amongst my experiences in NDC i can now add the WWF Pulpect. i have performed WWF SAP before, whereby when i really need to get a patient cleaned up in a hurry (think pack-a-day smoker, never been cleaned in his life and radiotherapy looming in a month) i will head-lock the patient in the crook of my left arm and get the job done. not my favourite maneuvre, but i do seem to be using it a lot more than i would like to have to. but today, i had to use the same headlock to do a pulpectomy...
pt was scheduled for CAP #47(d).
hx of an impacted #48, causing the caries for which i was scheduled to spend a leisurely hour digging out. NRMH, NKDA
and so there i was, with the patient in the chair. EPT -ve but cold ++ve, non-lingering. this was probably a sign of trouble to come, but as i was checking the tooth over it didn't seem terribly out of the ordinary. 2 carts into the IDN and some initial caries free later, i was greeted by the sight of a mass of hyperplastic, hyperaemic strawberry-red tissue bursting out of the distal cavity. and IDN be buggered, it was sensitive to manipulation.
one quick scream to Dr Lui and some prodding later, and it seemed that my only option would be for the patient to grin and bear it while de-roofing the pulp chamber to allow for a good intrapulpal. the sheer irony of of hyperplastic pulp is that the tissue that you want desperately to anaesthetise is blocking the line of sight for you to get your needle into position to do the intrapulpal. damn. and so i had to headlock the patient and rip a diamond bur across the occlusal, and then stuff in a big-head round bur to slash out the pulp from the chamber, all the while apologising profusely and sweating in the deficient air-conditioning. to compound matters, when i sent the patient in for a PA to make sure i was digging in the right direction, and not to china, the radio auntie didn't have the faintest idea how to handle a PA for a patient with dam on! gwaaaaaaaaargh... ended up grabbing an EndoRay from Dr Kuah and aiming it meself.
upon returning from the PA queue, the pulp stumps were still gushing fantastic amounts of blood (hyperaemia ftl) and so another shoutout to Dr Lui later i was witnessing my first live demo in the use of Ledermix. Dr Lui qualified that Ledermix is not a good thing to use in infected cases in general, but due to the sheer amount of inflammation in this case, closing up after splorking Ledermix onto the pulp stumps would prove helpful and allow me to finish up the case in 1-2 weeks with much less bleeding.
hope it all works out...
pt was scheduled for CAP #47(d).
hx of an impacted #48, causing the caries for which i was scheduled to spend a leisurely hour digging out. NRMH, NKDA
and so there i was, with the patient in the chair. EPT -ve but cold ++ve, non-lingering. this was probably a sign of trouble to come, but as i was checking the tooth over it didn't seem terribly out of the ordinary. 2 carts into the IDN and some initial caries free later, i was greeted by the sight of a mass of hyperplastic, hyperaemic strawberry-red tissue bursting out of the distal cavity. and IDN be buggered, it was sensitive to manipulation.
one quick scream to Dr Lui and some prodding later, and it seemed that my only option would be for the patient to grin and bear it while de-roofing the pulp chamber to allow for a good intrapulpal. the sheer irony of of hyperplastic pulp is that the tissue that you want desperately to anaesthetise is blocking the line of sight for you to get your needle into position to do the intrapulpal. damn. and so i had to headlock the patient and rip a diamond bur across the occlusal, and then stuff in a big-head round bur to slash out the pulp from the chamber, all the while apologising profusely and sweating in the deficient air-conditioning. to compound matters, when i sent the patient in for a PA to make sure i was digging in the right direction, and not to china, the radio auntie didn't have the faintest idea how to handle a PA for a patient with dam on! gwaaaaaaaaargh... ended up grabbing an EndoRay from Dr Kuah and aiming it meself.
upon returning from the PA queue, the pulp stumps were still gushing fantastic amounts of blood (hyperaemia ftl) and so another shoutout to Dr Lui later i was witnessing my first live demo in the use of Ledermix. Dr Lui qualified that Ledermix is not a good thing to use in infected cases in general, but due to the sheer amount of inflammation in this case, closing up after splorking Ledermix onto the pulp stumps would prove helpful and allow me to finish up the case in 1-2 weeks with much less bleeding.
hope it all works out...
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