The use of MTA in Clinical and Surgical Endodontics

LOD-082-00

Dr. Arnaldo Castellucci

Recently, Dr. Mahmoud Torabinejad of Loma Linda University, California, has developed a new cement named Mineral Trioxide Aggregate which appears to have all of the characteristics requested of the ideal cement to seal pathways of communications between the pulp and the oral cavity (mechanical and carious pulp exposures), and between the root canal system and the periodontium (iatrogenic perforations, open apices, resorbed apices, root-end preparations).<br><br>MTA is an endodontic cement that is extremely biocompatible, capable of stimulating healing and osteogenesis, and is hydrophilic. MTA is a powder that consists of fine trioxides (Tricalcium oxide, Silicate oxide, Bismute oxide) and other hydrophilic particles (Tricalcium silicate, Tricalcium aluminate, responsible for the chemical and physical properties of this aggregate), which set in the presence of moisture. Hydration of the powder results in formation of a colloidal gel with a pH of 12.5, that solidifies to a hard solid structure in approximately three-four hours. This cement is different from other materials currently in use because of its biocompatibility, antibacterial properties, marginal adaptation and sealing properties, and its hydrophilic nature.<br><br>The characteristic that distinguishes MTA from other materials used to date in endodontics is its hydrophilic properties. Materials used to repair perforations, to seal the retro-preparation in surgical endodontics, to close open apices, or to protect the pulp in direct pulp capping, are inevitably in contact with blood and other tissue fluids. Moisture may be an important factor due to its potential effects on the physical properties and sealing ability of the restorative materials. As shown by Torabinejad et al., MTA is the only material that is not affected by moisture or blood contamination: the presence or absence or blood seems not to affect the sealing ability of the mineral trioxide aggregate.<br><br>During the presentation, several cases of treatment with MTA will be showed. Aim of the presentation is to show the indications and the technique for the correct use of this relatively new material: how to seal an open apex, how to repair a strip-perforation under the microscope, how to protect a pulp exposure to perform a direct pulp capping, how to use MTA during surgery to seal the retroprep.<br><br>In conclusion, the viewers should be able to appreciate the advantages of this material, which made our treatments more predictable and gave us the possibility to save teeth otherwise condemned to extraction.

Integrating 'Esthetic' Dentistry and Prosthodontics

LOD-068-00

Dr. Kenneth A. Malament

Dentistry that is esthetic to the patient is an important clinical objective. The knowledge within dental technology, dental science and dental practice has dramatically expanded leading to better quality; artistry and more standards based clinical applications. Ceramics are the most consistently predictable esthetic dental material. Today dentists can offer more treatment options for patients complex problems. Metal-ceramics continue to be the state of the art and profoundly affect prosthodontic care and the future. <br><br>Understanding methods to manage simple and complex restorative issues are critical to improving patient acceptance and even long term ceramic success. Methods to integrate the efforts of laboratory technologists and managing occlusion and patients desires can have a profound impact in the practice of dentistry.<br><br>All-ceramic materials were developed to improve ceramic color and marginal fit. Until recently few research reports attempted to study their long term use or factors that relate to their performance without modeling the data. All-ceramic crowns on molars have yet to reach their full potential. Despite substantial improvements in material strength and toughness, they still fail at relatively high rates. Ultimately crown performance is a complex set of interactions between crown material and geometry, the characteristics of the support structure of the cement and crown, and the clinical loading history.<br><br>This presentation will provide a comprehensive look at failure modes and effects in bilayer all-ceramic crown-cement-tooth systems, tying together the influences on resistance to fracture initiation and propagation of ceramic material properties and thickness; crown/tooth geometry; cement modulus and layer thickness; damage induced by shaping, fabrication, clinical adjustments, and sandblasting; and fatigue in the wet intraoral environment. Some counter-intuitive findings will be addressed including changes in fracture behavior with different geometry and the influence of the compliant cement layer beneath stiff cores. Original research will be presented that studied the clinical behavior of over three thousand all-ceramic restorations. Life history and fracture rates were studied over twenty years in relationship to factors that might affect success. Factors such as tooth position, preparation, luting procedures and gender are significant to long term ceramic success.<br><br>Dental implants have become an integral part of dental practice today. Maintaining predictability and high success rates impose great challenges to the dental team. Edentulous ridge defects constitute a major problem. In the past long teeth have been placed into defects to take up vertical space. Gingival and tooth symmetry and the esthetic results were often compromised. Today these conditions as well as the lack of bone can be augmented surgically with soft and hard tissue grafting. This may not always produce a long-term predictable result. Prosthetic techniques will be discussed utilizing newly developed ceramic gingival material and design for fixed prosthodontics.

Minimally Invasive Soft Tissue Augmentation

LOD-067-00

Dr. Homa H. Zadeh

A variety of techniques have been described for augmentation of soft tissue around teeth with varying donor material and access. Recently, tunnel technique has been used for minimally invasive assess to sites being augmented. This presentation will describe a novel access for soft tissue augmentation and root coverage. Moreover, application of autogenous tissue, as well as growth factors will be discussed. Minimally invasive soft tissue augmentation may also be applied for modification of thin biotypes around dental implants. The techniques described will be illustrated with clinical cases.

All Ceramic Restorations - Achieving Esthetic Excellence

LOD-066-00

Dr. Mauro Fradeani

All Ceramic Restorations - Achieving Esthetic Excellence

Current trends in Aesthetic Periodontology

LOD-063-00

Dr. Andre Saadoun

Nowadays, the goal of periodontal plastic muccogingival procedure is to perform surgery as atraumatically as possible at the recipient and donor site. Recently, as an alternative to autogeneous gingival graft in root coverage procedures, Enamel Matrix Derivative and acellular dermal matrix allograft were utilized to correct this gingival defect, negating the requirement for a second surgical site.

Esthetic Dentistry - 2 Layer Composite Restorations (JAPANESE LANGUAGE ONLY)

LOD-060-00j

Dr. Didier Dietschi

Esthetic Dentistry - 2 Layer Composite Restorations (JAPANESE LANGUAGE ONLY)

All Ceramic Restoration (JAPANESE LANGUAGE ONLY)

LOD-056-00j

Dr. Hiro Hatano

All Ceramic Restoration (JAPANESE LANGUAGE ONLY) All Ceramic Restoration (JAPANESE LANGUAGE ONLY)

Predictable Anterior Aesthetics with Veneers - Interdisciplinary Approach

LOD-055-00

Dr. Galip Gurel

Creating the precision in terms of the preparation, fit and the aesthetic final outcome with veneer restorations needs a detailed treatment plan which is unique to each case. Designing a new smile for a patient consists of many steps which are very important and if followed correctly, produce predictable success. The key to aesthetic excellence requires patient communication as well as the communication with the laboratory and the specialists from the beginning of the case till the end. This presentation will help the clinician to understand the clinical steps as well the patient communication steps.<br><br>In todays dentistry success depends on an interdisciplinary team work. Every member of the team (including the specialists, lab technicians and the patient) should be aware of the treatment planning and the end result from the beginning. Every effort should be spent to bring the teeth to their natural position on the dental arch, hence creating enough space for the restoration to be received so that the aim should be minimum tooth preparation.<br><br>After that stage, in order to achieve a very precise and predictable tooth preparation, wax-up, silicon indexes and related techniques such as APR (Aesthetic Pre Recontouring), APT (Aesthetic Pre-evaluative Temporaries) and preparation through the APTs are extremely crucial. This eliminates all the possible mistakes and destruction of the depth cutters that could have been done if the tooth was to be prepared without realizing the aging affects on the enamel (volumetric enamel loss) or their inappropriate teeth positions on the dental arch

New Advances In Soft Tissue Esthetics Around Teeth and Implants

LOD-049-00

Dr. Eric van Dooren

New Advances In Soft Tissue Esthetics Around Teeth and Implants

Perio-prosthetic Considerations Around Natural Teeth

LOD-048-00

Dr. Eric van Dooren

Perio-prosthetic Considerations Around Natural Teeth