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.
Aspectos Biologicos em Implantes Unitarios (PORTUGUESE LANGUAGE ONLY)
LOD-073-00p
Dr. Mario Groisman
Aspectos Biologicos em Implantes Unitarios (PORTUGUESE LANGUAGE ONLY)
Clinical Pharmacology - What Every Dentist Should Know
LOD-072-00
Dr. Anthony Feck
Modern dentistry has expanded the arsenal of services to restore patients oral health and cosmetic needs like never before. These changes have corresponded to an increasingly complex medical environment where patients are presenting at a more advanced age, with more medical conditions, and taking more medications. Understanding the pharmacology as it relates to their systems and how the drugs they are taking, as well as those we intend to administer affect the patient, one another, and our planned treatment is necessary for a safe and successful outcome to our planned care.
Treating the Medically Complex Patient
LOD-069-00
Dr. Adi Garfunkel
• What is the dental-medical approach to the hypertensive patient?<br> • Could we treat patients with medication induced bleeding tendency?<br> • The use of adrenalin in local anesthesia constitutes at times a contradictory subject. How do we deal with this question?<br>
Bone Morphogenetic Proteins, A Realistic Alternative to Bone Grafting<br>
LOD-054-00
Dr. Ulf Wikesjo
Surgical placement of oral implants is governed by the prosthetic design and by the morphology and quality of the alveolar bone. Often, implant placement may be difficult, if at all possible, due to alveolar ridge aberrations. In consequence, prostheticly dictated implant positioning commonly entails bone augmentation procedures. One objective of our laboratory is to evaluate the biologic and clinical potential of bone morphogenetic proteins (BMPs) including rhBMP-2, rhOP-1/rhBMP-7, rhGDF-5, other candidate biologics, bone biomaterials, and devices for alveolar ridge augmentation and implant fixation. This presentation will discuss the unique biologic potential, the clinical relevance and perspectives of BMP technologies for alveolar bone augmentation and oral implant fixation, in particular the development of a unique bone-inductive oral implant. This presentation will also address merits and explain short-comings of current treatment protocol including bone biomaterials and guided bone regeneration (GBR). BMPs have an unparalleled potential to augment alveolar bone and support implant osseointegration and long-term functional loading. Inclusion of BMPs for alveolar augmentation and osseointegration will not only enhance predictability of existing clinical protocol but radically change current treatment paradigms. Inclusion of the bone-inductive oral implant in the treatment panorama may make 'grafting' and GBR procedures altogether obsolete.
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.
Soft Tissue Behaviour And Integration Around Dental Implants <br>
LOD-021-00
Dr. Peter Schupbach
The scientific evidence on the biomaterial surface TiUniteTM will be given and compared to other implant surfaces. Several studies confirm and support the clinical benefits of the conductive properties of TiUniteTM, allowing bone and soft tissue to adhere along the implant surface and into the pores of the surface. This results in faster osseointegration and higher biological stability, thus minimizing time at risk for effective and safe Immediate FunctionTM. The clinical implications of TiUnite as Immdiate FunctionTM, reduced marginal bone loss, soft tissue integration and predictable esthetics will be discussed. In addition the scientific evidence of micro grooves along the threads and around the implant shoulder will be given. The introduction of the Groovy technology provides yet another step in implant development. With this technology, the speed of osseointegration can be further increased. The biological stability is enhanced by up to 30% allowing the use of groovy implants in soft bone.
Biological Data for Bone Integration
LOD-018-00
Dr. Peter Schupbach
The scientific evidence on the biomaterial surface TiUniteTM will be given and compared to other implant surfaces. Several studies confirm and support the clinical benefits of the remarkable osseoconductive properties of TiUniteTM, allowing bone to grow along the implant surface and into the pores of the surface. This results in faster osseointegration and higher biological stability, thus minimizing time at risk for effective and safe Immediate FunctionTM. The clinical implications of TiUnite as Immdiate FunctionTM, reduced marginal bone loss, soft tissue integration and predictable esthetics will be discussed. In addition the scientific evidence of micro grooves along the threads and around the implant shoulder will be given. The introduction of the Groovy technology provides yet another step in implant development. With this technology, the speed of osseointegration can be further increased. The biological stability is enhanced by up to 30% allowing the use of groovy implants in soft bone.