Endodontics №3
Re-treatment (orthograde revision). Clinical solutions and techniques
This workshop reveals ways to solve technical difficulties in root canal repair, and contains an algorithm for when and what needs to be done.
Learn more This workshop reveals ways to solve technical difficulties in root canal repair, and contains an algorithm for when and what needs to be done.
1. The concept of success and failure in endotherapy
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Comparison of the concepts of success in endodontics and implantology. - Modern classification (Healed, Healing, Disease).
- Analysis of clinical examples.
2. Causes of endodontic pathologies after treatment
Mechanical and biological approaches
Mechanical and biological approaches
- Intraradicular infection.
- Errors in the treatment process.
- Coronal sealing in modern dentistry. Influence on the prognosis, recommendations on the timing of treatment and materials for temporary fillings.
- Extraradicular infection.
- Fashion or clinical reality?
- Non correct case selection.
- Erroneous diagnosis based on the example of periapical cement dysplasia of cement-ossifying fibroma.
- Lack of orthopedic-periodontal evaluation.
- Not using the Tracing procedure.
- Foreign body granuloma (talk, cellulose, cholesterol).
- Trueandpocketcyst.
- Scar tissue.
- Etiology, pathogenesis and prognosis of these conditions. Detailed analysis of each group.
3. Prediction of overtreatment based on Fabio Gorni's research, author's solution scheme
4. Apical surgery or/and re-treatment
- Features of modern microsurgical procedure.
- Advantages and disadvantages, risk and prognosis of procedures.
- Biological justification of the decision.
- CBT as a tool for a treatment plan
- Healing peaks are traps for the clinician
5. Algorithm of clinical decision-making
- The scheme of Stahlholz and Friedman is based on the author's additions based on data from recent decades.
- Consideration of the main problematic groups in everyday practice:
- Post-treatment on the background of endopathology.
- Overtreatment as prevention of endopathology.
6. Technical aspects of the treatment
- Treatment through a crown.
- Crown/bridge removal (Metaliflt).
- Removal of anchor pins: metal and fiberglass.
- Removal of cast tabs (Ultrasonic, Gonon extractor, Ruddle extractor, Masseran kit).
- Clinical treatment techniques:
- Gutta-percha.
- Gutta-percha on a carrier (Termafil, Softcore).
- Cement phosphate.
- Formalin resorcinol.
- Silver pins.
- Pastes.
- Tools, chemicals, clinical nuances and examples.
7. Broken tools
The author suggests a scheme for making a clinical decision based on the following factors:
- The tooth is vital or infected;
- The initial or final stage of channel cleaning;
- The instrument is broken before or after the apical bend.
Based on this scheme, the clinician can make a decision: try to remove the instrument, not to remove it, try to bypass it (anatomical reasons for technical procedures)
Detailed description of techniques for removing broken tools.
Detailed description of techniques for removing broken tools.
8. Overview of ultrasound devices and attachments in endodontics.
- Spartan (MTS): CPR nozzles.
- EMS / Sybroendo (minipiezon): RT1, RT2, RT3.
- Satellec (P5,Newtron): ET20, ET(D)40, ET 25, K10/21/25, S04.
- Osada (Enac): ST 17, ST 21.
- NSK (Varios). E7, E6.
- Proultra nozzles.
- B&L nozzles.
Principle of operation, applications: techniques of use (direct and indirect ultrasonation), clinical recommendations, matching diameters.
9. Perforations
- Modern classification, factors influencing the prognosis, treatment methods, analysis of materials for treatment: IRM, SuperEBA, MTA (ProRoot, MTA-angelous, MM-MTA).
Methods of the heat company
- Description of cold pluggers (shilder, mashtou, bucanan pluggers, sandensor, Dovgan pluggers,Bull pluggers,SSG).
- Thermal pluggers ("soldering irons"): Touch and Heat ,System B, Beefill pack, DownPak, E&Q,Endo@pex,B&L. ,GuthaEst.
- Vertical Schilder compaction/I'm waving.
- Hydraulic vertical condensation (Dedeus)
- Gutta-percha on a carrier (Thermafil, Softcore,Real seal Obstructor,Gutha-Core).
- Thermal injection (Obtura 2, Element Obstruction Unit, BeeFill, Calamus, HotShot,B&L).
- Thermal compression (McSpadden, Microseal, QuickSeal,MM Compactor).
- Hybrid technology (Tagger, Nahamias, Koenka).
- Combined technique (variations from Solomonov)
A detailed description of the techniques, advantages and disadvantages, recommendations for clinical use and case selection. Non-advertised information on degradation of the isoprene polymer, shrinkage. histological reactions
