u/placebooooo

My patient is 33. Has all his teeth. Anxious patient but otherwise fine. He had irreversible pulpitis on 14, and I started endo on 12/2025. Negotiating MB2 was very hard; I ended up separating an instrument in there, then I pushed myself outside MB2 way out of the tooth with rotary. Huge mistake. I wasn’t patient enough honestly and this is a rough case to look back on, but I save this in my case album just like I would my good cases.

I temporized. Informed patient of file separation as well as transportation/perf and discussed very guarded prognosis. Discussed option of seeing endo or ext. I discussed case with my endo and his plan was to try and obturate the transported area as he would any other canal up to the point right before exiting the tooth. The problem is the patient has been very inconsistent with visits. His wife schedules everything for him which is even harder. Patient called yesterday (for like the 3rd time) and is freaked out that #14 is “crumbling” but it’s really the cavit holding onto its dear life since December. Last time I saw him, I personally walked him over to endo with the referral. He doesn’t seem too motivated. I saw him last week and took an updated PA and everything looks fine. He just wants the tooth extracted.

I know it’s what the patient wants, but I feel like at his young age, if he’s coming to see me tomorrow for ext, why not finish it and crown prep it and hold onto it for as much as we can get? I feel like anytime is better than premature ext at his age, and it could last a while. It feels a bit wrong to just extract. Maybe it’s my guilt. Patient is not interested in grafting/implant.

Thoughts?

I just sent this patient over to endo, but she refused to be seen and wants tooth ext’d since endo does not accept her dental insurance. She’s having spontaneous pain and pain on percussion. I’m suspecting horizontal fracture due to lateral oriented lesion on scan. Would you have other thoughts here? No missed canals on scan. No isolated perio pockets. Could potentially retreat this case myself, I suspect the tooth is fractured though which is why I sent her over to endo and wanted their expertise on the case.

Edit: Documented well and ext’d. Patient didn’t want to pay for graft.

The owner at the office delivered a crown on #3 one year ago. I saw this 66 year old patient in hygiene and sent him to endo for a lesion on 3.

He gets endo done. He is on my schedule for a new core and crown on #3. 90 minutes. He came with endo letter and his crown in hand. Endo letter stated crown broke off with all buildup as soon as endo started prepping the access (no hole through crown). No problem, complications happen.

Problem is the tooth broke at the gumline. No palatal ferrule feel like it’s not restorable. I asked owner to go in there and he told me easy core and subg crown prep. I told him I’m not doing that for free. I sat there and contemplated what to do. I made sure patient aware of guarded prognosis. Instead of putting it back on the owner’s schedule, I prepped, shredded the tissue, got a shitty impression, and again told patient this is a Hail Mary. Patient wasn’t happy, neither was I. I was too focused on trying to make the most of my chair time. Don’t even think insurance will cover this. This tooth has also been crowned 3 other times in the past looking at his history.

#2 I planned for crown due to recurrent Caries. I’m not sure if I should just extract and bridge. Patient is 66 and he just paid for his endo.

How do you think I proceed from here? Patient coming back in an alleged delivery in 2.5 weeks. Crown is not gonna fit as I took a bad impression due to tissue trauma everywhere. I was thinking I just reimpress when he comes back for #2. Then again, #2 doesn’t have an opposing, should I even crown it or just restore it with composite. I wasn’t thinking straight. I attached photos of my pancake prep

This was a first shell swap for me. I’ve encountered a few problems with the swap and it took such a large amount of my time with a meh result.

I want to start by saying that most of my anguish with the shell replacement was with the quality of the screws. Most of the screws were not going down to place, causing click and pop sounds, and just were incredibly difficult to screw into the shell. I’m not sure if it’s the screws or the quality of the plastic, but even using the OEM screws wasn’t working well. A few places on my shell swap let out creek sounds with pressure, and I couldn’t tighten the 5 screws around the screen fully, which caused me to be unable to place the rubber covers of the screws on the screen.

The A and B buttons feel awful. All the other buttons feel fine. It almost feels like the A and B hardly depress when pressed (no to very minimal feedback).

The most annoying part was removing the rotating hinges from the original. I imagine I probably damaged them, but my gba sp doesn’t fully close (stays open). It does “snap” when opening and closing as intended, however.

I did also order a gba shell to replace, but I’m not motivated to swap that after my experience with this.

Edit: I’ve been reading that the nes shells have a common issue of the gba sp not fully closing. So I got unlucky with my selection?

(FINAL EDIT)****

I just want to say, my hinges are in fact not broken, my hinges are not (and never were) installed incorrectly. The fault is with the janky extreme rate shell that everybody had seemed to recommend.

​I just inserted the same hinges onto my original gba sp shell and it closes and snaps shut/open perfectly.

I’ve been reading this morning that the nes shells seem to have this problem. Aside from the hinge situation, once again, the biggest anguish was the god damn screws that seemed impossible to thread into place (every. Single. One). Why is the plastic not threaded?

For the people that really tried to offer help, thank you. For the other people that rushed in here to just immediately go “everything wrong”, I don’t know what to say to you. Downside is I’ve wasted many, many hours of my time trying to figure out what is wrong with this. Upside is extremerate reached out and hoping they remedy the situation with a new, actually functioning shell. This experience taught me I should be able to hopefully put things together quickly too. Let’s just hope I figure out the stupid screw design situation.

Leaving this thread here for anyone who may need to reference in the future. Awful experience. Picture in comments of seated OEM with same hinges. Cross posted to r/Gameboy

Hi colleagues,

I’m a 4-year out general dentist. I love endodontics and learning about it. I’ve had great successes with endo, and many failures/difficulties. My only regret is not doing endo enough (I do maybe 3 cases a month). As much as I love it, it gives me anxiety and I fear failure as well as wasted chair time for cases I may not be able to complete. I have a great case to share that I did today that I’m very happy with: endo retreatment of #19. This case was carried out on my in-law, for free, and the procedure took 2.5-3 hrs. I performed treatment in a single session due to hardships taking time off from her job and difficulty on my end to make time in my schedule for her. This is my third retreatment to date, with the other two also being on family.

Clinical exam and Diagnosis:
Previously endo treated. Asymptomatic apical periodontitis. Exam shows lesions on M and D roots. Short obturation with recurrent Caries. CBCT taken and reviewed with an endo. Scan showed no missed canals, no fracture. Endo was done 8 years ago overseas.

Step 1:
Excavated caries. Performed pre endo buildup with SDR bulk fill composite and tofflemire. Wasn’t crazy about contours because she’s coming back for crown.

Step 2:
All 3 canals located. There was a bunch of excess sealer gunked around the access and orifices that was hard. I had to drill a good amount away prior to beginning go removal.

Step 3:
Used endo sequence brassler rotary files at 900 rpm to begin gp removal. Got to length in MB and ML canals, finished instrumenting MB and ML with waveone gold (green, size 35).

Step 4:
Instrumenting the D was tough. My rotary stopped at the same point where the previous provider obturated to. I curved a 6, 8, 10 k hand files (90 degree bend right at the tip) and scouted until I found an exit. Got to length on my locator, started going ham to loosen up the sharp curve. Went through many hand files. Finally got my zenflex rotary to pass through, then finished with large waveone file (size 45).

Step 5:
Obturated with endo sequence bc sealer, single cone method. For distal canal, I fit additional accessories. Cleaned up the chamber and sealed case with core buildup.

I’m a nutcase about irrigation. I irrigated each canal with 6 mL NaOCl (5%), then activated each canal with edta for 1 min, then activated each canal with NaOCl for 1 min, then irrigated each canal once more with additional 6 mL (12 mL total per canal). Dried and obturated. I rarely feel good doing dentistry, but I really felt good about what I did for my patient today.

I have this case on my schedule and never did this before. Broken cement-retained implant crown #13.

I talked with perio and was able to identify that the implant is a novel trilobe. My plan tomorrow is to section the crown like I would off a natural tooth, gain access to the abutment and unscrew it? Then place my scan body and scan for a new implant crown. Maybe preserve the abutment if possible.

The only problem is I don’t know if I have a scan body compatible with this implant system. We have a bunch of Nobel active scan bodies, and a few knock-off Nobel scan bodies. I have 1 trilobe scan body, but it’s for regular connection implants. How can I tell which implant I have (narrow, regular or wide?) after I remove the crown and abutment? What part of the implant exactly am I measuring with my perio probe to determine? Might have to just place a healing abutment and order my parts after I identify.

Patient came in today with severe ache on 31. Diagnosed pulp necrosis and symptomatic apical periodontitis.

I don’t do endo often, but when I do, I really enjoy it. I never access through crowns, especially molars, so this was a first for me. I had 2 hrs on my schedule of free time so thought I’d take my time and give it a go.

Accessed. Orifices were calcified (patient is 66). I had to poke holes through the expected orifice location based on what I was seeing clinically. The image of the access is before I poked through. I found the distal and what I think is the ML. I couldn’t find the MB. I instrumented the D (I was 0.5-1 mm short here with my gp and hoped to go back in. I was having difficulty with the ML and thought to work on that first).

The ML was tough. It was so tight in there. The radiograph shows my size 6 file with a 90 degree curve. This, in combination with being unable to find the MB led me to refer.

The lesion looks suspicious too so maybe endo will take a scan and assess for possible fracture as well. It was an interesting case. I’m curious if there are strategies to navigate the 90 degree curve or if it is a matter of instrumenting right before the curve starts and trying to push the sealer in the area or curvature. I’m hoping to at least alleviate some of the symptoms the patient was having.

SNES with two controllers and all the items included in the picture. The snes is in pristine condition! Mint! Looks like it came right out of the box (aside from the yellowing base). I think this is the most unbelievable part of this pickup. Amazing games as well. The 4th game in the picture behind Mario is a hockey game. He just said I could have it.

I was ecstatic. I always see stuff like this happening to other people, so I was gleeful with joy at my turn!

It motivated me to rebuild my original snes collection when I was a child as well as get my childhood games for other childhood consoles as well. I went to the flea market today and picked up my first 4 snes games since picking up the console. I managed to pickup donkey Kong, killer instinct, mortal kombat 3, street fighter 2, each for $11. My only regret is wishing street fighter 2 was the turbo addition.

Like, talked to patient about possible endo and CL on 18 but I don’t know why the case is 3 days away and I’m having nightmares about this. Do other people still get anxious about trying to crown these?