Cover / Editorial / Content / Endodontic retreatment and adhesive restoration of structurally compromised second premolar / Greater N.Y. Dental Meeting offers lots of resources for endodontists / AAE brings annual meeting to Hawaii / COLTENE ENDO launches CanalPro Ultrasonic Irrigator / Wykle Research expands its Calasept Endo line / Submissions / Imprint
Cover
01 - 01 viewEditorial
03 - 03 viewContent
04 - 04 viewEndodontic retreatment and adhesive restoration of structurally compromised second premolar
06 - 12 viewGreater N.Y. Dental Meeting offers lots of resources for endodontists
13 - 14 viewAAE brings annual meeting to Hawaii
16 - 16 viewCOLTENE ENDO launches CanalPro Ultrasonic Irrigator
18 - 18 viewWykle Research expands its Calasept Endo line
20 - 20 viewSubmissions
21 - 21 viewImprint
22 - 22 viewArray
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[1] =>
roots
issn 2161-6558
the international C.E. magazine of
1
2013
_C.E. article
Endodontic retreatment
and adhesive restoration of
structurally compromised
second premolar
_events
Greater N.Y. Dental
Meeting offers lots of
resources for
endodontists
_events
AAE brings
annual meeting
to Hawaii
North America Edition • Vol. 4 • Issue 1/2013
endodontics
[2] =>
[3] =>
editorial _ roots
I
There is always
more to learn
I always enjoy myself at dental meetings. It sure is great to connect with compatriots, and there is undoubtedly something different to experience, a novel approach or technique to explore, or new technology
to learn about. There is also plenty of printed material available to take home. Perhaps you picked up this
very magazine at a dental meeting and are reading it on the plane or train trip home.
Welcome.
For this issue of roots, you can read a report on an endodontic retreatment and adhesive restoration of
a structurally compromised second premolar by Dr. Stela Nicheva, Dr. Lyubomir St. Vangelov and Dr. Ivan
Filipov of Bulgaria. And speaking of meetings, Managing Editor Fred Michmershuizen has written a report
on the many offerings for endodontists that were available at the recent Greater New York Dental Meeting.
You can also read a preview of the American Association of Endodontists Annual Session, which is
planned for April 17-20 in Honolulu.
But there’s even more.
Every issue of roots magazine also contains a C.E. component. By reading the article on endodontic retreatment and adhesive restoration, then taking a short online quiz about this article at www.
DTStudyClub.com, you will gain one ADA CERP-certified C.E. credit. Keep in mind that since roots is
a quarterly magazine, you can actually chisel four C.E. credits per year out of your already busy life
without the lost revenue and time away from your practice.
To learn more about how you can take advantage of this C.E. opportunity, visit www.DTStudyClub.com.
Annual subscribers to the magazine ($50) need only register at the Dental Tribune Study Club website to
access these C.E. materials free of charge. Non-subscribers may take the C.E. quiz after registering on the
DT Study Club website and paying a nominal fee.
I know that taking time away from your practice to pursue C.E. credits is costly in terms of lost revenue
and time, and that is another reason roots is such a valuable publication.
For those of you who will be attending the upcoming AAE meeting in Hawaii, I will see you there.
Meanwhile, I hope you will enjoy this issue of roots and that you will take advantage of the C.E.
opportunity.
Fred Weinstein, DMD, MRCD(C),
FICD, FACD
Sincerely,
Fred Weinstein, DMD, MRCD(C), FICD, FACD
Editor in Chief
roots
I 03
1
_ 2013
[4] =>
I content_ roots
page 06
page 06
I C.E. article
06 Endodontic retreatment and adhesive
restoration of structurally compromised
second premolar
page 13
I about the publisher
21
22
_submissions
_imprint
_Stela Nicheva, DMD; Lyubomir St. Vangelov DMD;
and Ivan Filipov, DMD, PhD
I events
13 Greater N.Y. Dental Meeting offers lots of
resources for endodontists
_Fred Michmershuizen, Managing Editor
16 AAE brings its annual meeting to Hawaii
roots
North America Edition • Vol. 4 • Issue 1/2013
issn 2161-6558
the international C.E. magazine of
endodontics
1
2013
_C.E. article
I industry
Endodontic retreatment
and adhesive restoration of
structurally compromised
second premolar
_events
18 COLTENE ENDO launches CanalPro
Ultrasonic Irrigator
I on the cover
New York meeting
offers lots of resources
for endodontists
_events
AAE brings
annual meeting
to Hawaii
Image courtesy of Barry
Lee Musikant, DMD, FICD
20 Wykle Research expands its Calasept Endo line
page 16
04 I roots
1_ 2013
page 18
page 20
[5] =>
[6] =>
I C.E. article_ retreatment
Endodontic retreatment
and adhesive restoration
of structurally compromised
second premolar
Authors_Stela Nicheva, DMD; Lyubomir St. Vangelov, DMD; and Ivan Filipov, DMD, PhD
_c.e. credit
This article qualifies for C.E.
credit. To take the C.E. quiz,
log on to www.dtstudyclub.
com. Subscribers to the magazine can take this quiz for
free and will be emailed an
access code after the magazine’s release. If you do not
receive the code, please write
to support@dtstudyclub.com.
Non-subscribers may take the
quiz for $20. You can access
the quiz by using the QR code
below. The quiz will be available on Feb. 18.
(Photos/Provided by
Dr. Stela Nicheva)
06 I roots
1_ 2013
_In light of the scientific literature concerning the outcome of the endodontic treatment,
it doesn’t sound inappropriate that the restoration
of the endo-coronal complex has to be completed
by the endodontist1. In this context the following
report presents a complete rehabilitation of a second premolar, including retreatment and definitive
restoration.
Fig. 1
Teeth that need retreatment are most often
grossly decayed due to caries, fracture and/or previous restoration. The endodontic retreatment in
such cases is a challenge concerning the isolation,
overcoming different obstructions, perforation
management (if they exist) and final restoration.
The success rate for teeth that exhibit one or more
technical problems, such as transportation, strip-
[7] =>
C.E. article_ retreatment
ping, perforation or internal resorption, is reported
to be 47 percent.2 Perforations have the most negative influence.3
One of the factors that influence the outcome
following non-surgical retreatment is the final
restoration. Though some authors question the
importance of the coronal restoration for the
longevity of endodontically treated teeth,4,5 it
is well accepted that the final restoration is as
important for the outcome of the endodontic
treatment as the quality of the treatment itself.6
Still, restoration of endodontically treated teeth
remains a controversial issue. In the context of
the increasing relevance of biomimetics,7,8 adhesively inserted indirect partial tooth-colored
restorations are gaining more and more attention. The restoration or mimicking of the biomechanical, structural and esthetic integrity of the
teeth in a conservative manner is an advantage
that must be used and preferred whenever possible. Still, these types of restorations are an
underutilized restorative modality, particularly
on endodontically treated teeth compared to
crowns.9 This may be because clinicians and
I
Fig. 2
Fig. 3
Fig. 4
Fig. 5
dental technicians are more familiar with crown
restorations, the results of which are predictable,
and insecure about the adhesive protocol for
bonded partial restorations.
Once the decision for tooth-colored partial
restoration is made, the operator must choose
between two materials — composite or ceramics.
The benefits of the former (less abrasiveness and
brittleness, lower costs, easy to polish and repair,
user friendly) encounter the strength, inertness
and biocompatibility of the latter. While some
studies indicate that ceramic and composite
inlays provide similar fracture resistance on endodontically treated premolars,10 other suggest that
when cuspal coverage is required composite resin
may be more beneficial in endodontically treated
posterior teeth compared to ceramics pertaining
to its greater survival rate, fatigue resistance and
more favorable failures.11 This can be explained
with the more friendly stress distribution of composite resin onlays, confined above the cementoenamel junction.12
The present report describes the microscopic
retreatment and the definitive restoration of a
roots
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[8] =>
I C.E. article_ retreatment
Fig. 6
Fig. 7
grossly decayed perforated maxillary premolar.
The reasons for the applied treatment are discussed.
_Case report
A 34-year-old male patient reported to the
department of Operative Dentistry and Endodontics, complaining of symptoms from another
tooth. The radiographic examination (Fig. 1)
revealed inadequate endodontic treatment and
perforation with radiolucent area at the apex of
tooth 15. The tooth was endodontically treated
four years ago.
Medical history was non-contributory. Probing
was within normal limits. Local anesthesia with
Ubistesine DS was administered. After the removal
of the old restoration (Fig. 2) and cleaning up the decay, a pre-endodontic buildup was accomplished.
Undercuts were not removed but were blocked out
with the composite resin. The operative field was
isolated with retraction cord immersed in AlCl3
and Matrix band (Fig. 3). While keeping the orifice
and perforation open with gutta-percha points
and Cavit, a total etch technique was performed.
Enamel and dentin were covered with adhesive
(Prime & Bond NT, Dentsply) and polymerized for 10
seconds. Bulk-fill flowable composite was applied
(SDR, Dentsply) and polymerized for 40 seconds in
order to create a reservoir for the irrigants during
endodontic retreatment (Fig. 4). After the removal
of gutta-percha points and Cavit, the real canal
(blue arrows) and the perforation (red arrow) were
easily accessible (Fig. 5).
Since the artificial canal was previously obturated with a paste, cleaning with a combination
08 I roots
1_ 2013
of hand files, ultrasonics (Pro Ultra 5 and 6) and
irrigation with citric acid was used. To confirm
the effectiveness of the cleaning procedure, an
intra-operative X-ray was done (Fig. 6). Because
of the different angulation of the beam, it seems
as if the perforation is on the level of the crestal
bone, which is not the real case.
For cleaning and shaping of the real root canal, the
following protocol was used:
1) Glide path was established using SS K-files
08, 10, and Path Files 013, 016, 019, (Dentsply
Maillefer).
2) The upper two-thirds was prepared using
S1 and S2 files from Pro Taper system (Dentsply
Maillefer).
3) The apical third used a 20 (04) GTX file (Dentsply
Maillefer).
Throughout the whole procedure, irrigation
with Citric acid (40 percent, Cerkamed, Poland)
and NaOCl (2 percent, Cerkamed, Poland) was
used.
We preferred S1 and S2 files because of their
ability to brush against the canal wall, which is very
useful in cases with oval cross sections, where it is
of paramount importance to clean all aspects of the
root canal spaces. For the apical one third we choose
a landed GTX file, because the canal was very narrow and we wanted to eliminate the possibility to
transport the apical foramen. Both artificial and true
canal were obturated using warm vertical compaction of gutta-percha and MTA-based sealer (FillApex,
Angelus, Brazil). On the post-op radiograph, the
preparation and obturation seem short, but this was
the reading we repeatedly got with our apex locator
(RayPex5, WDV, Germany) (Fig. 7).
[9] =>
C.E. article_ retreatment
After the completion of the endodontic retreatment, the pre-endodontic buildup was left
at place and the endodontic access was restored
again with SDR, creating a core, on which an onlay
preparation with diamond burs (Mani Inc.) was
performed (Figs. 8,9). The enamel margins were
exposed and unsupported enamel prisms were
removed using fine-grit diamond points. The remaining tooth structure was prepared to create a
butt-joint with the restoration margins. Internal
line angles were rounded and the walls provided
5- to 15-degree path of divergence. The proximal
boxes preparations extended to the existing composite, since they were located in the dentin.
The dimensions of the preparation provided at
least 2 mm interocclusal clearance, which could
be verified on the impression. A condensable silicone impression was taken (Fig. 10). A custommade provisional restoration was created using
direct technique and temporarily cemented with
a non-eugenol luting agent (TempBond NE) (Fig.
11). The fitting aspect of the restoration was
sandblasted by the dental technician.
At the second appointment after assessment
of the prepared restoration, removal of the
I
Fig. 8
Fig. 9
Fig. 10
Fig. 11
provisional and cleaning of the preparation the
fit and aesthetics of the onlay were evaluated.
Rubber dam was placed and the preparation was
cleaned with acetone, etched with 37 percent
phosphoric acid for 15 seconds, rinsed and dried.
The fitting aspect of the restoration was also
cleaned with acetone prior to cementation. A
dual-cure self-adhesive luting resin (SmartCem2,
Dentsply) was applied to the walls of the preparation and the restoration was placed with firm
pressure until fully seated. The excess cement was
removed with an explorer, a #12 scalpel blade and
dental floss in the interproximal area after fivesecond polymerization that brought the cement
to a “rubbery” stage (Figs. 12,13). The restoration
was covered with glycerin and finally cured for 60
seconds from each side (Figs. 14,15). The minimal
occlusal adjustments were done with fine diamond burrs under water coolant. Finishing and
polishing were accomplished with the Enhanse
system (Dentsply) (Fig. 16).
Once finishing and polishing was done, a 37
percent phosphoric acid gel was applied for 15
seconds to clean the surface of the restoration
and to acid etch the marginal enamel. After
roots
I 09
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_ 2013
[10] =>
I C.E. article_ retreatment
Fig. 12
Fig. 13
Fig. 14
Fig. 15
washing and drying, the nanofilled adhesive
(Prime&BondNT, Dentsply) was applied and
permitted to rest for 10 seconds to permeate
the surface and margin fissures created by the
finishing process. The adhesive was then thinned
with air and polymerized for 40 seconds (Fig. 17).
At the six-month recall, the tooth was asymptomatic and the patient was completely satisfied
(Figs. 18,19).
_Discussion
This case report demonstrates endodontic retreatment and composite onlay as definitive restoration for a compromised tooth with minimal coronal
tooth structure.
The two most important factors in terms of
prognosis of treatment of perforations are the
age of the lesion and degree of bacterial contamination.13 In our case, the previous endodontic treatment was done four years ago. The long
period of time is not favorable for the prognosis,
but since the perforation is in the apical third
the likelihood of bacterial contamination is low.
10 I roots
1_ 2013
After the patient has been informed, he chooses
orthograde endodontic retreatment as a treatment modality.
The material of choice for perforation repair
is MTA (mineral trioxide aggregate). Because of
the small size and apical position of the lesion,
we desided to treat it like a second canal and
to obturate with gutta-percha and MTA based
sealer. The absence of worsening of the periapical conditions in the six months post-op X-ray
(Fig. 19) supports this approach, and the patient
is still under observation.
Although still debatable, recent comprehensive meta-analysis by Gillen et al.6 demonstrates
that a well-fitting, bacteria-proof final restoration has the same importance for the long-term
prognosis of the endodontically treated tooth
as does the well-performed endodontic therapy.
Besides the prevention of coronal microleakage, a key factor for the long-term survival of
an endodontically retreated tooth appears to
be the amount of remaining tooth substance,14
which is determined by the dimensions of the
final restoration. So an ideal treatment option
[11] =>
C.E. article_ retreatment
for an endodontically retreated tooth seems to
be adhesively bonded restoration that preserves
as much of the tooth structure as possible.
An endodontically treated posterior tooth presenting with extensive decay is most frequently
restored with a post and a crown. That is intelligible, because crowns are a well- established and
known, clinically proven restorative modality, and
still a considerable amount of research is being
performed in this direction.15 On the other hand,
partial tooth-colored restorations are recognized
as valuable alternatives to full coverage crowns,
and questions are raised if intracanal posts are
necessary at all for an endodontically treated
tooth.
Since their introduction in 1980,16 indirect laboratory processed composites are being continuously improved in their physical and mechanical
properties. Now this restorative option offers
adhesive, biomimetic approach far less aggressive than crowns and far less technique sensitive
than ceramics.
Achieving a perfect marginal quality with composite onlays, when gingival margins are located
in the dentin, continues to be critical even when
I
Fig. 16
Fig. 17
Fig. 18
Fig. 19
new adhesive techniques and systems are used.17
The application of a composite base underneath
indirect composite restorations represents a feasible non-invasive alternative to surgical crown
lengthening to relocate cavity margins from an
intra-crevicular to a supra-gingival position. This
also permits the placement of a rubber dam for
absolute isolation. Surgical crown lengthening
may also compromise the periodontal tissue support of neighboring teeth.18 We did this relocation
simultaneously with the pre-endodontic buildup
with SDR. This material has the intimate wetting
ability of low viscosity composite and in the same
time polymerization shrinkage stress similar to
regular viscosity composite.
To simplify the procedures for bonding indirect
restorations, resin cements have been introduced
recently that are promoted as self-adhesive — i.e.,
do not require a separate adhesive application step.
Manufacturers claim that these cements are hydrophilic when mixed (acidic phase) but become hydrophobic (neutral pH) upon reaction with the tooth
structure. The bond strengths to the tooth structure
are questioned. In our case we decided to additionally etch the enamel margins of the preparation,
roots
I 11
1
_ 2013
[12] =>
I C.E. article_ retreatment
although not recommended by the manufacturer,
because the procedure is simple and, as Duarte et al.19
and de Andrade et al.20 demonstrated, improves the
bond strength of the restoration.
We preferred condensation-type silicone impression material for its better ability to reproduce the
surface characteristics of low viscosity resin reported
by Takano et al.21
The surface and margins of the restoration were
sealed with filled adhesive. This treatment improves
the marginal adaptation,22 and it could be demonstrated that adhesives are superior to specially
designed resin coating materials._
_References
1.
Robbins J W. Restoration of the endodontically treated
tooth. Dent Clin North Am. 2002 Apr; 46(2):367–384.
2. Gorni FGM, Gagliani MM. The outcome of endodontic
retreatment: a 2-yr follow-up. J Endod. 2004 Jan;
30(1):1–4.
3. Farzanah M, Abitbol S, Friedman S. Treatment outcome in
endodontics: the Toronto study. Phases I and II: Orthograde
retreatment. J Endod 2004 Sep;30(9):627–633.
4. Chugal NM, Clive JM, Spångberg LS. Endodontic
treatment outcome: effect of the permanent restoration.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007
Oct;104(4):576–582.
5. Ricucci D, Gröndahl K, Bergenholtz G. Periapical status of
root-filled teeth exposed to the oral environment by loss of
restoration or caries. Oral Surg Oral Med Oral Pathol Oral
Radiol Endod. 2000 Sep;90(3):354–359.
6. Gillen BM, Looney SW, Gu LS et al. Impact of the quality of
coronal restoration versus the quality of root canal fillings
on success of root canal treatment: a systematic review and
meta-analysis. J Endod. 2011 Jul;37(7):895–902.
7. Magne P., Belser U. Bonded Porcelain Restorations in the
Anterior Dentition: A Biomimetic Approach. Chicago, IL:
Quintessence Publishing Co Inc, 2002.
8. Magne P. Composite resins and bonded porcelain:
the postamalgam era? J Calif Dent Assoc. 2006
Feb;34(2):135–147.
9. Jackson RD. The role of modern composites and ceramics
in clinical practice. Dent Today. 2011 Jun;30(6).
10. de V Habekost L, Camacho GB, Azevedo EC, Demarco FF.
Fracture resistance of thermal cycled and endodontically
treated premolars with adhesive restorations. J Prosthet
Dent. 2007 Sep;98(3):186–192.
11. Magne P, Knezevic A. Simulated fatigue resistance
of composite resin versus porcelain CAD/CAM
overlay restorations on endodontically treated molars.
Quintessence Int. 2009 Feb;40(2):125–133.
12. Magne P. Virtual prototyping of adhesively restored,
endodontically treated molars. J Prosthet Dent. 2010
Jun;103(6):343–351.
13. Simon S, Pertot W-J. Clinical success in endodontic
retreatment. Quintessence Pub Co; Apr 1, 2009.
12 I roots
1_ 2013
14. Mannocci F, Bhuva B, Stern S. Restoring teeth
following root canal re-treatment. Endod Topics 2008
Sept;19(1):125–152.
15. Peroz I, Blankenstein F, Lange KP, Naumann M. Restoring
endodontically treated teeth with posts and cores-a review.
Quintessence Int. 2005 Oct;36(9):737–746.
16. Nandini S. Indirect resin composites. J Conserv Dent. 2010
Oct;13(4):184–194.
17. Soares CJ, Celiberto L, Dechichi P et al. Marginal integrity
and microleakage of direct and indirect composite inlays:
SEM and stereomicroscopic evaluation. Braz Oral Res.
2005 Oct-Dec;19(4):295–301.
18. Ricucci D, Grosso A. The compromised tooth:
conservative treatment or extraction? Endod Topics 2006
Mar;13(1):108–122.
19. Duarte S Jr, Botta AC, Meire M, Sadan A. Microtensile
bond strengths and scanning electron microscopic
evaluation of self-adhesive and self-etch resin cements
to intact and etched enamel. J Prosthet Dent. 2008
Sep;100(3):203–210.
20. de Andrade OS, de Goes MF, Montes MA. Marginal
adaptation and microtensile bond strength of composite
indirect restorations bonded to dentin treated with
adhesive and low-viscosity composite. Dent Mater. 2007
Mar;23(3):279–287.
21. Takano Y, Nikaido T, Tagami J. Visual and SEM observation
of resin coated dentin after taking impression. J Jpn Adhes
Dent. 2001;19:117–124.
22. Ramos RP, Chimello DT, Chinelatti MA et al. Effect of
three surface sealants on marginal sealing of Class V
composite resin restorations. Oper Dent. 2000 SepOct;25(5):448–453.
_about the authors
roots
Stela Nicheva, DMD,
graduated in dentistry
from Medical University, Plovdiv, Bulgaria,
in 2010. Currently she
is taking a PhD position
at the Department of
Operative Dentistry and
Endodontics, Faculty of
Dental Medicine, PlovdivBulgaria. She may be contacted at stelanicheva@
gmail.com.
Lyubomir Vangelov, DMD, is an assistant professor at Faculty of dental medicine, Department of Operative Dentistry
and Endodontics, Plovdiv-Bulgaria. Simultaneously he
maintains his private practice in Dental Center “Avangard,”
limited to endodontics and esthetic restorations.
Ivan Filipov, DMD, PhD, is associate professor at Faculty of
Dental Medicine, Department of Operative Dentistry and
Endodontics, Plovdiv-Bulgaria, and maintains his private
practice in Dental Center “Avangard.”
[13] =>
events Greater New York Dental Meeting
I
Greater N.Y. Dental
Meeting offers lots of
resources for endodontists
Author_Fred Michmershuizen, Managing Editor
_When it comes to learning about the newest
procedures and the most innovative products
in dentistry, there was no better place to be in late
November 2012 than at the Greater New York Dental
Meeting (GNYDM). The meeting, held for the 88th
time, attracted dental professionals from across the
country and around the world. A wide range of offerings were of particular note to endodontists.
The event featured products and services from
hundreds of exhibiting companies, plus a plethora of
educational opportunities.
The Live Dentistry Arena, which had 425 seats and
two big screens so that every seat in the house was
a good one, was standing-room-only through much
of the meeting. Right next door to the Live Dentistry
Arena was the Dental Tribune Study Club C.E. Symposia. The lineup featured lectures on a range of topics,
including endodontics.
Dr. Selma Camargo presented “Optimizing Endodontic Treatment with High Intensity Laser Therapy.”
She discussed how to identify endodontic disease,
treatment possibilities and understand their limitations. Furthermore, attendees could hear how scientific and clinical points of view establish laser therapy
indications for endodontics. Attendees learned how
to perform such procedures and to implement this
type of treatment into their practices.
On the exhibit hall floor, NSK offered the Ti-Max
Z, a durable premium handpiece that is claimed to
have the smallest head and neck in the industry, as
well as an exceptionally low noise level and virtually
no vibration.
Coltene Endo showcased its HyFlex CM NiTi files with
Controlled Memory, which the company says are up to
300 percent more resistant to cyclical fatigue compared
to other NiTi files, which substantially helps reduce the
Fig. 1_Dr. Selma Camargo
presents a Dental Tribune Study
Club lecture on the use of lasers in
endodontic therapy. (Photos/Fred
Michmershuizen, Dental Tribune)
Fig. 2_Dr. Andrew W. Krieger,
left, visits with Jeff Jones of
Technology4Medicine.
Fig. 1
Fig. 2
roots
1
_ 2013
I 13
[14] =>
I events_ Greater New York Dental Meeting
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 3_Christopher Utz, left, and
Sam Turner of Coltene.
Fig. 4_Meeting attendees enter the
exhibit hall of the Greater New York
Dental Meeting.
Fig. 5_Josh Coe, left, and Jennifer
Gibson of the American Association
of Endodontists.
Fig. 6_Paul Berezny, left, and Kevin
Maidy of SS White.
Fig. 7_Dan Dezak, left, and Dawn
Petit of NSK.
Fig. 8_Koichi Arakawa of Mani.
14 I roots
1_ 2013
Fig. 7
incidence of file separation. According to Coltene Endo,
HyFlex CM NiTi files have been manufactured utilizing
a unique process that controls the material’s memory,
making the files extremely flexible but without the shape
memory of other NiTi files. This gives the file the ability to
follow the anatomy of the canal very closely, reducing
the risk of ledging, transportation or perforation.
Essential Dental Systems (EDS) offered its
Endo-Express reciprocating handpiece and its
Fig. 8
SafeSiders, designed to eliminate the fear of
fracture associated with crown-down systems
and the typical shortcomings of the step-back
process.
Roydent Dental Products offered 12.5, 15 and
assorted packs 06-10 of C-Files, all in 21 and 25 mm
lengths. Roydent brand C files are indicated for calcified canals, and they are also ideal for locating canals
and instrumenting narrow canals._
[15] =>
[16] =>
I events_ AAE Annual Session
AAE brings
annual meeting
to Hawaii
Waikiki Beach is the backdrop for
the 2013 American Association of
Endodontists Annual Session.
(Photo/Hawaii Tourism Authority/
Joe Solem)
16 I roots
1_ 2013
_The American Association of Endodontists
2013 Annual Session will offer more than 100
high-quality educational sessions in Honolulu at
the Hawaii Convention Center April 17-20. Attendees
can earn up to 22.5 hours of continuing education
credit by attending the various courses during the
meeting, “Endodontics: Exceeding Expectations.”
Curriculum varies from nine different tracks. New
tracks this year include Endo 2025, Imaging, Pain
and Pharmacology and Systemic Health, covering
pertinent topics such as tissue engineering, pain
management, outcome assessments, medical myths
in dentistry and more. “Mega-Session Wednesday,”
also new, will allow attendees to delve deeper into
a topic of their choice with longer, more in-depth
presentations on the first day of the meeting.
“We have educational sessions given by cuttingedge presenters on cutting-edge topics,” said AAE
President Dr. James C. Kulild. “Attendees can apply
those principles in their own practices in order to
increase their quality of care and their value to their
referrers and their patients.”
The always popular “Master Clinician Series” and
hands-on workshops will feature leading experts
in topics such as “Differential Diagnosis of Pain,”
“Clinical Application of High Resolution CBCT in
Endodontics,” “Maximizing the Value of Your Endodontic Service” and “Functional Crown-Lengthening
Surgery.” Attendees can attend one of these workshops for a more hands-on experience in technique
and then head to a practice management course or
to the exhibit hall to explore specialized endodontic
distributors.
In addition to the C.E. opportunities, numerous
special events fill the schedule, allowing attendees
to network and catch up with old and new friends.
The schedule for the meeting sessions start and end
earlier this year, allowing guests to explore the beautiful Honolulu surroundings. The AAE Foundation live
auction will feature a dunk tank, where well-known
members have volunteered to help raise money by
testing the fate of the payers’ accuracy. Additionally,
during the Grossman breakfast, the American Board
of Endodontics will recognize the 86 endodontists
who achieved board certification in the past year, the
largest class of diplomates ever.
To make the meeting experience seamless and
convenient, attendees can download the AAE’s Annual Session app to a smartphone or tablet. Visit your
mobile device app store and search for “2013 AAE
Annual Session,” or access crwd.cc/AAEAnnual13
from your mobile device. Attendees can also connect with the AAE through the AAE Facebook page at
www.facebook.com/endodontists, the AAE YouTube
channel at www.youtube.com/rootcanalspecialists
and Twitter at www.twitter.com/AAENews.
For more information, to register or to see the full
schedule, visit www.aae.org/annualsession. Dental
professionals who join the AAE receive a member
discount on meeting registration of more than 40
percent._
(Source: AAE)
[17] =>
[18] =>
I industry_ COLTENE ENDO
COLTENE ENDO
launches CanalPro
Ultrasonic Irrigator
The CanalPro™ Ultrasonic Irrigator
(Photo/Coltene/Whaledent)
18 I roots
1_ 2013
_Attached to a piezo unit, the CanalPro™
Ultrasonic Irrigator allows for distribution of activated sodium hypochlorite to increase debridement
of lateral canals and isthmuses.
The autoclavable, nickel titanium tip provides
excellent access to the canal, while the ratcheting
syringe permits controlled delivery of 0.2 ml of solution with each audible click. The CanalPro Ultrasonic
Irrigator fits all major ultrasonic units.
COLTENE®ENDO brands represent more than a
century of experience in providing essential and
reliable endodontic products and materials that are
clinically proven to ensure successful endodontic
therapy.
For more information about the new CanalPro
Ultrasonic Irrigator and the many other products
available from COLTENE ENDO, contact Coltène/
Whaledent at (330) 916-8800 or visit coltene.com._
[19] =>
[20] =>
I industry_ Wykle Research
Wykle Research
expands its
Calasept Endo line
Fig. 1_Calasept Irrigation Needles
(Photos/Provided by Wykle Research)
Fig. 2_Calasept Irrigation Syringes
_Wykle Research has announced the release
of two new Calasept Endo products, which it
distributes for Nordiska Dental of Sweden, the manufacturer of Calasept and Calasept Plus.
Calasept Irrigation Needles are high-quality,
double-side-vented, luer-lock irrigation needles
that optimize the cleansing of canals, creating a
“swirl effect.”
The needles are available in 27 g or 31 g, in packs
of 40 needles.
Features include the following:
• Bendability
• Luer-lock hub
• Sterile and disposable
• Designed for ease in cleaning roots
• High-quality stainless steel
Calasept Irrigation Syringes are 3 ml luer-lock,
single-use syringes. They are color coded to eliminate
risk when using multiple irrigation liquids. They are
available in packs of 20 syringes, 10 white and 10
green.
Features include the following:
• High-quality, three-part syringe
• Color coded
• Luer lock
These new products complement Wykle’s popular
Calasept line, which includes Calasept and Calasept
Plus calcium hydroxide paste for temporary filling of
root canals, sold in packages of four syringes with 20
needles. Calasept EDTA is 17 percent EDTA solution.
Calasept CHX is 2 percent chlorhexidine solution for
irrigation. Both solutions are packaged with a luer
adaptor for easy filling of syringes.
Wykle Research distributes Calasept Endo
products by Nordiska Dental, a Swedish manufacturer of Dental supplies. Wykle Research and
Nordiska Dental will continue to provide new
endo products.
For more information, contact Wykle Research at
(800) 859-6641 or visit the company online at www.
wykleresearch.com._
Fig. 1
Fig. 2
20 I roots
1_ 2013
[21] =>
about the publisher_ submissions
I
submissions
formatting requirements
Please note that all the textual elements
of your submission:
• complete article
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• contact info (email address please)
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must be combined into one Microsoft Word
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for each of these items. In addition, images
(tables, charts, photographs, etc.) must not
be embedded in the text document. All images
must be submitted separately, and details
about how to do this appear below.
If you are interested in submitting a C.E.
article, please contact us for additional instructions before you make your submission.
_Text length
Article lengths can vary greatly — from a
mere 1,500 to 5,500 words — depending on
the subject matter. Our approach is that if
you need more or less words to do the topic
justice, then please make the article as long or
as short as necessary.
We can run an extra long article in multiple parts, but this is usually discussing a subject matter where each part can stand alone
because it contains so much information. In
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you in terms of article length, so please use
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There are menus in every program that
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Please number images consecutively by
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imperative that certain images are grouped
together, then use lowercase letters to designate the images in a group (i.e., Fig. 2a, Fig.
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Insert figure references in your article
wherever they are appropriate, whether that
is in the middle or end of a sentence, but
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If you have an image that is greater than
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Also, please remember that you should
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You may submit images through a
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images directly to us (please contact us
for the mailing address as this will depend
upon where in the world you will be mailing
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Please do not forget to send us a head
shot photo of yourself that also fits the
image requirements noted above so that it
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_Abstracts
An abstract of your article is not required.
However, if you choose to provide us with
one, we will print it in a separate box.
_Contact info
At the end of every article is a contact info
box with contact information along with a
portrait photo of the author.
Please note at the end of your article the
exact information you would like to appear
in this box and format it according to the
previously mentioned standards.
A short bio (50 words or less) may precede the contact info if you provide us with
the necessary text.
_Questions? Comments?
Please do not hesitate to contact us for our
International C.E. Magazine Author Kit or if
you have other questions/comments about
the article submission process:
Group Editor Robin Goodman
r.goodman@dental-tribune.com
Roots Managing Editor Fred Michmershuizen
f.michmershuizen@dental-tribune.com
Managing Editor Sierra Rendon
s.rendon@dental-tribune.com
roots
I 21
1
_ 2013
[22] =>
I about the publisher _ imprint
roots
the international C.E. magazine of endodontics
U.S. Headquarters
Tribune America
116 West 23rd Street, Ste. 500
New York, NY 10011
Tel.: (212) 244-7181
Fax: (212) 244-7185
feedback@dental-tribune.com
www.dental-tribune.com
Publisher
Torsten R. Oemus
t.oemus@dental-tribune.com
Chief Operating Officer
Eric Seid
e.seid@dental-tribune.com
Managing Editor
Sierra Rendon
s.rendon@dental-tribune.com
Managing Editor
Robert Selleck
r.selleck@dental-tribune.com
Designer
Kristine Colker
k.colker@dental-tribune.com
C.E. Director
Christiane Ferret
c.ferret@dtstudyclub.com
Marketing Director
Anna Wlodarczyk-Kataoka
Group Editor
a.wlodarczyk@dental-tribune.
Robin Goodman
r.goodman@dental-tribune.com com
Roots Managing Editor
Fred Michmershuizen
f.michmershuizen
@dental-tribune.com
Product/Account Manager
Humberto Estrada
h.estrada@dental-tribune.com
Product/Account Manager
Mara Zimmerman
m.zimmerman@dental-tribune.
com
Product/Account Manager
Will Kenyon
w.kenyon@dental-tribune.com
Product/Account Manager
Charles Serra
c.serra@dental-tribune.com
International Product/Account
Manager
Jan Agostaro
j.agostaro@dental-tribune.com
Feedback & General Inquiries
feedback@dental-tribune.com
Editorial Board
Marcia Martins Marques, Leonardo
Silberman, Emina Ibrahimi, Igor Cernavin,
Daniel Heysselaer, Roeland de Moor, Julia
Kamenova, T. Dostalova, Christliebe Pasini,
Peter Steen Hansen, Aisha Sultan, Ahmed
A Hassan, Marita Luomanen, Patrick Maher,
Marie France Bertrand, Frederic Gaultier,
Antonis Kallis, Dimitris Strakas, Kenneth Luk,
Mukul Jain, Reza Fekrazad, Sharonit
Sahar-Helft, Lajos Gaspar, Paolo Vescovi,
Marina Vitale, Carlo Fornaini, Kenji Yoshida,
Hideaki Suda, Ki-Suk Kim, Liang Ling Seow,
Shaymant Singh Makhan, Enrique Trevino,
Ahmed Kabir, Blanca de Grande, José Correia
de Campos, Carmen Todea, Saleh Ghabban
Stephen Hsu, Antoni Espana Tost, Josep
Arnabat, Ahmed Abdullah, Boris Gaspirc,
Peter Fahlstedt, Claes Larsson, Michel Vock,
Hsin-Cheng Liu, Sajee Sattayut, Ferda Tasar,
Sevil Gurgan, Cem Sener, Christopher Mercer,
Valentin Preve, Ali Obeidi, Anna-Maria
Yannikou, Suchetan Pradhan, Ryan Seto, Joyce
Fong, Ingmar Ingenegeren, Peter Kleemann,
Iris Brader, Masoud Mojahedi, Gerd Volland,
Gabriele Schindler, Ralf Borchers, Stefan
Grümer, Joachim Schiffer, Detlef Klotz,
Herbert Deppe, Friedrich Lampert, Jörg
Meister, Rene Franzen, Andreas Braun, Sabine
Sennhenn-Kirchner, Siegfried Jänicke, Olaf
Oberhofer and Thorsten Kleinert
Tribune America is the official media partner of:
roots_Copyright Regulations
_the international C.E. magazine of roots published by Tribune America is printed quarterly. The magazine’s articles and illustrations are
protected by copyright. Reprints of any kind, including digital mediums, without the prior consent of the publisher are inadmissible and liable
to prosecution. This also applies to duplicate copies, translations, microfilms and storage and processing in electronic systems. Reproductions,
including excerpts, may only be made with the permission of the publisher.
All submissions to the editorial department are understood to be the original work of the author, meaning that he or she is the sole copyright
holder and no other individual(s) or publisher(s) holds the copyright to the material. The editorial department reserves the right to review all
editorial submissions for factual errors and to make amendments if necessary.
Tribune America does not accept the submission of unsolicited books and manuscripts in printed or electronic form and such items will
be disposed of unread should they be received.
Tribune America strives to maintain the utmost accuracy in its clinical articles. If you find a factual error or content that requires clarification, please contact Group Editor Robin Goodman at r.goodman@dental-tribune.com. Opinions expressed by authors are their own
and may not reflect those of Tribune America and its employees.
Tribune America cannot assume responsibility for the validity of product claims or for typographical errors. The publisher also does not
assume responsibility for product names or statements made by advertisers.
The responsibility for advertisements and other specially labeled items shall not be borne by the editorial department. Likewise, no responsibility shall be assumed for information published about associations, companies and commercial markets. All cases of consequential liability
arising from inaccurate or faulty representation are excluded. General terms and conditions apply, and the legal venue is New York, New York.
22 I roots
1_ 2013
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Cover
01 - 01
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-
Editorial
03 - 03
view
-
Content
04 - 04
view
-
Endodontic retreatment and adhesive restoration of structurally compromised second premolar
06 - 12
view
-
Greater N.Y. Dental Meeting offers lots of resources for endodontists
13 - 14
view
-
AAE brings annual meeting to Hawaii
16 - 16
view
-
COLTENE ENDO launches CanalPro Ultrasonic Irrigator
18 - 18
view
-
Wykle Research expands its Calasept Endo line
20 - 20
view
-
Submissions
21 - 21
view
-
Imprint
22 - 22
view
[toc_titles] => Cover
/ Editorial
/ Content
/ Endodontic retreatment and adhesive restoration of structurally compromised second premolar
/ Greater N.Y. Dental Meeting offers lots of resources for endodontists
/ AAE brings annual meeting to Hawaii
/ COLTENE ENDO launches CanalPro Ultrasonic Irrigator
/ Wykle Research expands its Calasept Endo line
/ Submissions
/ Imprint
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