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Dental Tribune Middle East & Africa Edition

7Dental Tribune Middle East & Africa Edition | May - June 2014 mcme Les Kalman, B.Sc (Hon), DDS, graduated from the University of Western Ontario with a doc- tor of dental surgery degree in 1999. He then completed a GPR at the London Health Sciences Centre. He has been involved in general dentistry within private practice since 2000. He has served as the chief of dentistry at the Strathroy-Mid- dlesex General hospital. In 2011, he transitioned to full- time academics as an assis- tant professor at the Schulich School of Medicine and Den- tistry. Kalman’s research fo- cuses on clinical innovations, including the Virtual Facebow app. Kalman is also the direc- tor of the Dental Outreach Community Services (DOCS) program, which provides free dentistry within the commu- nity. Kalman has authored articles ranging from pediat- ric impression to immediate implant surgery in both Cana- dian and American journals. He has been a product evalu- ator for several companies, including GC America and Cli- nician’s Choice. Kalman is the co-owner of Research Driven, a company that deals with intelectual property develop- ment. Kalman is a member of the American Society for Forensic Odontology, Interna- tional Team for Implantology, Academy of Osseointegration, American Academy of Implant Dentistry and the Internation- al Congress of Oral Implantol- ogy. He has been recognized as an academic associate fellow (AAID) and diplomate (ICOI). He can be contacted at lkal- man@uwo.ca. About the Author mCME SELF INSTRUCTION PROGRAM CAPP together with Dental Tribune provides the opportunity with its mCME- Self Instruction Program a quick and simple way to meet your continuing education needs. mCME offers you the flexibility to work at your own pace through the material from any location at any time. The content is international, drawn from the upper echelon of dental medicine, but also presents a regional outlook in terms of perspective and subject matter. Membership: Yearly membership subscription for mCME: 600 AED One Time article newspaper subscription: 100 AED per issue. After the payment, you will receive your membership number and Allowing you to start the program. Completion of mCME • mCME participants are required to read the continuing medical education (CME) articles published in each issue. • Each article offers 2 CME Credit and are followed by a quiz Questionnaire online, which is available on http://www. cappmea.com/mCME/questionnaires.html. • Each quiz has to be returned to events@cappmea.com or faxed to: +97143686883 in three months from the publication date. • A minimum passing score of 80% must be achieved in order to claim credit. • No more than two answered questions can be submitted at the same time • Validity of the article – 3 months • Validity of the subscription – 1 year • Collection of Credit hours: You will receive the summary report with Certificate, maximum one month after the expiry date of your membership. For single subscription certificates and summary reports will be sent one month after the publication of the article. The answers and critiques published herein have been checked carefully and represent authoritative opinions about the questions concerned. Articles are available on www.cappmea.com after the publication. For more information please contact events@cappmea.com or +971 4 3616174 FOR INTERACTION WITH THE WRITERS FIND THE CONTACT DETAILS AT THE END OF EACH ARTICLE. < Page 6 “NaOCl has several advantages for its role as an endodontic irrigant, but its use must be exercised with caution in order to prevent injury.” Fig. 5 Radiograph of endodontic treatment on #47. Fig. 7 Radiograph of endodontic treatment on #16. Fig. 9 Radiograph of endodontic treatment on #16. Fig. 6 Radiograph of endodontic treatment on #26. Fig. 8 Radiograph of endodontic treatment on #36. been suggested as the larger volume, positive pressure ir- rigant that may be delivered into the canal space. CHX has favorable antibacterial char- acteristics but minimal injuri- ous effects, if mismanagement of the irrigant has occurred. If positive pressure delivery of CHX is required, the op- erator should regulate the pressure and avoid the risk of injection beyond the apex. The use of EDTA (ethylenedi- aminetetraacetic acid) could be employed after NaOCl, to minimize the formation of precipitates.2 The application of micro-vol- ume management of NaOCl suggests that the canal space can be effectively cleaned in a conservative manner. Ap- plication of this principle has been applied to clinical cases with little to no post-endodon- tic sensitivity. Obturation has been completed with Therma- Seal and Thermafil (DENT- SPLY). Even though there is evidence of sealer extrusion, the absence of post-operative symptoms and pathology sug- gests adequate volume for suf- ficient disinfection. Further laboratory studies are required to understand per- meability, fluid mechanics and multiphase fluid flow through porous media and their rela- tion to the micro-manage- ment of NaOCl. Additional clinical investigations should be implemented to assess and validate the efficiency and ef- ficacy of micro-volume man- agement of sodium hypochlo- rite on endodontic therapy. Conclusions Introduction of lubricants and irrigants into the canal com- plex is crucial for endodontic success. The action of fluids in the canal complex must be understood within the context of permeability, fluid mechan- ics and multiphase fluid flow through porous media. NaOCl has several advantages for its role as an endodontic ir- rigant, but its use must be ex- ercised with caution in order to prevent injury. Application of NaOCl as a passive, micro- volume liquid has been illus- trated. Further consideration is re- quired to validate the theory. The potential to minimize morbidity while maximizing clinical endodontic success seems promising for both cli- nician and patient. References 1. Dang E. Comparison of so- dium hypochlorite and chlo- rhexidine gluconate: qual- ity of current evidence. The Journal of Young Investiga- tors: An Undergraduate, Peer- Reviewed Science Journal 2008:23(1):1–9. 2. Basrani BR, Manek S, Rana SNS, Fillery E. and Manzur A. Interaction between so- dium hypochlorite and chlo- rhexidine gluconate. J Endod 2007;33: 966–969. 3. Dutner J, Mines P, and An- derson A. Irrigation trends among American Association of Endodontists members: a webbased survey. J Endod: 2011;-: 1–4. 4. 3M ESPE: Peridex™ Chlo- rhexidine Gluconate (0.12%) Oral Rinse Fact Sheet: 2009. 5. Clarkson RM, and Moule AJ. Sodium hypochlorite and its use as an endodontic irri- gant. Australian Dental Jour- nal 1998;43:(4). 6. Hülsmann H. & Hahn W. Complications during root canal irrigation-literature re- view and case reports. Inter- national Endodontic Journal: 2000;33:186–193. 7. Trefethen L. Surface ten- sion in fluid mechanics. Ency- clopaedia Britannica. (12ed.) Wiley:Chicago,1969;1–7. 8. West JD, Roane JB and Go- ering AC. Cleaning & shap- ing of the root canal system. In Cohen S. and Burns RC. Pathways of the Pulp. (6th ed.) Mosby:St. Louis,1994;179–218. 9. Trowbridge HO. and Kim S. Pulp development, structure & function. In Cohen S. and Burns RC. Pathways of the Pulp. (6th ed.) Mosby:St. Lou- is,1994;296–336. 10. Templeton CC. and Rush- ing SS. Jr. Oil-water displace- ments in microscopic capil- laries. Journal of Petroleum Technology. 1956;8:(9):211– 214. 11. Crotti MA. Motion of Flu- ids in Oil and Gas Reservoirs. Mosby:New York,1978;8–14.

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