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A2 ◊Page A1 plished with few drops of anaes- thesia in between, especially when endodontics is involved. The “No An- aesthesia” approach for enamel den- tine restorations are the erbium laser Prep mode for restorative dentistry: MX7, 3.25 W, 25 Hz, air, water. There are two commercial settings that can be followed for the most acceptable cavity preparation: – Rapid Prep: MX7, 5 W, 20 Hz, air 80, water 50. This setting is usually used for enamel caries removal as water content is lesser. Since there is less water in the enamel, higher power is needed for appropriate absorption of laser. – Comfort Prep: MX7, 3.75 W, 25 Hz, air 60, water 30. This setting is usu- ally advised when we have reached the level of the dentine as the water content in the dentine is higher in comparison to enamel. Once complete excavation of the de- cay has been attempted with laser, gentle hand excavation, low speed excavation is attempted. This step should be followed with Bond prep: MX7, 3.25 W, 50 Hz, air 60, water 30. Following this step, the tooth is iso- lated and restored with composite (Figs. 1 & 2). Pulpotomy procedure with erbium laser When the carious decay is found deep and in close proximity to pulp, exposure of the pulp canals can hap- pen while removing this decay. In such situations, exposed pulp needs to be treated by removing the affect- ed coronal pulp contents. This proce- dure is referred to as Pulpotomy. Deep caries are excavated with pre- adjusted rapid prep settings: MX7, 5 W, 20 Hz, air 80, water 50; and then comfort prep settings: MX7, 3.75 W, 25 Hz, air 60, water 30 are used as we ENDO TRIBUNE Dental Tribune Middle East & Africa Edition | 3/2018 ing and composite restoration. Pulpectomy procedure in primary tooth with abscess or fistula In cases where there are long stand- ing infections o chronic irreversible pulpitis, it be- comes invariable to use both diode and erbium laser sterilisation after the laser assisted access and further steps as described above. Until the point that canals are found completely dry, obturation is de- ferred. Usually it takes one or two visits to complete the final step of obturation in teeth with abscess or fistula. The entire treatment is com- pleted with intrapulpal drops of an- aesthesia when required. No infiltra- tions or blocks are used in the entire procedure. This procedure has been practiced as an alternate to pre-times extrac- tion of primary teeth that has to be then replaced with a space main- tainer. Most of the parents prefer this approach when compared to extraction, as they do understand that having the natural tooth as the space maintainer is indeed the best approach. Benefits of “No Anaesthesia” dentistry – No risk of children having traumat- ic bite after the procedure is com- pleted. The times when anaesthesia in children was a common practice, it was imperative to let the child and parents know about the numbing effect that would stay for few hours after the procedure. Cotton roll is given to bite on so that it serves as a reminder for the child. – Despite all these precautions, chil- dren may still land up in biting there lip or cheek. Once there is a traumat- ic bite, there is nothing much that can be done as the traumatized tis- sue has to self-heal. This can be quite painful for the child, thereby defeat- ing the entire purpose of pain free dental approach. – Multi-quadrant dentistry can be practiced on the same day, same ap- pointment. – There is actual saving of chairside time, as there is no waiting period for local anaesthesia to work. – Children can eat a few minutes af- ter the procedure, which is not the case with dental local anaesthesia. Conclusion Practicing contemporary dentistry in children with the appropriate us- age of technology and the key tools, is the way forward. The benefits of the “No Anaesthesia” erbium ap- proach far outweighs the existing al- ternatives. This kind of professional approach can certainly become the gold standard for dentistry in chil- dren in the very near future. Dr Imneet Madan Specialist Pediatric Dentist MSc Lasers Dentistry (Germany) MDS Pediatric Dentistry MBA Hospital Management Children’s Dental Center, Dubai Villa 1020 Al Wasl Road Umm Suqeim 1, Dubai United Arab Emirates Tel.: +971 506823462 imneet.madan@yahoo.com www.drmichaels.com Figs. 1 & 2: The laser is a helpful tool in the dental treatment of children that can be used for various procedures. approach deep into the dentinal car- ies. As soon as there is pin point pulp exposure, few drops of Lignospan are dropped inside the coronal pulp chamber. This step is followed by opening partial access into the coro- nal pulp chamber. As we go further deep into the coronal chamber, more anaesthetic intrapulpal infilteration is used followed by complete laser access opening. After removing the coronal pulp contents, the chamber is irrigated and dried followed by diode laser sterilisation and coronal pulp filling with zinc oxide eugenol. The tooth is then filled with base Fuji IX and final restoration is done with composite or stainless steel crown. Pulpectomy procedure with erbium laser Teeth that have chronic profound caries, active signs and symptoms, and radiographical signs of pulp in- volvement, are indicated for Pulpec- tomy. Pulpectomy involves the re- moval of both coronal and radicular pulp contents. When the tooth is indicated for pulpectomy or root canal procedure, deep caries are excavated with pre- adjusted rapid prep settings: MX7, 5 W, 20 Hz, air 80, water 50; and then comfort prep settings: MX7, 3.75 W, 25 Hz, air 60, water 30 are used as we approach deep into the dentinal car- ies. As soon as there is pin point pulp exposure, few drops of Lignospan are dropped inside the coronal pulp chamber. This step is followed by opening partial access into the coro- nal pulp chamber. infilteration As we go further deep into the coro- nal chamber, more anaesthetic intrapulpal is used followed by complete laser access opening. Once access has been done with laser, coronal pulp contents are removed. Before gaining access into radicular pulp chamber, few more drops of anaesthesia are dropped in. Complete extirpation of radicular pulp contents is done with rotary instruments. Continuous copious irrigation is done with saline and chlorhexidine. Canal measurement is done, and as a final step before obturation, both the erbium and diode laser are used for sterilisation. Final step is zinc oxide eugenol obturation, Fuji IX base fill- Endo Non-surgical and Surgical Retreatment (Management of Endodontic Failure) Dr. Antonis Chaniotis, Greece PRICE: 4,400 AED (1198USD) CONTACT: Email: events@cappmea.com Mob: +971 50 2793711 Endo Micro Surgical Retreatment (Management of Endodontic Failure) Prof. James Prichard, UK PRICE: 4,400 AED (1198USD) CONTACT: Email: events@cappmea.com Mob: +971 50 2793711 TIME & LOCATION: Thursday - Friday 05 - 06 July 2018 | 09:00 – 18:00 CAPP Training Institute, Dubai, UAE CAPP designates this activity for 14CE Credits TIME & LOCATION: Saturdy - Sunday 07 - 08 July 2018 | 09:00 – 18:00 CAPP Training Institute, Dubai, UAE CAPP designates this activity for 14CE Credits COURSE OUTLINE: DAt 1 - To understand the rational behind non surgical retreatment approaches and the aitiology of initial root canal treatment failure. To present an evidence based framework for the safe and effective dissasembly of non obturation and obturation materials. DAt 2 - To understand the factors related to the long term outcome of non surgical endodontic retreatment and to develop a rational diagnostic and decision making framework. To appreciate the importance of magnification and illumination for the management of complicated non surgical retreatment cases. COURSE AIMS: DAY 1 - To understand the rational behind micro surgical retreatment approaches and acquire basic surgical knowledge. DAY 2 - To understand the importance of magnification in endodontic microsurgery and acquire basic microsurgical skills. 14 CE Credits Est. 14 CME HAAD Est. 12 CME DHA 14 CE Credits Est. 14 CME HAAD Est. 12 CME DHA