today IDS Cologne Show Preview

such as the EndoVac (SybronEndo, USA), which delivers apical negative pressure(ANP)irrigation,30 theplastic rotary F File (Plastic Endo, Lincoln- shire, IL),31,32 the Vibringe (Vibringe BV, The Netherlands),33 the RinsEndo (Air Techniques Inc., USA),9 and the Endo-Activator(DENTSPLYTulsaDen- tal Specialties, USA). Of all the tech- niqueslisted,onlytheEndoVachasre- peatedly shown to break the apical vapour lock (the column of gas that is formed at the apical 3 mm of the root canal formed by the hydrolysis of organic tissue by sodium hypochlo- rite), produce a current of irrigant, re- move debris and deliver voluminous amounts of irrigant to the apex with- out the risk of apical extrusion.15,50 Lasers Theintegrationoflasersisaviable addition to the endodontic armamen- tarium and has the potential to over- come some of the challenges to suc- cessful root canal therapy.51 Of partic- ular benefit is the ability to avoid vibration pain upon access, even in “hot” teeth that are difficult to anaes- thetise, and the three-dimensional ability to remove pulpal tissue, bacte- ria, smear layers and dentin from canal walls via laser energy and hy- drophotonic activity. Of particular significance is the ability of laser light to penetrate 1,000 microns into the dentinal tubules.52 Bacterial infiltra- tion into dentinal tubules has been re- ported to be 400 microns53 and chemi- cal rinses have a penetration depth of only 100 microns.54 This results in the possibility of bacterial entombment andmicroleakage.Theresultingdisin- fectionandreductionofbacteriainthe dentinal tubules is significant with re- spect to providing unparalleled levels of endodontic success.50 Digital Radiography Digital radiography has signifi- cantly reduced treatment time for endodontic procedures with far less exposure compared to conventional film. High-resolution digital images are instantaneously generated and easilymanipulatedforenhanceddiag- nostic performance. Digital storage of imagesissimple,allowingquicktrans- fer and communication.34,35,50 Cone-Beam Computed Tomography (CBCT) What digital radiography has pro- vided us for imaging in the present, CBCT (cone-beam computed tomo- graphy) will carry us into the future. CBCT technology has been around since the1980s, however, only re- centlyhasitbecomeaviableoptionfor the endodontic office.36 Cone-beam technology uses a cone-shaped beam of radiation to acquire a volume in a single 360-degree rotation, similar to panoramic radiography.36 It has advantages over conventional med- ical CT, including increased accuracy, higherresolution,scan-timereduction anddosereduction.36 Endodonticuses includebutarenotlimitedtodiagnosis of odontogenic and non-odontogenic cysts, cysts vs. granulomas,37 location of untreated canals and the diagnosis of certain root fractures. The extent of internal, external and cervical re- sorption can be accurately mapped and the presurgical evaluation of anatomic landmarks can be precisely surveyed.36,50 Regenerative Endodontics Regenerative endodontics has be- come an exciting possibility, allowing stem cells found in the dental pulp to regenerate and replace diseased tissue with healthy tissue and revi- talize a tooth.38 The vascularisation of necrotic teeth with immature apices can be a significant challenge to the clinician. In the past, apexification procedures have allowed root length to continue, but the walls of the roots remained thin, allowing the high risk and probability of fracture. Revascu- larization techniques provide such a tooth the ability to not only continue linear root growth, but also to allow increased thickness of dentin on the rootcanalwalls,whichwillultimately allow retention of the natural tooth, obviating the need for extraction and implant replacement.39 The technique is uncomplicated and easy to learn. Through the use of a specialized tri- antibiotic mixture, blood clot induce- ment and its coronal sealing with MTA, many necrotic and immaturely developed teeth that would other- wise be extracted can now be re- tained.40,50 Endodontics vs.Implants With the advent of implants, pa- tients were able to maintain their oc- clusion and health in those functional areas that were missing teeth. Unfor- tunately implants are also being used to replace viable teeth.41 If a tooth is sound from both a restorative and periodontal aspect, then endodontic therapy should be the treatment of choice. However, if a tooth is compromised from a restora- tive or periodontal perspective, then an implant may be considered.42 Both root canal therapy and orthograde re- treatment as a first and second line of intervention are more cost-effective compared to implant therapy. Current cost structures indicate that implants are limited to a third line of inter- vention.43 Confidence and embracing the advances in the science and art of endodontics is imperative if we are to continue to achieve and improve the successes that we have achieved. There are numerous studies that sup- porttheexcellentclinicalresultsofen- dodontic treatment.44 Kim and Iqbal conductedareviewoftherelativesuc- cessratesofendodontictreatmentand implants. The literature review found equalsurvivalratesofsingle-toothim- plants and endodontically restored teeth. Both therapies had overall sur- vival rates of 94 per cent, thus provid- ing predictable outcomes.45,46 How- ever, implants have a longer mean andmediantimetofunction,andhave a higher frequency of postoperative complications requiring additional treatment intervention.47,50 Where We Are Going Science and research will elevate the specialty of endodontics to its rightfulpinnacle.48 Thecornerstoneof ourspecialty’sintegrityandrelevance must be built on a strong foundation of randomized clinical trials and evi- denced-based endodontics.48 The fu- tureofendodonticsisbrightaswecon- tinue to develop new techniques and technologies that will allow us to per- form endodontic treatment painlessly and predictably, and continue to sat- isfy one of the main objectives in den- tistry, that being to retain the natural dentition.14,50 7 A complete list of references is available fromthepublisher.DrGaryGlassmanmain- tains a private practice in Toronto, Canada, andisonstaffinthegraduatedepartmentof endodontics at the University of Toronto’s Faculty of Dentistry. The author of numer- ouspublications,heisaregularcontributor to today’s sister publication roots the inter- national magazine of endodontics. science & practice20 Show Preview IDS Cologne 2013 Corte del Medà, 27/B - 31053 Pieve di Soligo TV - ITALY - P.I. 04337970265 CE n. 0476 CDSCO MD-1015 Indian food and drug administration AD ➟ nTheDentalTradeAlliance(DTA)has been representing the interests of the NorthAmericandentalindustrysince 2004, when the American Dental TradeAssociationmergedwithDental Manufacturers of America. It is also the organiser of the US pavilion at the upcoming International Dental Show (IDS) in Cologne. today international had the opportunity to speak with Gary W. Price, CEO and president of the dental trade organisation, about the state of the industry and the im- portance of the show to US manufac- turers of dental equipment. today international: At IDS Co- logne 2011, the US dental industry was the second-largest group of manufacturers from one country. Arewegoingtoseeanotherincrease in participation this year? Gary W. Price: The International Dental Show is a very popular venue for the majority of American and Canadian companies. We see this in the increasing number of companies exhibiting under the joint US dental industry pavilion that we organize in Hall 4.2. For the period 2011–2015, we anticipate additional growth in participating exhibitors of roughly 15 per cent. The IDS attracts the largest num- berofdistributors,governmenthealth- care agencies and authorised buyers of any dental meeting that US man- ufacturers can attend. It gives our industry the best opportunity to con- nect with reputable and new strategic partners. Therecessionseemstohavehad a significant impact on dental mar- kets in North America. What’s the current state of the industry there and what are the most prominent trends? Sales of oral health-care products and equipment have been increasing moderately since the economic turn- down. Certain segments like digital radiography, however, are growing rapidly. This year is shaping up to be a good one for sales owing to pent-up demandandnewdentistswantingthe latest technology for their practices. Retiring dentists are also increasingly upgrading their equipment to make their practices more attractive to po- tential buyers. How important is the IDS for Americancompanieswithregardto sales, as well as a being a showcase for innovation? Based on demand for exhibition space,attendeeregistrationsandhotel rooms, IDS 2013 is poised to be one of thebestmeetingseverinthedentalin- dustry.Whileeveryeditionshowcases new technologies, the reality is that companies and dentists from around theworldcovetAmericandentalprod- ucts and equipment for their relia- bility, versatility and cost. Innovation is important but in general the world wants American products, whether they are new cutting-edge technolo- gies or tried-and-true products used daily by dentists everywhere. How does the show compare to the big US shows like the Chicago Midwinter Meeting or GNYDM? The IDS is seven times larger than all the dental meetings in New York, Chicago or any show organised by the American Dental Association. While US meetings tend to be a more tradi- tional model of companies selling to or educating dentists, American com- panies typically exhibit in Cologne because they are seeking new global partnerships. The EU has recently announced a revision of its existing medical de- vice regulations, which could also affect manufacturers of dental ma- terialsandequipment.Doyouthink that this will have any impact on your industry? TheDTAiskeenlyawareofchang- ing European and other international regulations. The impact of these modi- fications will probably be low. Many US companies export to Europe and have EU specifications. Our organiza- tion is helping to bring international accreditation to the industry so that a company’sproductscanbeaccredited and inspected once and approved for sale in most countries. This is some- thing DTA has taken the lead on. Thank you very much for the interview. 7 “Seeking new global partnerships” An interview with GaryW.Price,CEO and president of the DentalTradeAlliance 5 Gary W. Price