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ePaper created 2016-11-22, 09:52:12 | version 1.38.0
47 roots 4 2016 Image courtesy of Koelnmesse. contact Koelnmesse GmbH Messeplatz 1 50679 Köln Germany Tel.+49 221 821-2486 Fax +49 221 821-3544 j.mader@koelnmesse.de www.koelnmesse.de tobecomelessallthetimeor—animportantdevelop- mentofourera—onlyonesequenceoffilingisneeded even. Depending on the individual case and personal experience, the practitioner decides between classic rotating filing with a high degree of flexibility and if necessaryincreasedbreakageresistance(continually rotatingmovement)andaneffectiveandsimplepro- cess (reciprocal file movement). Depending on the filing system, classic endo mo- tors can be implemented or advanced systems that can work either continually or reciprocally. Alterna- tively to the usual touch-screen operating surface, in somemodelsitispossibletosteerthemperBluetooth viaanappfromtheiPadMini.Thiscanmakethestor- ageoffilingsequences,thegraphicrepresentationof treatment scenarios to the patient much easier. With the subsequent rinsing of the treated canals (i.e. with NaOCI, EDTA) numerous details have been optimised over the past years—one of them: The for- mationofandtherelatedlimitedflowoffluidaround it is avoided by activating the rinsing fluid. This is made possible by a pressure/vacuum rinsing or by combined vibrating and swaying movements with selectable sequences. The suitable devices normally comprise of a handpiece (possibly cordless) and spe- cial inserts/attachments. In some cases these can be benttosuitthecanalanatomyandtheninserted.This can lead to the achievement of the desired clean sur- face with open dentine tubules. The next partial goal is the hermetic sealing of the canal system. Usually this is carried out using gut- ta-percha, whereby both systems for the lateral con- densationorthemulti-filltechniqueaswellasforthe onepost,twomaterialmethod(flexibleplasticcarrier + heated gutta-percha) can be implemented. Thanks to the obturation options available today, they can frequently be carried out in such a forward-looking way that a possible revision is even facilitated. Strongly co-decisive: Posts and coronal provision Finally, the quality of the coronal restauration also plays a decisive role for the overall success of the “endo“.Ifafterthepreparationasmallamountofnat- ural tooth substance remains (i.e. no more cavity wall or at the most one single wall), it is worth considering implementingaposttostabilisethetooth,ifnecessary afterapplyingadentinepin(usually2mmhigh).There is a wide selection here: Posts made out of zirconium oxide fibreglass with a 10–20% resin content, out of different fibreglass/resin mixtures, out of pre-si- lanized fibreglass reinforced composites, etc. and in differentgeometricalexecutions,forexampleconical, cylindrical,optionallywithanactivatedthreadorwith a separate head (two-piece), conically cylindrical or with a double taper design with a slightly less conical lowerthird.Severalpostsbehavelikeachameleonand displayacolourcodingatroomtemperaturetoenable a safe recognition, only to take on the colour of the natural tooth at body temperature. Last, but not least: After the “endo“ is before the “post-endo“. The final coronal care has to be hermeti- cally sealed and must remain stable long-term. Here thepractitionercanchoosebetweentheconventional prosthetic materials, classic filling materials and (ex- ceptfortheformationofposts)bulkfillingcomposites. Borderline: Special area endo/perio lesion The endoperiodontal lesions generally constitute a significant borderline case because in the individual casesthetherapyisstronglydependentonthecause. If it is primarily due to a periodontal inflammation, bothendodontictreatmentandacurettagewillbere- quired. However, if the cause of the disease in the re- spective tooth is primarily endodontic, root canal treatmentcouldsufficeandacurettageshouldnotbe carried out. Comprehensive probing and a high-per- formance microscope aid the differential diagnosis. Whereas in the case of endodontic treatment a hostofindividualdecisionshavetobetaken.Manual or mechanical production of the glide path? Prepa- ration with multi-filing or one-time filing systems? Root post or not? Restauration of the crown using composites or prosthetics? A series of predecisions could be taken at the International Dental Show in Cologne from 21 to 25 March 2017, because the dif- ferent processes, products and ultimately an abun- dance of endo experts will be available. “The desire to preserve one's own teeth up until an advancedageisgrowingwithinthepopulation.Thanks totheprogressofthepastyears,therehavebeenshifts in the borders in the field of endodontics: What was consideredtobeahealingattemptorevena“risk“five or ten years ago, has often become a challenge today thatcanbemastered.Astheleadingtradefairforden- tistryanddentisttechnology,IDS,from21to25March 2017, shows which innovations are carrying on this trend-theentirespectrumofmodernendodonticsand the current therapy and diagnostic developments,“ saidDr.MartinRickert,ChairmanoftheVDDI. IDS (International Dental Show) takes place in Co- logne every two years and is organised by the GFDI Gesellschaft zur Förderung der Dental-Industrie mbH, the commercial enterprise of the Association of German Dental Manufacturers (VDDI) and staged by Koelnmesse GmbH, Cologne._ IDS meetings | 42016 Tel.+49221821-2486 Fax +49221821-3544