Endo Tribune Middle East & Africa No. 3, 2018
“No Anaesthesia” endodontics in children / Root canal therapy and coronectomy / When an idea turns into innovation
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www.dental-tribune.me
PUBLISHED IN DUBAI
May-June 2018 | No. 3, Vol. 8
“No Anaesthesia”
endodontics in children
SUBSCRIBE NOW
www.me.dental-tribune.com/e-paper/
Vol. 13 • Issue 4/2017
issn 2193-4673
roots
international magazine of
endodontics
4
2017
By Dr Imneet Madan, UAE
“Laser Popping Sound” in dentistry
for children is one of the best approaches that can help us to overcome the initial fear of the unknown
when it comes to first treatment appointments in children. Its uniqueness lies in the fact that the need for
numbing is completely exempted.
Today’s children like technology
playing at its best. Lasers definitely
meet that perception of technology.
The routine first visit appointments
are usually not a concern as children
do not anticipate any intervention.
Since they are not in pain, their
mindset of approach is not defensive. Rather when there is no prebiased opinion or fear, there is a
pleasant sense of adaptation that
allows the smooth flow of the appointment. Any different kind of behavioural exhibit occurs only when
kids are anticipating an intervention,
when they had been in pain or when
in general they come fatigued.
The discussion of needles is considered to be the most common subject
just prior to the visit to the dentist.
This discussion can become even
more intense when there is already
a perceived treatment need. Very
young children can have the fear of
the unknown, anxiety with strange
and new places.
The older ones develop extreme
fear by talking to peers who have
been to the dentist before. Some
of them might have had good and
some others not so good experience.
Sometimes, past unpleasant parental experience can distort the child’s
adaptability to the dental appointment. They enter the clinic with
the preformed image of the dentist
which is not very convincing and
helpful to the child. These external
experiences can lay the foundation
of the child’s coping ability in the
dental chair.
How can lasers help?
Since laser is not commonly available at all practices, there could be
a possibility that there had been no
real discussion on the use of lasers in
the treatment. Another possibility of
having a good experience with lasers
can change the perception of the
child who is in for the first time.
When laser is introduced to the
parents, they are informed about
details on the functioning of laser
and its benefits. While explaining
euphemisms to the child, the laser is
shown as “Popping Light”. There is a
significant number of children who
go awe-inspired to come back and
get there teeth fixed.
research
Photodamage of dental pulpa stem cells
during 700 fs laser exposure
case report
Apexification treatment with MTA REPAIR HP
interview
The whole mindset of the child
changes when they are told that
treatments do not involve any needles approach.
“No Anaesthesia”
Procedures that can be done without
anaesthesia are:
– Restorations: Decays involving occlusal, labial, palatal, buccal or proximal surfaces of the teeth.
– Deep restorations on teeth with decays close to the pulp.
Understanding sonic-powered irrigation
– Pulpotomies in primary teeth.
– Pulpectomies in primary teeth.
– Pulpectomies in primary teeth
with abscess, fistula or swellings.
The term “No Anaesthesia” is a misnomer as the procedure is accom-
ÿPage A2
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[2] =>
A2
ENDO TRIBUNE
Dental Tribune Middle East & Africa Edition | 3/2018
◊Page A1
plished with few drops of anaesthesia in between, especially when
endodontics is involved. The “No Anaesthesia” approach for enamel dentine 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 usually 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 decay 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 isolated 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 happen while removing this decay. In
such situations, exposed pulp needs
to be treated by removing the affected coronal pulp contents. This procedure is referred to as Pulpotomy.
Deep caries are excavated with preadjusted 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
ing and composite restoration.
Pulpectomy procedure
in primary tooth with abscess
or fistula
In cases where there are long standing infections o
chronic irreversible pulpitis, it becomes invariable to use both diode
and erbium laser sterilisation after
the laser assisted access and further
steps as described above.
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 caries. 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 coronal 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 involvement, are indicated for Pulpectomy. Pulpectomy involves the removal of both coronal and radicular
pulp contents.
When the tooth is indicated for
pulpectomy or root canal procedure,
deep caries are excavated with preadjusted 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 caries. 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 coronal pulp chamber.
As we go further deep into the coronal chamber, more anaesthetic
intrapulpal infilteration 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-
TIME & LOCATION:
Thursday - Friday 05 - 06 July 2018
CAPP Training Institute, Dubai, UAE
Practicing contemporary dentistry
in children with the appropriate usage of technology and the key tools,
is the way forward. The benefits of
the “No Anaesthesia” erbium approach far outweighs the existing alternatives. This kind of professional
approach can certainly become the
gold standard for dentistry in children in the very near future.
Benefits of
“No Anaesthesia” dentistry
– No risk of children having traumatic bite after the procedure is completed. 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, children may still land up in biting there
lip or cheek. Once there is a traumat-
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
(Management of Endodontic Failure)
(Management of Endodontic Failure)
PRICE:
4,400 AED (1198USD)
This procedure has been practiced
as an alternate to pre-times extraction of primary teeth that has to be
then replaced with a space maintainer. 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.
Conclusion
Endo Micro Surgical Retreatment
Endo Non-surgical
and Surgical Retreatment
Dr. Antonis Chaniotis, Greece
Until the point that canals are found
completely dry, obturation is deferred. Usually it takes one or two
visits to complete the final step of
obturation in teeth with abscess or
fistula. The entire treatment is completed with intrapulpal drops of anaesthesia when required. No infiltrations or blocks are used in the entire
procedure.
ic bite, there is nothing much that
can be done as the traumatized tissue has to self-heal. This can be quite
painful for the child, thereby defeating the entire purpose of pain free
dental approach.
– Multi-quadrant dentistry can be
practiced on the same day, same appointment.
– There is actual saving of chairside
time, as there is no waiting period for
local anaesthesia to work.
– Children can eat a few minutes after the procedure, which is not the
case with dental local anaesthesia.
CONTACT:
Email: events@cappmea.com
Mob: +971 50 2793711
CAPP designates this activity for 14CE Credits
| 09:00 – 18:00
COURSE OUTLINE:
DAY 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.
DAY 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.
Prof. James Prichard, UK
PRICE:
4,400 AED (1198USD)
TIME & LOCATION:
Saturdy - Sunday 07 - 08 July 2018
CAPP Training Institute, Dubai, UAE
CONTACT:
Email: events@cappmea.com
Mob: +971 50 2793711
CAPP designates this activity for 14CE Credits
| 09:00 – 18:00
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
14 CE
Credits
Est.
14 CME
HAAD
Est.
14 CME
HAAD
Est.
12 CME
DHA
Est.
12 CME
DHA
[3] =>
[4] =>
4
ENDO TRIBUNE
Dental Tribune Middle East & Africa Edition | 3/2018
Root canal therapy and coronectomy
Fig. 1: Partially erupted third molar and inflammation of the gingiva
distally
Fig. 2: Pre-op radiograph showing a hook-like curve of the mesial root,
as well as the relationship between the pulp chamber position and the
bone level.
Fig. 3: CBCT scans showing the intimate relation between the mesial root
and the IAN and confirming the bone level relative to the pulp chamber.
and evidence-based minimum. The
alternative solution in such cases is
coronectomy.
Fig. 4: File in a mesial canal showing the abrupt curvature.
By Drs Mirna Hobeika, Ali Hajj Hassan, Edgard Jabbour & Philippe Sleiman, Lebanon
Coronectomy is a procedure that
generally spares the vital coronal
pulp and is performed to avoid the
risk of damaging the inferior alveolar nerve (IAN) during the surgical
rocedure when extraction of mandibular third molars is indicated or
needed. Coronectomy is the removal
of the crown of the mandibular
third molar without exposing the
pulp.1 The coronectomy procedure
is performed only on the third molar
crown, leaving the roots in the socket. This procedure is now known for
its benefits and success rate, in contrast to the contemporary belief that
the roots left behind will be a source
of problems.2 Risk factors for nerve
injury include root proximity, the
surgeon’s experience, surgical pro-
Fig. 5: A complete root canal therapy was performed.
cedures, the patient’s age and preexisting disease. Several studies have
shown that coronectomy significantly decreases the risk of iatrogenic injury to the IAN and lowers the
complication rate.3 Coronectomy
has been associated with a low incidence of complications in terms of
IAN injury (0.0–9.5 %), lingual nerve
injury (0.0–2.0 %) and pulp disease
(0.9 %),4 in addition to other rare
events, such as swelling, fever, alveolitis, pulpitis and root exposure.5
Coronectomy to prevent IAN damage was first proposed by Ecuyer and
Debien in 1984,6 and it remained
controversial owing to the possibility of infection and other pathologies
arising from the roots left behind.2
Potential complications include
deep dry sockets, local postoperative
infections, postoperative pain, pulpitis, root canal necrosis and infection,
Fig. 7: A small field of view CBCT scan confirmed the outcomes of the
surgical procedure and root canal therapy.
Fig. 6: Bitewing radiograph taken during the surgical procedure, showing the level of the surrounding bone and
the remaining part of the tooth.
and an increased risk of IAN infection, which is known as failed IANI.7
The point of discussion is whether
it is necessary to perform root canal
therapy simultaneously with coronectomy if the pulp is going to be exposed during the surgical procedure.
A new method combining coronectomy with root canal therapy, when
necessary, in order to decrease the
risk of infection, pain and other complications is introduced in this paper.
Case presentation
A female patient in her mid-twenties
was suffering from typical partially
erupted third molar complications
(Fig. 1). Extraction was advised in order to relieve the patient. A preoperative radiograph was taken (Fig. 2)
for the surgeon and endodontist to
discuss the shape of the roots and
the IAN proximity. At the request
of the endodontist, a CBCT scan was
performed (i-CAT), as is advised prior
to any surgery (Fig. 3). The cross sections revealed an intimate relation
between the mesial root and the
nerve, and thus indicated that any
surgery at this point could cause
some trauma to the nerve.
The situation was explained to the
patient, who was very concerned
about the potential injury to the
IAN. However, the patient presented
with acute pain, which would require treatment, possibly antibiotic
therapy, which in the future would
be her go-to in case of a flare-up.
This was definitely not an ideal solution, especially in view of the efforts
currently being undertaken by the
European Society of Endodontology
to limit antibiotic prescription for
root canal therapy to a reasonable
Fig. 8: Two-year follow-up radiograph.
From discussing this option with
the surgeon and studying carefully
the radiographs and CBCT data, it
was clear that, if the surgeon was to
cut the crown below bone level, pulp
exposure and partial pulpectomy
were inevitable. Therefore, in order
to minimise postoperative complications, the decision was made to
perform a root canal therapy on the
third molar to reduce the risk of pulpitis or infection in the apical part.
The patient agreed to this solution.
Endodontic treatment was performed using the TF Adaptive SM
(small/medium) procedure pack
(Kerr) for root canal shaping. During the treatment, one periapical
radiograph was taken (Fig. 4) and
it showed the curve on the mesial roots. Irrigation was performed
very safely with the EndoVac unit
(Kerr), as any extrusion of sodium
hypochlorite could have severe
consequences for the nerve and the
apical area. The root canal therapy
was completed in a single visit (Fig.
5), following which the surgeon performed the coronectomy. A bitewing
radiograph was taken to check the
level of the coronal part after the excision and confirm that it was completely under the bone level (Fig. 6).
A reinforced glass ionomer was used
to seal the roots, and sutures were
placed and left for one week. A small
field of view CBCT was taken to check
the postoperative outcome of the
procedure (Fig. 7).
Two years after the treatment, the
patient returned to the clinic complaining of some pressure sensations in the area. A CBCT scan allowed us to investigate the situation,
and it revealed a pleasant surprise:
the tooth had migrated coronally
and gone above the nerve (Figs. 8 &
9). We explained to the patient that
the remaining part of the tooth had
moved towards the gingival level,
which was why she was feeling pressure, and now it would be safe to remove the remaining tooth. The surgeon performed the intervention.
Figure 10 shows how much the tooth
had migrated over the two years and
demonstrates the absence of any infection under the roots.
Editorial note: A list of references is
available from the publisher.
Fig. 9: CBCT scans showing the root migration above the nerve, allowing for safe extraction
to be performed.
Fig. 10: Comparison of the immediate post-op situation and the situation at the
two-year follow-up.
Dr Philippe Sleiman
is an assistant professor at the Faculty of
Dentistry of the Lebanese University in
Beirut in Lebanon. He can be contacted at
profsleiman@gmail.com.
[5] =>
A5
ENDO TRIBUNE
Dental Tribune Middle East & Africa Edition | 3/2018
Fig. 1
When an idea turns into innovation
By Marc Chalupsky, DTI
Although the headquarters of COLTENE are in Switzerland, its endodontics plant is in southern Germany. At
the factory, located in Langenau, a
town between Stuttgart and Munich,
155 employees produce treatment
auxiliaries and endodontic equipment in a fully automated and camera- and laser-controlled process. The
German location houses an impressive logistics department thanks to
the office’s central location. Dental
Fig. 2
Tribune was invited to learn more
about the company’s endodontic
products.
A now well-known expert in endodontics, Dr Barbara Müller has been
responsible for the company’s endodontics business unit for over 20
years. She takes pride in the company’s achievements. Today, COLTENE is an international leader in
the development and manufacture
of dental consumables and solutions for a variety of applications.
Fig. 3
The company operates worldwide,
with subsidiaries and distributors
in over 120 countries. With the 1990
introduction of the ParaPost X System, COLTENE came to be known as
a provider of endodontic solutions.
This position has been further entrenched in recent years as the company’s portfolio of endodontic products has continued to grow.
Fig. 4
An impressive
endodontic range
The CanalPro line, for example, features a cordless endodontic motor,
a fully automated electronic apex
locator and a variety of rinsing solutions, which are colour-coded for
procedural safety. ROEKO and HYGENIC paper points are sterile and
highly absorbent, and being nonadhesive, allow for reliable and easy
drying of the root canal. Fast and
safe obturation can be conducted
Fig. 5
with GuttaFlow bioseal, a bioactive
three-in-one obturation material
that combines cold free-flow guttapercha with a sealer and bioceramic
in one outstanding filling system
and with HYGENIC and ROEKO Guttapercha points. Recent studies have
evaluated the in vitro toxicity of endodontic sealers such as GuttaFlow
bioseal and GuttaFlow 2, as well as
Angelus’s MTA-FILLAPEX and Dent-
ÿPage A6
[6] =>
A6
ENDO TRIBUNE
Dental Tribune Middle East & Africa Edition | 3/2018
◊Page A5
Fig. 6
sply Sirona’s AH Plus, on stem cells
from the periodontal ligament. It
was found that especially GuttaFlow
bioseal and also GuttaFlow 2 showed
lower toxicity levels and higher
cell viabilities than the competing
sealers did. In addition, GuttaFlow
2 demonstrated a better result in
terms of microleakage and sealing
ability than the competing sealers
did.
COLTENE’s HyFlex instrument, probably its best-known product, has set a
new benchmark for NiTi rotary files.
HyFlex EDM, the latest generation,
integrates the controlled memory
effect of its predecessor, HyFlex CM.
Furthermore, owing to an innovative manufacturing process using
electrical discharge machining, HyFlex EDM has a specially hardened
surface that makes the files stronger
and more fracture-resistant. The
controlled memory of both HyFlex
CM and HyFlex EDM gives the instruments a number of important
properties, including extreme flexibility, superior canal tracking, regeneration after repeat autoclaving and
strong fatigue resistance.
To achieve these characteristics,
HyFlex CM and HyFlex EDM are
manufactured using a special thermomechanical process whereby
the crystallographic phase transition from austenite to martensite
at room temperature results in an
advanced controlled memory of the
material, making both files extremely flexible. “We successfully managed to give our NiTi material shape
memory properties,” said Müller.
“We did this by changing the DNA of
the material through a switch from
low to room temperature. Our idea
became not only an innovation, but
a product many of our competitors
have tried unsuccessfully to copy.”
Introduced at the International
Dental Show in Germany two years
ago, the new HyFlex EDM reduces
the number of files needed to two
to three, particularly in straight and
larger canals.
Proven clinical experience
According to Müller, a number of
clinical studies have demonstrated
the efficacy of both systems. For
example, Goo et al. compared the
bending stiffness, cyclic fatigue and
torsional fracture resistance of NiTi
rotary instruments, including VTaper 2, V-Taper 2H (both SS White),
HyFlex CM, HyFlex EDM and ProTa-
Fig. 7
Fig. 8
Fig. 9
per Next X2 (Dentsply Sirona). HyFlex EDM showed the highest cyclic
fatigue resistance of the group, with
V-Taper 2H and HyFlex CM coming
in next. Overall, they showed high
torsional resistance. In comparison
with HyFlex CM, the EDM version
demonstrated a higher fracture resistance.
it to remain usable for longer when
shaping severely curved canals.
joen.2017.01.001. Epub 2017 Mar 23.
https://www.ncbi.nlm.nih.gov/pubmed/28343929
Mechanical Properties of Various
Heat-treated Nickel-Titanium Rotary Instruments, J Endod. 2017 Sep
23. pii: S0099-2399(17)30703-3. doi:
10.1016/j.joen.2017.05.025.
[Epub
ahead of print] https://www.ncbi.
nlm.nih.gov/pubmed/?term=mech
anical+properties+of+various+heat
+treated+Goo+et+al.
In another study, Kaval et al. aimed
to evaluate these properties in novel
NiTi rotary files, including HyFlex
EDM OneFile from COLTENE, ProTaper Gold and ProTaper Universal
(both Dentsply Sirona). The results
showed that HyFlex EDM OneFile
demonstrated significantly higher
cyclic fatigue resistance and higher
distortion angle to fracture, but
a lower torsional resistance than
both ProTaper options. In addition,
Pedulla et al. sought to measure
the torsional and cyclic fatigue resistance of HyFlex EDM OneFile in
comparison with VDW’s RECIPROC
R25 and Dentsply Sirona’s WaveOne
Primary. HyFlex was found to have a
significantly higher cyclic fatigue resistance and higher angular rotation
to fracture.
Furthermore, Lacono et al. aimed to
measure the wear of HyFlex EDM after clinical application. No fractures
were registered, no wear or degradation was reported, and the increased
fatigue resistance of HyFlex EDM
(compared with HyFlex CM) allowed
A case from the Philippines
Dr Margaret Tui, a clinician based in
the Philippines, agrees that the increased fatigue resistance and strong
flexibility of both HyFlex systems
allowed her to manage an S-shaped
case more easily. At a recent COLTENE Train the Trainer event, she
presented a mandibular first molar case with four canals that was
referred to her by another dentist
who could not negotiate the canal
owing to its difficult anatomy. After
utilising the crown-down technique
and the HyFlex CM files to flare the
coronal third of the distobuccal and
distolingual canals, Tui then continued to use HyFlex EDM to negotiate
the mesiobuccal and mesiolingual
canals, as she had discovered a slight
curvature in the middle third of the
canals. As for the S-shaped distobuccal and distolingual canal, she
continued with the Hyflex CM files.
Post obturation radiograph showed
properly shaped canals with proper
healing.
References
Cytotoxicity of GuttaFlow Bioseal,
GuttaFlow2, MTA Fillapex, and
AH Plus on Human Periodontal
Ligament Stem Cells, J Endod. 2017
May;43(5):816-822. doi: 10.1016/j.
Evaluation of the Cyclic Fatigue and
Torsional Resistance of Novel Nickel-Titanium Rotary Files with Various Alloy Properties. J Endod. 2016
Dec;42(12):1840-1843. doi: 10.1016/j.
joen.2016.07.015. Epub 2016 Oct
21. https://www.ncbi.nlm.nih.gov/
pubmed/?term=Evaluation+of+the
+Cyclic+Fatigue+and+Torsional+Re
sistance+of+Novel+Nickel-Titanium
+Rotary+Files+with+Various+Alloy
+Properties
Torsional and Cyclic Fatigue Resistance of a New Nickel-Titanium Instrument Manufactured by Electrical Discharge Machining. J Endod.
2016 Jan;42(1):156-9. doi: 10.1016/j.
joen.2015.10.004. Epub 2015 Nov
14. https://www.ncbi.nlm.nih.gov/
pubmed/?term=Torsional+and+Cyc
lic+Fatigue+Resistance+of+a+New+
Nickel-Titanium+Instrument+Man
ufactured+by+Electrical+Discharge
+Machining
Root canal treatments with the EndoSystem by VDW – Peace of mind included
By VDM
MUNICH, Germany: Deliver root
canal treatments with an opti-mally
integrated concept from a single
source. This claim is be-hind the
campaign ‘Peace of mind included –
the Endo-System’ by VDW.
‘Peace of mind included’ with the
Endo-System by VDW means that
dentists have a holistic system for
simplified, individualised work processes. They also benefit from safety
in use, time and cost efficiency and
long-term treatment success.
Endodontics in four steps
The key drivers to success with VDW
are products and services linked
through all treatment steps:
1. Preparation
File systems such as RECIPROC® blue
combined with VDW drives can be
used to prepare the root canal with
only one instrument.
2. Irrigation
The sonic-powered EDDY® irrigation
tip cleans even complex root canal
anatomies safely and efficiently.
3. Obturation
GUTTAFUSION® can be used for
homogeneous, wall-adapted obturation of the root canal.
4. Post-Endo
DT Post quartz fibre posts with double taper design contribute to preserving more dentine during postendodontic treatment.
Education and services
for treatment success
The Endo-System by VDW is backed
up by almost 150 years of experience in endodontics. Dentists can
take advantage of this expertise with
the VDW education programme.
Comprehensive service and consulting offers help to set up the optimal
Endo-System and integrate it into
the practice routine – with peace of
mind included.
More about ‘Peace of mind included
– the Endo-System’ by VDW can be
The VDW Endo-System
found at vdw-dental.com/endosystem and at congresses and trade fairs.
About VDW
VDW GmbH based in Munich, Germany is one of the most well-known
manufacturers working in the den-
tal field of endodontics. For almost
150 years, VDW has been a pioneer in
shaping the evolution of root canal
treatment significantly. VDW focuses on offering the dentist a holistic
solu-tion covering the entire endodontic treatment process including
prepara-tion, irrigation, obturation
and post-endodontic care as well as
service and training.
For more information about the
com-pany, the VDW brand and products, please visit www.vdw-dental.
com/en/
[7] =>
Membership in mCME Program
20 CME
credit hours
per year
quick and
easy way to
meet your
needs
flexibility
to work at
your own
place
» mCME participants are required to read the Continuing Medical Education (CME) articles published in each issue
» Each article offers 2 CME Credit and is followed by a questionnaire online
» Participants will receive the summary report with Certificate
For more information please contact
marketing@cappmea.com or call +97143616174
www.cappmea.com/mCME
[8] =>
WaveOne Gold
®
Now with WaveOne® Gold Glider
Surf the canal
with confidence
WaveOne® Gold offers you the simplicity of a one-file
shaping system combined with higher flexibility* to respect
the canal anatomy. Now available with a corresponding glide
path file to optimize your shaping preparation. Experience
the feeling of confidence throughout your treatment.
*compared to WaveOne
© 2018 Dentsply Sirona, Inc.
Rx Only
ST8/ B EN W1G0 ADV 000 / 03/2017 – updated 04/2018
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