Endodontic Rotary Instrumentation - How to achieve maximum efficiency while eliminating failure
LOD-085-00
Dr. John T. McSpadden
There may be more instrumentation technique recommendations than there are endodontic instruments available. Obviously, all cannot be the 'best' approach. Are these techniques confusing motion with accomplishment and time with safety? This presentation describes 6 basic principles that enable the practitioner to maximize endodontic rotary instrumentation in terms of effectiveness, efficiency and safety for any type endodontic file available today and as they become available in the future. Saving valuable time and eliminating pernicious stress are the result.
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.
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
Posterior Composites Restorations (Direct and Semidirect Techniques)
LOD-043-00
Dr. Didier Dietschi
The reduction in the carious disease incidence and the growing concern of patients for potential toxicity of metals and for dental aesthetics, have called the profession for developing restorative options adapted to new demands. Composites and adhesive techniques have then become the foundation of modern restorative dentistry, following tremendous improvements in material mechanical performances, wear resistance and aesthetic potential. Composite resins are currently used in a broad range of situations, including the treatment of initial decay to the restoration of extended and serial cavities, or the adhesive luting of ceramic work-pieces. However, polymerisation shrinkage of the resin matrix remains a crucial problem and still imposes certain limitations for the use of direct techniques. Therefore, other restorative options such as semidirect and indirect techniques have to be considered for large and deep cavity configurations. The lecture will overview decision criteria for the treatment of posterior teeth, the main restorative options at hand and will provide a comprehensive description of clinical procedures.
LOD-042-00
Dr. Didier Dietschi
Different types of discoloration, some of displasic origin and others from acquired pathologies or tissue aging can be improved or sometimes fully corrected by bleaching. Bleaching aims to remove or treat several types of dark stains. The lecture will emphasize on the principles, application methods and potential indications of the various bleaching techniques at hand. All different bleaching protocols have potential to lighten tooth colour but not at the same level of efficacy; information will be provided as regard the likely indications for power / chair-side bleaching and other home bleaching methods. Attendees will also learn how to integrate chemical treatments in a comprehensive approach of aesthetics, which ultimately help us creating beautiful and attractive smiles without unnecessary tissue sacrifice.
LOD-041-00
Dr. Didier Dietschi
The dramatic improvement in the overall population oral health as well as the growing concern of patients for tissue preservation and dental aesthetics has rejuvenated 'free-hand bonding' and made it a primary treatment option for the anterior teeth. Today, composite resin restorations offer conservative, biological and esthetic solutions to many problems, which formerly could only be approached by expensive and more invasive ceramic restorations. However, composite systems are based on different layering concepts and as a consequence, the restoration esthetic potential is strictly linked to a perfect understanding of the shading concept and optical properties of the composite masses in relation with those of natural tissues.<br>Based on a thorough observation of natural esthetics and the application of the so-called 'natural layering', together with an appropriate selection of composite brands, the clinicians can produce beautiful natural like direct composite restorations. The lecture will cover fundamental knowledge about colour and optical properties of natural tissues, will overview the indications of composite restorations in the front teeth and will provide a comprehensive description of clinical procedures.
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.
Challenging Composite Restoration With Free-Hand-Bonding - An Illusion Became Reality
LOD-008-00
Dr. Didier Dietschi
The growing concern of patients for tissue preservation and oral aesthetics has rejuvenated 'free-hand bonding with composites' and made it a primary treatment option for the anterior teeth. This lecture covers fundamental knowledge about color and optical properties, different treatment options with composite restorations, and provides a comprehensive description of clinical procedures.