Apicoectomy (1 of 2)

[YearraeY]

honest?

best to just remove the fecking tooth and have an implant than going through this shit.

[MeMo5682]

MTA.......... Metiltrioxidagregat

[ROZX5452]

yeahhhh. get that gross tissue out. awsome

[lizalaguapa]

ah y por cierto los dentestas tienen mas cojones que los toreros... normal que ganen tanto dinero un dienro muy bien merecido, un oleee por los dentistas

[camelocamelarte]

@lizalaguapa jajaja esoo es verdadd ganan muxooo dinero pero los toreros ganan mas te lo aseguro jajaja

[lizalaguapa]

en principio a mi me tienen que hacer todo esto.....

pero sabes que... prefiero que me saquen la muela antes que me hagan todo esto, ami no me tocan. ya he tenido experiencias bastantes malas como para pasar por aqui tambien.... NOOOO

si mi muela no se cura con el tratamiento que mi dentista me a puesto dentro de la muela.... me la saco y punto

[benzondmd]

dr, i think ur incision is not according to d principles of making a mucoperiosteal flap.. the base should always be wider.. i wonder how long did it take to heal?

[endoguy]

@benzondmd Flap design as per textbook by Arens and Chivian with a striaght vertical release incision. Arens was my instructor.  the flap design you're referring to is typically for exodontia.

[benzondmd]

dr, i think ur incision is not according to d principles of making a mucoperiosteal flap.. the base should always be wider.. i wonder how long did it take to heal?

[peggy187]

why are you using a root planing tool to scrape the cyst out with? isnt there a sharp angle on the front of it that (by the looks of things on the video) might puncture it during removal? why not use a periotome?

[GTWCMT]

thats pretty bad, Looking at the Xray it wasn't far off mine about 4 years ago,  I took Tetralysal for 18 months when they tried root canal 4 times and failed (my tooth has been dead for about 20 years and the root had closed)

In more recent xrays it wasn't so bad and most of the infection had gone down from using combination antibiotics.

I had my surgery under local and it took 45 minutes, I'm in no more pain than I was with the infection.. with the reduction in toxins I feel much better

[endoguy]

@GTWCMT  this was done over 5 yrs ago. tooth is healed doing fine.

[leeus20007]

ugh by bro just had this done. ugh terrible

[Ramiammoun]

very nice work

[ringgiant1]

I had a dentist puncture my rt sinus during this procedure and cause a severe bone infection. After a seven hour surgery I still lost the tooth, wasted 1100 bucks, and once the nova wears off after having your bone drilled it is excruciating. I am not too proud to say I pretty much almost cried. That hurts.

[endoguy]

@ringgiant1

I'm not sure what would take 7 hours? It is usually under an hour start to finish. Perforating the sinus is usually not a big deal. Sorry to hear you had such a rough go.

[ringgiant1]

My case became a teaching case. It was pretty horific. I kept the xray as a reminder never to trust yourself to just any dentist or endo. Always be selective, and their were other circumstances from a sinus surgery that were mitigating as well.

[MizzMinea]

Urgh. I had that yesterday i better stop watching...*gulp*

[anotheraka]

Bad dentistry prior to this.

[jswaffxxx]

my dudes teeth are so yellow, he spits butter.....

[deledinho]

su bajon fue el colgajo, un semilunar por ultimo pero esos angulos agudos y la base recta no amplia, pueden provocar una necrosis del tejido mas periferico k puede complicar la cicatrizacion

[Leenao]

why is the whole is tooo bigggggg!!

[marialuisabarbieri]

Exelente!

[cruzscrillio]

I had that done u r numb throughout but after......u r in hell I winded up in ER 2 but in the end it was worth it

[farariazvatan]

I wish it had sound and explenation,still great work ,you are a RRO

[farariazvatan]

fantastic a 10+prformance

[JOberacker]

I'm not an endo, just a patient, so my terminology might not be precise. Just had this procedure done LESS THAN AN HOUR AGO. I'm still so numb, I can't yet comment on post-operative pain. Overall, the procedure itself was "painless" - but there was a significant amount of "pressure" as the endo was pulling back the gum. I was very apprehensive going into it, but overall it wasn't as bad as I expected. Total procedure took about an hour. Bring your ipod - Mozart made me much more relaxed!

[sanjayjamdade]

how come air rotor is used for surgery? won't that pump lubrication oil and air in to the tissues?

[endoguy]

its an 45 deg. impact air hp. doesn't blow air only water.

[sanjayjamdade]

O.K. you mean surgical handpiece!

[bergler71]

but I didnt have a cyst just a really tiny piece of infected tissue. I can also recommend getting a second opinion for all this. I had some concerns and found a doctor who gave me valium and gas for my nervousness and also saved me 1500 bucks over the first guy i saw about the procedure.

[bergler71]

I had one of these two days ago, Im all puffed up and on hydrocodone. The recovery blows so far. The procedure itself was surprisingly painless

[valleyjulie]

uh no offense but why didn't you just pull that cyst sac the opposite way that you were pulling it? It seems it might have come out easier.

[samordental]

very nice video...congratulations

[DrSandmann]

Endodontists are a disgrace to the dental profession. They are doctors who specialize in two procedures: root canal therapy (and its variants) and apicoectomies. That's like having an ER physician who "specializes" in intubations. As a general dentist, I do my own root canals and my own apicoectomies. The rare apicoecomies I don't do myself, I refer to oral surgeons (who can deal with the risk of nerve injuries). Endodontist have such weak surgical skills that they shouldn't hold scalpels.

[endoguy]

I'm sure you only have your patients' best interests in mind by doing all your own endo. General dentists such as yourself are why endodontic treatment has the second highest fequency of malpractice complaints amongst procedure categories that GENERAL DENTIST's perform. Yet ENDODONTISTS collectively have one the lowest incidences of patient complaints among specialists(closely behind Dental Public Health and Dental Radiology.

Your comment neither enlights nor enriches the discussion.

[jaydelotte]

Well stated. I go to a general dentist for my routine dental work. I had an oral surgeon remove my wisdom teeth and my general dentist referred me to an endodontist for my root canal. It went perfect and had absolutely no pain afterword. Endo's rock!

[rmgj]

oh, jealous of your specialty being ripped?

[klauz89]

it is true what they say.. maxilofacial surgeons are assholes with a god complex...

I hope this doesn't happen to me...

By the way, I just saw ur profile.. Man!! ur a 48 year old surgeon and you have time to be here trashing other people's work??

if u have that much time on ur hands u must not be as good as u think...

[rmgj]

Well, well, have I stirred a hornet's nest, Klauz, son, you are d-r-o-o-l-i-n-g to become a MaxilloFacial surg., that is. at the moment you are a wanna-be, and that is all, I see you posted my video of a mandibular fracture as favorite of yours, do you also have a love hate relationship with your Dad?, perhaps some meditation could help you clear your mind.

[klauz89]

I am not drooling to become a maxillofacial surgeon, I consider the posibility along with others...

And I do admire your work but that does not mean that I don't think u were a little arrogant before [which does not justify my being disrespectuf, I apologize] I guess that's what u ment by the love-hate remark..

[rmgj]

Prt 2:Still, lateral incisors are the upper teeth with the least load, and if you leave them well protected by trimming and/or splinting it might work, but the prognosis and the strict indications for such a technique here can be questioned, the incision I did not like, and what I said , stands, along with the suturing, but, the oral cavity is so noble, it tolerates even us, dental surgeons, what stopped me dead on my tracks was his manners an education, and made me realize I had become

[rmgj]

Part3:A key board bully, and that was a shock, so that was the biggest lesson learned here, and for that I thank him and you, regarding the correct apicoectomy, there are many ways to skin a cat, cheers and good luck to you both.

[rmgj]

By the way, you can read spanish, please check how I answer the comments in my videos, I am a very religious person, and consider myself just an instrument, and, insulting a whole lot of surgical specialists is running off the mouth, and please when writing "God", do it with a capital G.

[klauz89]

Again, I apologize if I crossed the line.

oh, and i have to remind myself to capitalize my words when I type, sorry, i have a much better grammar on paper..

[rmgj]

I had been wanting to answer this for so long, indeed I owe you also my apologies for some belligerant behaviour, there was absolutely no need for that and I should have had m ore control, the rock bottom truth is, the apicoectomy here displayed is presumibly done on a patient without sufficient resources so as to choose one of the options, still the technique ends up creating a very poor crown/root ratio, if the X ray iscorrect, I measured it once and I seem to remember 1: .6,

[sanjayjamdade]

Extreme comments! What evidence justifies your comments?

[marcelokrauss]

I´m quite sure that you know that the problem is inside ... not outside the root.This is what qualifies a long term success.

It´s not just a matter of cut it out.

So I believe endodontists have a higher possiblity of success than surgeons by that.

[klauz89]

i'm sorry but at this day and age being just a general dentist is a bit mediocre... and i agree with endoguy the reason why people are so afraid to go to he dentist is because of people like you who think they can do any procedure without having the proper training and end up doing a half ass job and the only person that suffers is the patient..

[rmgj]

Son, for 20 years I have done nothing but surgery, and that includes dentoalveolar surgery, and dentoalveolar surgery includes apicoectomies, for it is a surgery, isn't it?, my apicoectomies have root canal treatments performed by endodontists and I perform the surgery, so, you see, I respect the speciality, see?.

[rmgj]

Listen to this 19 yr old Einstein¡¡¡¡¡¡¡

[klauz89]

I get that I sound like a smart-mouth little brat but this is a competitive career, you need a specialty and you need to be at the top of your game, I have A LOT TO LEARN but that rule applies to both school and worklife...

I'm sorry, I know I am waaaay out of my league here but is stand by my comment...

[johncab]

DrSandmann, your lack of professionalism is appalling. Please reconsider who is actually acting like a disgrace to the dental profession right now.

[davey914]

That's a very rude and glib interpretation of a very tedious and at times difficult specialty.

[shadowblade1985]

An apico is a procedure in which an Endodontist (might be Periodontist, I forget) goes deep into the gum tissue in order to remove infected portions which, if not removed, could lead to seriously bad problems involving not only your mouth, but your sinuses as well. Really, really sucks to go through this.

[rmgj]

That is a very hazy description of the procedure, please if you want to know more ask the author of the video.

[t5e2]

an apico is usually performed by an endodontist but many general dentists are also experienced in this procedure. Other specialists such as periodontists and oral surgeons also have had training in this area.

[LchanOtakudom]

Oooooooooookay, point taken, BRUSH AND FLOSS! *hops off to do just that*

[Vanimic]

wow oO c hot...

[carguyx50]

omg this is horrible. IM GONNA START BRUSHING MY TEETH 3 TIMES A DAY INSTEAD OF TWO!!!!

[1christie1]

ew what the hell

?

haha

[mmura88]

Wow!!!

[tieranika]

I had this precedure done a couple years ago, I never knew it was this brutal. No wonder I wanted to kill myself when I woke up...

[Seroganth]

good job on brushing your teeth daily!

[dfisk79]

does anyone else have a boner?

[clistsales10550]

OMG!

[racheltest]

Oh wow. This is awesome. I don't work in our office that does the Apico, so I never get to assist for one.

Thank you. Very informative.

[rmgj]

I agree on that, if he is still in his training phase

[charliebad]

Cool, just off for some lunch. Think I'll have a ham mayo sandwich.

[nikidizzi]

seems to me like its just a person with no hygiene at all

[ismail19918]

DISKUSTING

[WillGotti]

This looks like a person that just LOVES to eat and hates to brush.

[brakspbfun]

shit man you have to have a lot of guts to me a surgeon !

[rmgj]

Wow, here I was thinking I was a clumsy surgeon, the mouth is not some marsuplialis pouch, quit sticking your fingers carelessly¡, smart people have devised instruments to explore the mouth, a generation or more ago. good heavens¡¡

[mishelle111]

as IF you are,,,,they are doing the procedure perfect,,,you have no dental knowledge of anything,,your probably have upper and lower dentures...keep your neg. comments to yourself

[rmgj]

Please, I am a fully trained oral and maxilofacial surgeon and also a fierce self critic, hence the "here I was thinking I was a clumsy surgeon", sorry if that hurt, but surgery is a jealus mistress, demands attention and practice, and experience, your friend (he is your friend, right?) might be a superb endoguy, but his surgery could use some perking up, the way he handled the stitching is unelegant at most, the public has the right to know that, or have the videos reviewed before, cheers¡¡

[TentSailing]

A surgeon who misspells jealous? Scary. What the hell are all these so-called medical professionals doing haning out at YouTube?

[rmgj]

Haning at YouTube?, could it be some involuntary key-slip, yes?, please join the dots.

[TentSailing]

Touché.

[rmgj]

merci, Joyeux Noël¡¡¡¡

[B3rryblAst]

oh man thats goota hurt !

he better of giving you a freeze so it did hurt

is much

[AMIMAMA]

why do this happened to u??? that was so amazing u have to be a hero to survive that

[Kingknag]

That was nasty

[immortalove88]

AMAZING!!!! You are a trooper.

[TitsAlot]

It bugs the hell out of me when drs slice into you, then send you toddling off with 2 advil. Bastages are always undermedicating suffering patients.

[endoguy]

no suffering here .

[zoopu]

are you british?

[endoguy]

no canadian

[ruflosn]

from the looks of the rest of the teeth, this person could use a good cleaning, also.

[endoguy]

not much 2 advil,

[Cibersurfer]

An excellent case endoguy, but i have a question for you, wahat dis you use after the apicoectomy to sel the root canal,Thanks. Regards...

[endoguy]

mta