Please activate JavaScript!
Please install Adobe Flash Player, click here for download

Endo Tribune United Kingdom Edition

18 ENDO NEWS Endo Tribune United Kingdom Edition | 9/2017 process of eradication of the resid- ual microorganisms over a 2-week period. The choice between the two schemes sometimes boils down to the presenting factors of the case. Where a tooth is difficult to instrument, has a large lesion or is quite obviously chronically in- fected with a history of pain, then dressing may be more of a consid- eration. If a tooth is treated in a de novo manner and treatment goals are achieved with no history of AD pain then a single visit treatment could be utilised. eign body reaction could also de- velop. The goal of obturation is to seal the canal system to prevent any reinfection and entomb any bacteria not eradicated by chemo- mechanical debridement. If the obturation is through the apex, this can have significant implica- tions. GP through the apex can carry bacteria outwith of the canal and exacerbate symptoms. A for- We also have to remember that a beautiful obturation of a canal achieved without rubber dam and utilising saline or local anaesthetic irrigation is sub- standard treat- ment. It can be difficult to assess the “quality” of treatment when a radiograph of a “failed” tooth is ex- amined in this context. Indeed, an obturation that is short of the radi- ographic apex having been treated under rubber dam and with copi- ous amounts of irrigation is more likely to be successful than the pre- vious scenario. Attributing too much significance to the radio- graphic appearance of the obtura- tion Indeed, Katebzadeh and colleagues in the late ‘90s witnessed healing in the absence of obturation where teeth were instrumented and irrigated optimally under isolation. Seal- is short-sighted. The Dental Tribune International Magazines www.dental-tribune.com I would like to subscribe to CAD/CAM Clinical Masters* cosmetic dentistry* implants laser ortho** prevention* roots Journal of Oral Science & Rehabilitation*** EUR 44 per year (4 issues per year; incl. shipping and VAT for customers in Germany) and EUR 46 per year (4 issues per year; incl. shipping for customers outside Germany). * EUR 12 per year (1 issue per year; incl. shipping and VAT for customers in Germany) and EUR 14 per year (1 issue per year; incl. shipping for customers outside Germany). ** EUR 22 per year (2 issues per year; incl. shipping and VAT for customers in Germany) and EUR 23 per year (2 issues per year; incl. shipping for customers outside Germany). *** EUR 200 per year (4 issues per year; incl. shipping and VAT). Your subscription will be renewed automatically every year until a written cancellation is sent to Dental Tribune International GmbH, Holbeinstr. 29, 04229 Leipzig, Germany, six weeks prior to the renewal date. Shipping Address Name Address Zip Code, City E-mail Date, Signature Country ants are also antibacterial and aide filling the voids between the GP and the canal system. One further option would be to pro- vide a sub-seal to each of the canal orifices. This can be achieved by re- moval of 1 mm of GP and packing a good thick mix of IRM packed with a plugger. Covering the cusps The provision of a coronal res- toration (if provided optimally) can improve the coronal seal while also structurally protecting the underlying tooth tissue. Due to en- dodontic treatment, resulting in reduction of tissue bulk and stiff- ness the risk of fracture increases. Where both mesial and distal mar- gins have not been breached and the access cavity is confined to the occlusal surface, a crown restora- tion may not be required. Once a margin is breached the tooth is more likely to flex and result in cracks or fractures. A commonly asked question, “When should the crown be provided? Soon after the root canal treatment or when the treatment has proven to be suc- cessful?”If the success of endodon- tic treatment is significantly in doubt then this should be commu- nicated to the patient and a well compacted direct restoration may be the best option, otherwise an onlay or if tooth tissue is signifi- cantly reduced, a crown should be provided soon after completion. Conclusion Bacteria are public enemy number one in dentistry. Disin- fecting the root canal system by ir- rigating in combination with me- chanical instrumentation is key to success in root canal therapy. Pre- venting further re-infection or persistence of residual bacteria af- ter the formal stages of treatment through dressing initially and a quality coronal seal subsequently is as important as the root canal therapy. Editorial note: Aws Alani is leading a two-year postgraduate diploma in operative dentistry at King’s Col- lege London Dental Institute www.restorativedentistry.org. More is available online at www.kcl.ac.uk/study/ postgraduate/taught-courses/ operative-dentistry-pgdip.aspx. information PayPal Credit Card Credit Card Number Expiration Date Security Code SUBSCRIBE NOW! F +49 341 48474 173 subscriptions@dental-tribune.com Aws Alani is a Consultant in Restorative Dentistry at King’s College Hospital in London, UK. He can be contacted at awsalani@ hotmail.com. www.restorativedentistry.org

Pages Overview