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1)1) Rubber damRubber damRubber dam Rubber dam

Dental floss silk

a) pulp cappinga) pulp capping b) pulpotomy, partial puplectomy c)d)d)e) ,

a) pulp cappinga) pulp capping b) pulpotomy, partial puplectomyc)d)d)e) ,

Vital pulp treatmentVital pulp treatment

• Pulp cappingg• Pulpotomy, Pulp regeneration• Materials:-Calcium Hydroxide-Calcium Hydroxide-MTA-Bioceramic

pulp capping with MTApulp capping with MTA

MTA

Courtesy of Dr. Mike BrownCourtesy of Dr. Mike Brown

pulp capping with MTApulp capping with MTA

MTA

Courtesy of Dr. Mike Courtesy of Dr. Mike MarmoMarmo

ApexogenesisApexogenesis

Courtesy of Dr. Mike Courtesy of Dr. Mike MarmoMarmo

Pulpotomy with Ca(OH)2

CalciumHydroxide

ApexogenesisApexogenesis

8 m8 m

1 yr

a) pulp cappinga) pulp capping b) pulpotomy, partial puplectomyc)d)d)e) ,

11.

2.

•••••

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• NiTi file• NiTi file ,• ,,•

NiTiNiTi filefile

• Simple file system: ProTaper Next, BLX file O fil t W O• One-file system: WaveOne,Recipro.p

Simple file systemSimple file systemSimple file systemSimple file system

• BLX fileBLX file• ProTaper Next

By Martin Trope & Gilberto Debelian

#15/ 06 2 / 06 d 3 / 0#15/.064x gentle mov. Recapitulation

#25/.06 and #35/.044x gentle mov.

ProTaper NextProTaper NextProTaper NextProTaper Next

Unique off-centered rectangular cross section

ProTaper Next ProTaper UniversalProTaper Next ProTaper UniversalS1 018

X1 017 S2 020X1 017 S2 020F1 020

X2 025 F2 025X2 025 F2 025

X3 030 F3 030X3 030 F3 030X4 040 F4 040 X5 050 F5 050X5 050 F5 050

OneOne--file systemfile system

• ReciprocatinggMotionW O• WaveOne

• ReciprocReciproc

WaveOne (Dentsply Maillefer)WaveOne (Dentsply Maillefer)

WaveOne Small (21.06)WaveOne Primary (25.08)WaveOne Large (40.08)

• Reciproc (VDW, Munich, Germany)

R25 (25.08)R40 (40.06)R50 (50.05)

• Lateral Condensation• Vertical Condensation

Schilder Techniques- Schilder Techniques- Sectional Cone Techniques

• Thermoplasticized GP methodChemically plasticized GP techniques• Chemically plasticized GP techniques

Continuous Wave of Condensation Continuous Wave of Condensation

• System B heat source Bucchananpluggerplugger

Cordless Obturation SystemCordless Obturation System

• B&L Alpha : heat carrier for root canal fillifilling

• B&L Beta : backfill for root canal filling

Alpha BetaBeta

Canal irrigationCanal irrigation• Purposes

1. Flushing out debris and shavings2 Lubricating2. Lubricating3. Minimizing microorganismsg g4. Dissolving pulp tissue

ultrasonic irrigation: CK tip (B&L)ultrasonic irrigation: CK tip (B&L)

a) pulp cappinga) pulp capping b) pulpotomy, partial puplectomyc)d)d)e) ,

OneOne--VisitVisit EndodonticsEndodontics(( ))(( ))

Baek

OneOne--VisitVisit EndodonticsEndodontics (( ))OneOne VisitVisit EndodonticsEndodontics (( ))

1)2)2)3))

P li i C id tiP li i C id tiPreliminary ConsiderationsPreliminary Considerations

1.1. Operator ability and clinical experienceOperator ability and clinical experience2. Time and auxiliary utilization2. Time and auxiliary utilization3 Clinical techniques3 Clinical techniques3. Clinical techniques3. Clinical techniques

IndicationsIndications

• Isolation and sealing problemsg• Anterior esthetic problems• Restorative considerations• Vital pulp exposures and• Vital pulp exposures and

symptomatic pulpitis• Asymptomatic nonvital pulps

ContraindicationsContraindicationsContraindicationsContraindications

•• Periapical symptomsPeriapical symptoms•• Periapical symptomsPeriapical symptoms•• Anatomic problemsAnatomic problemsAnatomic problemsAnatomic problems•• Multirooted teethMultirooted teeth

Incidence of postoperative painIncidence of postoperative pain

InvestigatorInvestigator pulpalpulpal total total one visit one visit total total multivisitmultivisitstatusstatus casescases nonnon--sligslig/mod/mod--sevsev casescases nonnon--sligslig/mod/mod--sevsevstatusstatus casescases nonnon sligslig/mod/mod sevsev casescases nonnon sligslig/mod/mod sevsev

SoltanoffSoltanoff V.NV V.NV 89 81.0%/19.0%89 81.0%/19.0% 193193 86.0%/14.0%86.0%/14.0%So ta oSo ta o 89 8 0%/ 9 0%89 8 0%/ 9 0% 9393 86 0%/ 0%86 0%/ 0%AshkenazAshkenaz V V 195 195 96.0%/ 4.0% 96.0%/ 4.0%RunderRunder&&OlietOliet V,NV 98 88.5V,NV 98 88.5%/11.5%/11.5%% 185 185 88.588.5%/11.5%/11.5%%MulhernMulhern et al. NV et al. NV 30 76.730 76.7%/23.3%/23.3%% 30 30 73.373.3%/26.7%/26.7%%Roane et al. V,NV Roane et al. V,NV 250 84.8250 84.8%/15.0% 109%/15.0% 109 68.8%/31.2%68.8%/31.2%

oneone--visitvisit endodonticsendodontics Success/FailureSuccess/Failure

InvestigatorInvestigator pulpalpulpal total total recallrecall one visit one visit total total multivisitmultivisitstatus cases period success/failurestatus cases period success/failure cases success/failurecases success/failurestatus cases period success/failurestatus cases period success/failure cases success/failurecases success/failure

SoltanoffSoltanoff V NVV NV 8080 6m6m--2y2y 85 0%/15 0%85 0%/15 0% 186186 88 0%88 0% //12 0%12 0%SoltanoffSoltanoff V,NV V,NV 8080 6m6m--2y2y 85.0%/15.0%85.0%/15.0% 186186 88.0%88.0% //12.0%12.0%AshkenazAshkenaz V V 101101 1 yr1 yr 97.0%/ 3.0%97.0%/ 3.0%

44 2yr 97.744 2yr 97.7%/ 2.3%/ 2.3%%44 2yr 97.744 2yr 97.7%/ 2.3%/ 2.3%%RunderRunder & V,NV & V,NV 41 6 41 6 --12m 90.212m 90.2%/ 9.8%/ 9.8%% 91 85.791 85.7%/14.3%%/14.3%OlietOliet 27 27 12 12 --24m 24m 88.8%/11.288.8%/11.2% % 20 20 90.0%/10.0%90.0%/10.0%

3030 >>24m24m 90.0%/10.0% 74 91.8%/ 8.290.0%/10.0% 74 91.8%/ 8.2% %OlietOliet V,NV 153 V,NV 153 >>18m 88.8%/11.2%18m 88.8%/11.2% 185 88.6185 88.6%/11.4%%/11.4%

Single visit vsSingle visit vs. . Multiple visitMultiple visit

• No Statistical DifferenceK i t t l JOE 2004• Kvist et al, JOE 2004

• Friedman et al, JOE 2003• 2 or more visits increased success

• Weiger et al, IEJ 2000• Trope et al, JOE 1999

• Multivisit with Ca(OH)2 increased success f 64% 74%from 64% to 74%

• Kerekes & Tronstad, JOE 1979

a) pulp cappinga) pulp capping b) pulpotomy, partial puplectomyc)d)d)e) ,

Endodontic Microsurgery

99.02 99.03

99.08 00.01

i li l l il ii li l l il iIntentionalIntentional ReplantationReplantationIntentionalIntentional ReplantationReplantationPh i fPhysic forcep

IntentionalIntentionalReplantation

99.06

99 08 00 0899.08 00.08

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