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Hopkinton Endodontics - Judy McIntyre, DMD, MS

Endodontics Hopkinton MA

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Hopkinton Endodontics

Judy McIntyre, DMD, MS
225 Wood Street #1
Hopkinton, MA 01748
508-686-7668

Hours

M: 8am — 4pm
Tu: 8am — 5pm
W: by appointment
Th: 8am — 5pm
F: 8am — 3pm
Sat: by appointment
Sun: closed

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drjudyendo

Got quite a bit of feedback re: this calcified cas

Got quite a bit of feedback re: this calcified case.
My purpose in sharing was that not everything in endodontics is pretty, our work is hard and often, incredibly humbling.
🧘‍
The true point of this case was that I made a call.
I had already seen the patient for over an hour 2 weeks prior.
On #cbct as you can see, the DB was extremely calcified the entire way down
😔
I can usually find a hint of canal somewhere beyond the pulpal floor on my @kavoimaging scans, but in this case, it was "petrified" (my term for extreme calcification) the entire way down. I showed this to the #patient - when the pt can see the disease/obstruction/etc, I feel that this conveys what we are trying to share. This sharing of scans WITH our patients is truly helpful #imo and valuable to both of us, as well as to the RD. #teamwork
🙌
Initially, the pt was symptomatic but not severely so, and there was slight widening of the PDL on the #3dscan
We began treatment and I found MB and Pal canals.
🤞
I medicated, closed and chatted with the pt.
One thing that I have learned of SUPER IMPORTANCE this year is to convey to pts that you have worked your best but to also convey that you cannot risk further damage to the #tooth
(Sometimes in these instances a fresh set of 👀 as well as medication is helpful. Working longer is not always better)
This way, the pt hopefully understands that you are not simply giving up and that you are making your best professional opinion of weighing pros and cons.
On the 2nd appt the pt reported that it was a bit bothersome after the first appointment (we were a bit saddened that the pt didn't reach out to us, esp since we do F/U on each patient the next day) but we reiterated that we once again would try to find the canal and do some further cleaning in the other canals.
After 45 mins of Ultrasonic in the DB canal and on my highest magnification under 🔬, there were no promising signs. I finished the case and reiterated that I did my best and that I would like to follow up in 6 months but to please call if symptoms returned or worsened.
Sometimes, this is the BEST we can do.
🙏
Continued below....

Merry merry Christmas 🎅 🎄 ❤️!!! 🎁 Wi

Merry merry Christmas 🎅 🎄 ❤️!!!
🎁
Wishing us all a wonderful 2022!!!!🎊

CC: "sensitivity to cold a few weeks ago but that

CC: "sensitivity to cold a few weeks ago but that has faded"
🥶
This adult had braces >5y ago; had been in retention but the retainer was "really tight" and reportedly had been rubbing along both palatal surfaces of the U6s to such an extent that the palatal CEJ and palatal root were rather eroded on their surfaces!!!!
🤔🤷‍♀️
Pt also confessed to being a clencher
😬
PVTs were notable for decreased cold on both upper 6s
🙄
We decided to medicate w #calciumhydroxide
🙏
In the meantime, I did refer the #patient to consider an implant and the #periodontist encouraged the both of us to try to save this tooth since there was so much palatal cortical loss; no pressure!!!
🤗
We decided to medicate, and then 2 weeks later ***remedicate; then let the pt have "walking CH" for 6 months!!!
They were agreeable and understood
😷
We rescanned at their recent visit and there were NO changes on the #cbct
😵
We knew this was a complicated case... I also believe there's some internal resorption occurring mid-palatal root as well as apical root resorption too
🥴
My plan was to create stop at the apex, and I *wanted* to promote healing before completion but the #3dimaging revealed no changes towards healing in the past 7 mos.
We together decided to complete the case and I did the core also
🤝
Pondering over this case, I plan to discuss with the periodontist a possible palatal debridement/enucleation (thinking cystic lining that is refusing to respond to my 💪💪) and/or decompression.
🙏
#staytuned
Please comment with your thoughts🥰
Thank you for chiming in!!!!

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