The Success of Endodontic Therapy - Healing and Function

LOD-089-00

Dr. Shimon Friedman

The Success of Endodontic Therapy - Healing and Function<br>Over 30% of root-filled teeth in the population present with persistent disease, suggesting an extensive need to manage the affected teeth. Treatment options include extraction and replacement, orthograde retreatment and apical surgery, and selection between these can often be complex. When the patient is motivated to retain the affected tooth, a key consideration is the prognosis, or potential for healing; therefore, the prognosis should be communicated to patients in a clear and objective manner. This lecture focuses on the prognosis of orthograde retreatment and apical surgery.<br><br>Inconsistent reports on the prognosis of orthograde retreatment and apical surgery, in contrast with consistently favourable reports for implant-supported single-tooth replacement, have caused considerable confusion in the profession. To reliably reflect the prognosis, studies must conform to design and methodology criteria consistent with an acceptable level of evidence. These criteria are met by only a few studies on retreatment and apical surgery. This lecture identifies the studies that provide the best evidence and outlines the prognosis of retreatment and apical surgery in regards to healing and symptom-free function of the treated teeth. Furthermore, specific clinical factors are highlighted that may influence the prognosis.

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.

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.

The Art of The Smile-From Diagnosis to Individualized Multidisciplinary Treatment Plan

LOD-024-00

Dr. Rafi Romano

During the last decade aesthetic demands in general, and in dentistry in particular, have changed dramatically and patients are much more aware of the possibilities that are available for them to achieve better aesthetic results. Many dentists use the latest technology and the most recent innovations in dental materials, but ignore the fundamental factor of the treatment - the diagnosis. Adult treatment always involves a multidisciplinary approach which requires full cooperation of the dental team: prosthodontist-periodontist / dental surgeon-orthodontist. The orthodontist, who is usually the most skilled member of the team to analyze the facial complex, is responsible for providing a detailed diagnosis together with a few alternative treatment plans that are based not only on the dental findings, but also on the patient's request. The lecture will focus on the criteria for proper diagnosis and will provide the clinician the tools that will help him/her achieve a proper individualized treatment plan.

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.