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.
YSGG Laser Precision in Periodontal Plastic Surgery
LOD-059-00
Dr. Bobby Butler
Lasers have been used in dentistry for many years. Mostly they have been used with soft tissue procedures. Recently the Er,Cr:YSGG laser has been shown to be safe and effective in osseous procedures. Many cosmetic dentists have been using lasers for esthetic crown lengthening procedures, but most of these cases are simple gingivectomies and not true crown lengthening procedures. Complications can occur without understanding the biologic width and different periodontal biotypes. This presentation will discuss current and future applications with the Er, Cr: YSGG laser with periodontal surgical procedures. The focus will be its use in closed and open esthetic crown lenghtening procedures. Discussion with case selection and osseous biotypes with be stressed. Other applications involving osseous augmentation procedures, harvesting osseous blocks, ridge splitting and lateral sinus wall procedures, will also be briefly discussed.
Endodontic Access and Negotiation - Breaking & Entering
LOD-038-00
Dr. L. Stephen Buchanan
Technological advances in shaping and filling root canal systems have resulted in extremely consistent and ideal outcomes making those procedures more science than art form. However, cutting access cavities, finding all the canals in a tooth, and negotiating them to their full apical extents still requires developed skills and careful attention to detail. Ironically, many clinicians consider the access preparation and root canal negotiation those things we do to get to the important stuff afterwards this is ironic because when a mistake occurs during these initial phases in treatment it is often impossible to recover. Loss of structural integrity, perforations, missed canals, blocked canals, ledged canals and broken files are just some of the negative outcomes that occur when access and negotiation procedures go awry.<br><br>With adequate radiographs, the right access instruments, ultrasonic handpieces, lubricants, apex locators, and a predictable negotiating technique, artful outcomes can and should be the expected result when we head into a root canal space. Dr. Buchanan will show, in a step-by-step manner, the concepts, instruments, and techniques needed to set the stage for endodontic success using CT reconstructions of endodontic anatomy, video footage shot through an operating microscope, and radiographs of clinical cases.
Endo or Implant - Rational decision making from an Endodontist's viewpoint
LOD-029-00
Dr. L. Stephen Buchanan
As an Endodontists who places implants, Dr. Buchanan presents a uniquely balanced argument for when to save teeth with endodontic therapy and when the patient will be better served by replacement of the tooth with an implant. Dr. Buchanan will first explain the procedural advances available from endodontic specialists to save many teeth previously thought to be unsalvageable, including microsurgery, MTA root repair material, ultrasonics, and state-of-the-art shaping, cleaning, and 3D obturation technology. Then he will discuss how the structural integrity of roots greatly affects the long term prognosis of endodontically-treated teeth and methods for maintaining the inherent strength of teeth being saved with RCT. Finally, Dr. Buchanan will explore the advantages and satisfaction of a multi-disciplinary approach to treatment planning with an emphasis on the new trend of endodontists to view themselves as understructure specialists.
LOD-023-04
Dr. Sam Strong
This program reviews the essential components and appointments required to complete implant cases. Operatory room setup, materials, procedures, and implant component inventory are illustrated. Liaison with the front office and dental lab require a system by the assistant to keep cases on time and on track. Methods to liaison with the front office and dental lab are illustrated to help the assistant keep cases tracked and on time. Scripted responses to common patient comments about are illustrated that positively promote the use of implants.
Staff Training Systems for the Clinical Assistants - Responsibilities for Each Team Member
LOD-023-02
Dr. Sam Strong
This program reviews the essential components and appointments required to complete implant cases. Operatory room setup, materials, procedures, and implant component inventory are illustrated. Liaison with the front office and dental lab require a system by the assistant to keep cases on time and on track. Methods to liaison with the front office and dental lab are illustrated to help the assistant keep cases tracked and on time. Scripted responses to common patient comments about are illustrated that positively promote the use of implants.
Staff Training Systems for the Front Office - Responsibilities for Each Team Member
LOD-023-01
Dr. Sam Strong
How to communicate with the prospective implant patient from initial phone call through diagnostic appointments and to case presentation. A system for the front office that presents an organized, professional approach to the patient. Appointment control, financial arrangements, and inter-office communication between the surgical and restorative offices are also illustrated as keys to developing the implant practice.
Treatment Planning and Prosthetic Procedures for Removable Implant Overdentures
LOD-022-04
Dr. Sam Strong
Step by step procedures to successfully complete bar and attachment overdentures are illustrated and compared. Case cost analysis and fee determination are simplified using clinical examples. AND a revolutionary impression technique and centric bite registration procedure are illustrated that will simplify overdenture construction for the prosthetic zdentist.
Treatment Planning and Prosthetic Procedures for Fixed Restorations on Multiple Implants
LOD-022-03
Dr. Sam Strong
Step by step procedures are shown in detail to fabrication implant supported fixed partial dentures or splint multiple implants together. Surgical template construction techniques, decision making rationale for splinting implants together or not, cement vs. screw retained preferences, cement selection, and retrieval of cement retained prostheses are illustrated in this program. Combination cases with implant and all ceramic esthetic restorations on natural teeth are also presented.
Treatment Planning and Prosthetic Procedures for Single Implant Crowns
LOD-022-02
Dr. Sam Strong
The single posterior implant crown can be the most productive, profitable, and complaint-free procedure in dentistry. Methods for surgical template construction, implant placement, and streamlined prosthetics are explained in this program. Application and advantages of the Nobel Easy Abutment and Snappy Abutment are shown in step by step protocol as well as the rationale for a fixture level impression to employ pre-machined titanium or Procera ceramic abutments.