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12 Dental Tribune Middle East & Africa Edition | January-February 2016 ORAL HEALTH < Page 11 > Page 14 tooth is lost to disease? Once the referring doctors are made aware of the favorable benefits that will be derived, it becomes difficult for a consci- entious person to object to this concept of eliminating untoward possibilities that can lead to fail- ure of treatment. Conclusion The System “S” protocol de- mands thoroughness in treat- ment of the entire canal system. The author uses a Calamus for obturation, but carrier-based techniques of using warm GP can be used with the same de- gree of success, as long as they are done correctly. System “S” requires a commitment to com- plete all six steps to avoid the many pitfalls that present them- selves during treatment of the entire endodontic canal system. A survey of endodontists taken about nine years ago stated that 38 percent always used an SOM, 30 percent sometimes used it, and 32 percent never used it.12 Hopefully, things have changed. The use of an SOM is essen- tial for us, as “endo-doers,” to achieve the high level of predict- ability our current technology al- lows us to deliver. We only know what we see, and if we don’t see it we don’t know it. A good ex- ample is the high percentage of fourth canals (93 percent) that can be found in the maxillary molar segment. The clinical use of the SOM sig- nificantly increased the number of canals that were discovered.13 If these canals are not found, and the operator doesn’t take the time to locate and treat them, the predictability of success will be far less. It behooves all of us to do everything humanly possible to give our patients dental treat- ment that will create the health they expect from our profession. In general, our current endo- dontic vision has been directed to treatment of the apical half of the root canal system. It should not be a problem integrating the basic principles of bonding technology, restorative princi- ples and post core placement into our normal endodontic treatment protocol. We, as a specialty, should be thinking in terms of being responsible for the entire canal system and do- ing everything humanly possible to increase the predictability of our treatment. When endodon- tic treatment fails, it seems like everyone “stands around in a circle and points at one anoth- er.” Adhering to proven princi- ples eliminates the probability of contamination of the canal sys- tem by providing a solid founda- tion for the restorative aspect of the patient treatment. Obviously, those who are so con- cerned with the endodontic lack of respect for radicular structure have not witnessed what often happenstothatsametoothwhen preparing it for a crown. It is im- perative for the endodontic and restorative to be a team, work- ing together for predictability, in the interest of the patient. Our job as “endo-doers” is to learn, become teachers and educate the patients, staff and doctors we work with, so we can achieve dental health as a team. Let’s not “cave into” the demands of public convenience or political pressure, but rather be governed by proven dental principles, so we can achieve predictable endodontic success, saving the teeth our patients are born with. Isn’t that what endo- dontics is all about? References 1. Schilder H. Filling root canals in three dimensions. Dent Clin North Am 1967;11(7). 2. Weller RN, Kimbrough WF, Anderson RW. A comparison of thermoplastic obturation tech- niques: adaptation to the canal walls. J Endod 1997;23(11):703– 706. 3. Schilder, H. Cleaning and Shaping the Root Canal. Dent Clin North Am 1974;18(2):269– 296. 4. Veis A, Lamianidis T, Molyv- das I, Zervas P. Sealing ability of sectional injection thermoplas- ticized gutta-percha technique with varying distance between needle tip and apical foramen. Endod Dent Traumatol. 1992;8 (2):63-66. 5. Johnson WB. A new gutta- percha technique. J Endod 1978;4(6):184–188. 6. Southard DW. Immediate Core Buildup of Endodontically Treated Teeth: The Rest of the Seal. Pract Periodontics & Aes- thet Dent. 1999;11 (4): 519–526. 7. Heling I, Gorfil C, Slutzky H, Kopolovic K, Zalkind M, Slutzky- Goldberg I. Endodontic failure caused by inadequate restora- tive procedures: review and treatment recommendations. J Prosthet Dent. 2002;87(6):674– 678. 8. Weine FS. In: Endodon- tic Therapy. 5th Ed. St. Louis, MO:Mosby, 1996:4. 9. Salehrabi R, Rotstein I. Endo- dontic treatment outcomes in a large patient population in the USA: an epidemiological study. J Endod. 2004;30(12):846-850. 10. Kois J. Implants — Restora- tive Heroics vs. Replacement Antics, 47th Annual Meeting American Equilibration Society, Feb 21, 2002, Chicago. 11. Goldberg PV, Higginbottom FL, Wilson TG. Periodontal con- siderations in restorative and implant therapy. Periodontol 2000. 2001;25:100–109. 12. Dental Products Report Sur- vey: Endo Survey to Dentists. Dental Products Report. July 2004, p.20. 13. Stropko J. Canal Morphol- ogy of Maxillary Molars: Clinical Observation of Canal J of Endo, 1999;25(6):446–450 John J. Stropko received his DDS from Indiana University in 1964. For 24 years he practiced restorative dentistry. In 1989 he received a certificate for endodontics from Boston University and has recently re- tired from the private practice of endodontics in Scottsdale, Ariz. Stropko is an internationally recognized authority on micro- endodontics and has performed numerous live microendodon- tic and microsurgical demon- strations. He has been a visiting clinical instructor at the Pacific Endodontic Research Founda- tion (PERF); an adjunct assis- tant professor at Boston Univer- sity; an assistant professor of graduateclinicalendodonticsat Loma Linda University; a mem- ber of the endodontic faculty at the Scottsdale Center for Den- tistry in Scottsdale, Ariz., as an instructor of microsurgery; and is a co-founder of Clinical End- odontic Seminars. His research on in-vivo root canal morphol- ogy has been published in the Journal of Endodontics. He is the inventor of the Stropko Irri- gator, has published in several journals and texts and is an in- ternationally known speaker. Stropko and his wife, Barbara, currently reside in Prescott, Ariz. You may contact him at docstropko@gmail.com. About the Author Beverly Hills Formula - Over 20 Years Perfecting the Business of Smiling By Chris Dodd, CEO Beverly Hills Formula M anufactured in Ire- land, the Beverly Hills Formula ranges are rapidly becoming the go-to whitening products, with many people opting to use these safe at-home whitening toothpastes over harsh and abrasive treat- ments. The company is con- stantly expanding its range and endeavours to have a whiten- ing toothpaste to suit all pref- erences. With over 20 years’ experience, the company, based in Ireland, has grown considerably in the past few years. In 2015 Nielson/Check- out Magazine named Beverly Hills Formula as one of the top five oral care brands. This is an appreciable achievement when one takes into consideration the vast number of whitening toothpastes available on the market today. The success of Beverly Hills Formula comes down to a num- ber of factors: • The company is streets ahead in terms of new product development. • Their range of whitening products are safe to use at home. • The company has ensured that their products are as ef- fective as possible, and have proved themselves as leaders in expert stain removal. Launched in 2012, the Perfect White Range has been viewed as a revolutionary way of al- lowing patients to whiten their teeth without opting for prod- ucts containing high percent- age of peroxide - potentially devastating to teeth in the long term. The company responded to the need for quality and ef- fective whitening products in the market. New product devel- opment has always been some- thing that Beverly Hills For- mula held in great importance, and owes much of its success to the fact that they have brought some of the most innovative and effective products to the market. Launching in 2013, Perfect White Black was the first of its kind on the market. The toothpaste, containing activated charcoal, took the market by storm. Charcoal is a centuries old method of clean- ing teeth, and this cutting-edge product was well received by consumers. Although a num- ber of copy-cat products have emerged in the market, none have seen the same success as Beverly Hills Formula’s very own Perfect White Black, with qualified dentist and cosmetic doctor Dr Martin Kinsella say- ing: ‘I’ve tried the Beverly Hills Perfect White Black toothpaste and found it to be effective in removing stains and helping to achieve a whiter, brighter smile.’ Following on from this, the company introduced Per- fect White Black Mouthwash in 2015, also the first of its kind. The ‘shake to activate’ charcoal mouthwash keeps breath fresh for up to 12 hours, whilst removing stains. Perfect White Gold toothpaste, con- taining real gold particles was launched later that year. Both of these products have seen considerable success in the market. 2016 will be a huge year for Beverly Hills Formula, with the company planning on in- troducing an expert whitening product. Perfect White Expert toothpaste, containing effective and safe levels of peroxide, will offer a high performance whit- ening boost. As well as this, the company will launch Perfect White Black Sensitive, the first charcoal toothpaste for sensi- tive teeth. The brand will also add a charcoal dental floss and Fig. 1. Stain Removal Study Results (UK, 2012).