I encourage anyone doing expansive and comprehensive treatment plans to evaluate endodontic needs PRIOR of the non-Richard kind as a component of the critical thinking using cbCT. Remove the existing restorative and prosthetic work and construct provisionals for the patient and then assess the endodontic situation. Identify alterations in pulp chamber anatomy, line up the planes so they course down the long axis of each pulp horn and determine their proximity to exposure. Make your own assessment of the accompanying imagine – hint – check the 4.6 and 4.7.
The rush to place permanent restorations on teeth that have been impacted upon by the vicissitudes of bacteria, previous practitioners, malocclusion, anon still remains startling after 37 years of clinical practice. The joy of removing an acrylic transitional that hasn’t fractured, has elicited an exquisite tissue response and mostly “doesn’t smell” optimizes the chances for success, but moreover, it’s simply pragmatic to do root canal before the zirconia crown has been permanently cemented.