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The filling of the elliptical retro- grade cavity with MTA was also evident on the postoperative CBCT scan. Selecting the appropriate ret- rograde obturation material is fundamental for achieving a high level of success. The ideal material should promote the filling of the region, protect the surgical wound and be radiopaque, biocompati- ble, impermeable, antimicrobial and osteoconductive. It should also have excellent properties in a moist environment. Various ma- terials, including Cavit (3M ESPE), zinc oxide, eugenol, calcium hy- droxide, amalgam, gutta-percha, tricalcium phosphate and hy- droxyapatite, have been used in the attempt to seal retrograde preparations.21 However, none of these materials have been found to be capable of re-establishing the original architecture of the areas affected. The introduction of bioactive sealant materials such as MTA, the precursor of the group of bioce- ramics, made a great leap in terms of sealing and biocompatibility. It offers the most desirable charac- teristics of a repair material, such as tissue biocompatibility, stimu- lation of neo-formation of cement and biomineralisation. It also pro- motes superior sealing compared with other materials.21–23 Owing to the qualities described, MTA is now the material that best meets the requirements for material suitable for retrograde obturation. It is also the material with the best scientific track record in terms of effectiveness and clinical safety. For this reason, it was the material of choice for the apical sealing in this case. In the apical repair process, bone repair is expected to occur through neo-formation of bone tissue in the region of the apical periodontitis and the repair is expected to be without scars or periodontal recession. Conclusion The combination of operating microscopy, ultrasound and MTA allows for extremely precise and predictable treatment. Endodontic microsurgery, when performed in accordance with these modern concepts, can be considered to be a therapeutic alternative for the aes- thetic and functional maintenance of teeth with secondary or persis- tent apical periodontitis. Editorial note: A list of references is available from the publisher. 16 Dental Tribune United Kingdom Edition | 7/2016 TRENDS & APPLICATIONS Career development opportunities and support in a corporate practice By Sarah Weston, UK Having worked for most of my career in the independent sector I was aware of the negative press surrounding corporate dentistry before I joined the mydentist group, but I have to say that those rumours were all unfounded. In fact, I feel quite passionately that new graduates are still being given that negative message. As a com- pany we should try to give the next generation the facts and talk to them directly. 20 years ago I qualified from Guy’s Hospital. Since then I have worked in Australia, New Zealand and the UK across most sectors of the profession, be it as a house of- ficer in New Zealand, in NHS and private practices, as a partner or associate. At my current practice in Woodbridge in Suffolk we are predominately NHS in a small market town, but do offer a range of private services. With an interesting demo- graphic of patients we get the chance to utilise all our skills. We routinely see 25–30 patients a day and I am lucky that I work with a really great team and most of us have worked together for a while now. It’s good to be with other people who understand the stress and strains of the job and can have a good laugh together at times. I work full time so my days tend to be fairly similar. I start with a coffee then move on to checking day-lists, patient records and lab work etc. I hate surprises so I like to know what’s coming. Most of my days are spent per- forming a mix of examinations and treatments with the odd in- teresting case thrown in. I also offer facial aesthetic procedures and have recently been on the denture excellence course. It is great to be able to offer such a wide choice of treatment options to patients and the denture ex- cellence has really taken off. It is an area I really enjoy as a good denture can make so much dif- ference to someone’s quality of life. I am hoping to undertake an implant restoration course soon as well, so I will be able to restore the implants placed by colleagues at local practices in the group. Since working for the corpo- rate I have also become a mentor, which has definitely been a high- light for me. It is a role I really enjoy, as after 20 years in the job it is nice to pass on some of my ex- perience to the younger genera- tion. I had a great VT instructor when I started and I hope I can be as good to new associates as he was to me. It’s a job that is mutu- ally beneficial—it is extremely re- warding to see a mentee improve and gain in confidence and it does the same for the mentor. Within the corporate we are so lucky to have a high level of support from practice and area managers through to clinical sup- port managers (CSM) and clinical directors. They are there to help prevent small problems becom- ing larger ones. I know that the ‘red flags’ and KPIs can feel intru- sive at times, but I do feel they are there to help clinicians above everything else. A visit from the CSM should be seen as a positive thing and I am lucky to have a great CSM in my area. One thing I have learned is that it can be lonely in the independent sector and there is no-one looking out for you in the same way. I think the support network available is the real strength of corporate dentistry. We are also incredibly lucky to have the online academy and the reminder to complete CPD when it is required. This can be a burden for dentists and if there is any way to make it easier then we should be grateful. My practice manager keeps us in check with when our CPD is due and the opportunity to complete it online is a great help, especially when I am busy in prac- tice five days a week. Overall, I feel that my move to mydentist was the best thing I could have done for my career. The opportunities are there to further my career in ways that I didn’t feel existed in the independent sector. While I enjoy my job enor- mously, I would relish the chance to move out of the surgery envi- ronment a little in the coming years and expand on my mentor- ing role and continue with more training and support of new den- tists. I hope I can achieve this within the company. Sarah Weston has been work- ing for myden- tist, a member of the Asso- ciation of the Dental Groups (www.dental groups.co.uk), in Woodbridge, Suffolk, since 2013. Leandro A.P. Pereira is a pro- fessor at the São Leopoldo Mandic dental school in Bra- zil. He can be contacted at leandroapp@gmail.com. “ Page 14 12 13 15 16 14 17 Fig. 12: Isthmus filled with white MTA Angelus.—Fig. 13: Post-op radiograph after 72 hours.—Fig. 14: Post-op radiograph.—Fig. 15: Post-op CBCT scan showing the filled isthmus.—Fig. 16: Post-op radiograph at six months.—Fig. 17: Post-op radiograph at 12 months. 1213 1516