com/farran/dentaltown/2018April
https://www.nxtbook.com/farran/dentaltown/2018March
https://www.nxtbook.com/farran/dentaltownuk/2018March
https://www.nxtbook.com/farran/dentaltown/2018February
https://www.nxtbook.com/farran/dentaltownuk/2018February
https://www.nxtbook.com/farran/dentaltown/2018January
https://www.nxtbook.com/farran/dentaltown/2017December
https://www.nxtbook.com/farran/dentaltownuk/2017Winter
https://www.nxtbook.com/farran/dentaltown/2017November
https://www.nxtbook.com/farran/dentaltown/2017October
https://www.nxtbook.com/farran/dentaltownuk/2017october
https://www.nxtbook.com/farran/dentaltown/NewGrad2017
https://www.nxtbook.com/farran/dentaltown/2017September
https://www.nxtbook.com/farran/dentaltownuk/2017September
https://www.nxtbook.com/farran/dentaltownuk/2017August
https://www.nxtbook.com/farran/dentaltown/2017August
https://www.nxtbook.com/farran/dentaltown/2017July
https://www.nxtbook.com/farran/dentaltownuk/2017July
https://www.nxtbook.com/farran/dentaltown/2017June
https://www.nxtbook.com/farran/dentaltownuk/2017may
https://www.nxtbook.com/farran/dentaltown/2017May
https://www.nxtbook.com/farran/dentaltownuk/2017April
https://www.nxtbook.com/farran/dentaltown/2017April
https://www.nxtbook.com/farran/dentaltown/2017March
https://www.nxtbook.com/farran/dentaltownuk/dentaltownuk/2017march
https://www.nxtbook.com/farran/dentaltown/February2017
https://www.nxtbook.com/farran/dentaltown/2017January
https://www.nxtbook.com/farran/dentaltown/2016December
https://www.nxtbook.com/farran/dentaltown/2016November
https://www.nxtbook.com/farran/dentaltown/2016October
https://www.nxtbook.com/farran/dentaltown/2016nge
https://www.nxtbook.com/farran/dentaltown/2016september
https://www.nxtbook.com/farran/dentaltown/2016august
https://www.nxtbook.com/farran/dentaltown/2016july
https://www.nxtbook.com/farran/dentaltown/2016june
https://www.nxtbook.com/farran/dentaltown/2016may
https://www.nxtbook.com/farran/dentaltown/2016april
https://www.nxtbook.com/farran/dentaltown/2016march
https://www.nxtbook.com/farran/dentaltown/2016february
https://www.nxtbook.com/farran/dentaltown/2016january
https://www.nxtbook.com/farran/dentaltown/2015december
https://www.nxtbook.com/farran/dentaltown/2015november
https://www.nxtbook.com/farran/dentaltown/2015october
https://www.nxtbook.com/farran/dentaltown/2015nge
https://www.nxtbook.com/farran/dentaltown/2015september
https://www.nxtbook.com/farran/dentaltown/2015august
https://www.nxtbook.com/farran/dentaltown/2015july
https://www.nxtbook.com/farran/dentaltown/2015june
https://www.nxtbook.com/farran/dentaltown/2015may
https://www.nxtbook.com/farran/dentaltown/2015april
https://www.nxtbook.com/farran/dentaltown/2015march
https://www.nxtbook.com/farran/dentaltown/2015february
https://www.nxtbook.com/farran/dentaltown/2015january
https://www.nxtbook.com/farran/dentaltown/2014december
https://www.nxtbook.com/farran/dentaltown/2014decemberb
https://www.nxtbook.com/farran/dentaltown/2014november
https://www.nxtbook.com/farran/dentaltown/2014october
https://www.nxtbook.com/farran/dentaltown/2014newgrad
https://www.nxtbook.com/farran/dentaltown/2014september
https://www.nxtbook.com/farran/dentaltown/2014august
https://www.nxtbook.com/farran/dentaltown/2014july
https://www.nxtbook.com/farran/dentaltown/2014june
https://www.nxtbook.com/farran/dentaltown/2014may
https://www.nxtbook.com/farran/dentaltown/2014april
https://www.nxtbook.com/farran/dentaltown/2014march
https://www.nxtbook.com/farran/dentaltown/2014february
https://www.nxtbook.com/farran/dentaltown/2014january
https://www.nxtbook.com/farran/dentaltown/2013december
https://www.nxtbook.com/farran/dentaltown/2013november
https://www.nxtbook.com/farran/dentaltown/2013october
https://www.nxtbook.com/farran/dentaltown/2013newgrad
https://www.nxtbook.com/farran/dentaltown/2013september
https://www.nxtbook.com/farran/dentaltown/2013august
https://www.nxtbook.com/farran/dentaltown/2013july
https://www.nxtbook.com/farran/dentaltown/2013june
https://www.nxtbook.com/farran/dentaltown/2013may
https://www.nxtbook.com/farran/dentaltown/2013april
https://www.nxtbook.com/farran/dentaltown/2013march
https://www.nxtbook.com/farran/dentaltown/2013february
https://www.nxtbook.com/farran/dentaltown/2013january
https://www.nxtbook.com/farran/dentaltown/2012december
https://www.nxtbook.com/farran/dentaltown/2012November
https://www.nxtbookmedia.com