Endosequence BC Sealer as root canal filling in endodontic retreatment

Rezumat. Reluarea tratamentului endodontic constă în dezobturarea canalelor unui dinte deja tratat, refacererea tratamentului chemomecanic pe întreg canalul până la apex, tratament antispetic cu hidroxid de calciu și clorhexidină și refacerea corectă a obturaţiei de canal. Dezobturarea este etapa cea mai laborioasă din cauza durităţii unor cimenturi de sigilare care nu pot fi îndepărtate decât prin mijloace mecanice rotative, de unde și riscul de apariţie a unor iatrogenii care complică tratamentul. Se impune de asemenea o lărgire suplimentară a canalului cu 0,05-0,10 ISO pentru îndepărtarea mai eficientă a materialelor de obturaţie și biofilmelor de interfaţă de pe pereţii canalelor. Reobturarea canalelor radiculare presupune utilizarea gutapercii, prin diverse tehnici, simultan cu un ciment de sigilare biocompatibil, radioopac, cu contracţie de priză minimală, efect antibacterian și capacitatea de a se cupla adeziv la pereţii de dentină ai canalelor radiculare. EndoSequence® BC Sealer™ este un asemenea sigilant, de natură bioceramică, care în plus oferă posibilitatea formării unui monobloc adeziv cu dentina prin hidroxiapatita generată în cursul prizei în urma contactului cu lichidele tisulare.Summary. The endodontic canal retreatment lies in removal of root canal filling of previously treated tooth, an additional enlargement of root canal to its apical terminus, calcium hydroxide and chlorhexidine dressing and, the appropiate root canal filling. The removal of root canal filling is the most difficult step due to the hardness of sealares that need rotary instruments to be pushed out and sometimes may generate iatrogenies. An 0.5-0.10 ISO additional enlargement of root canal is also required for better cleaning of filling material remnants and biofilms that adhered on root canal walls. The root canal refill is based on gutta-percha core and sealer that ideally has to be biocompatible, radiopaque, with minimal setting shrinkage, antibacterial and strongly adhesive to dentinal tissue of root canal walls. EndoSequence® BC Sealer™ is such a bioceramic-based sealer that has the possibility to generate an adhesive monoblock with dentine because during setting is combined with tissue fluids resulting in an interface layer of hydroxyapatite

EndoSequence BC Sealeras root canal filling in endodontic retreatment

Rezumat Reluarea tratamentului endodontic constă în dezobturarea canalelor unui dinte deja tratat, refacererea tratamentului chemomecanic pe întreg canalul până la apex, tratament antispetic cu hidroxid de calciu și clorhexidină și refacerea corectă a obturaţiei de canal. Dezobturarea este etapa cea mai laborioasă din cauza durităţii unor cimenturi de sigilare care nu pot fi îndepărtate decât prin mijloace mecanice rotative, de unde șiriscul de apariţie a unor iatrogenii care complică tratamentul. Se impune de asemenea o lărgire suplimentară a canalului cu 0,05-0,10 ISO pentru îndepărtarea mai eficientă a materialelor de obturaţie și biofilmelor de interfaţă de pe pereţii canalelor. Reobturarea canalelor radiculare presupune utilizarea gutapercii, prin diverse tehnici, simultan cu un ciment de sigilare biocompatibil, radioopac, cu contracţie de priză minimală, efect antibacterian și capacitatea de a se cupla adeziv la pereţii de dentină ai canalelor radiculare. EndoSequence® BC Sealer™ este un asemenea sigilant, de natură bioceramică, care în plus oferă posibilitatea formării unui monobloc adeziv cu dentina prin hidroxiapatita generată în cursul prizei în urma contactului cu lichidele tisulare.Summary The endodontic canal retreatment lies in removal of root canal filling of previously treated tooth, an additional enlargement of root canal to its apical terminus, calcium hydroxide and chlorhexidine dressing and, the appropiate root canal filling. The removal of root canal filling is the most difficult step due to the hardness of sealares that need rotary instruments to be pushed out and sometimes may generate iatrogenies. An 0.5–0.10 ISO additional enlargement of root canal is also required for better cleaning of filling material remnants and biofilms that adhered on root canal walls. The root canal refill is based on gutta–percha core and sealer that ideally has to be biocompatible, radiopaque, with minimal setting shrinkage, antibacterial and strongly adhesive to dentinal tissue of root canal walls. EndoSequence® BC Sealer™ is such a bioceramic based sealer that has the posibility to generate an adhesive monoblock with dentine because during setting is combined with tissue fluids resulting in an interface layer of hydroxyapatite

MILLING MACHINES TOOLS USED IN CAD-CAM TECHNOLOGY OF DENTAL PROSTHESES

Numerically controlled modern CAD-CAM milling machines tools dedicated to dental technology are kinematic structures that work in 4 or 5 axes and represent one of the key links of CAD-CAM technology flow. The 4-axis and 5-axis machines allow for superior quality of the milling surface integrity by controlling both the inclination of the feed angle and the direction of the milling guide on which depends the contact surface between the cutting tool and the workpiece. The milling tools are available for both dental offices and dental laboratories as well as for industrial dental laboratories. The CAD-CAM milling machines provide superior results to conventional methods in terms of mechanical strength in mastication and aesthetics of dental prosthese

3D printing in dental technolog - present status

Rezumat Printarea 3D reprezintă o tehnologie a viitorului care permite laboratorului de tehnică dentară confecţionarea prin procedee aditive a unor lucrări protetice cu geometrie spaţială complexă. Printerul 3D multimaterial propulsează procedeele de confecţionare aditivă a lucrărilor protetice la un nivel superior deoarece permite realizarea diverselor componente ale acestora mai simplu și mai rapid, reducând și preţul de cost. Printarea 3D a demonstrat de asemenea avantajul unei flexibilităţi nelimitate de design, al elaborării într-o singură etapă a unor lucrări protetice de mare complexitate structurală, prin prelucrarea fișierelor în format STL, și capacitatea de includere în fluxul tehnologic digital tip chairside. Valoarea restaurărilor protetice printate 3D necesită totuși studii clinice de durată privind biocompatibilitatea și integrarea lor funcţională cât și impactul ecologic.Summary In dental laboratories 3D printing, as a technology of the future, allows to the additive procedures to obtain a complex spatial geometry of dental prosthesis. Due to multi material 3D printer the dental laboratory additive procedures are higher appreciated since the different parts of dental prosthesis are easier and faster made-up, leading to lower costs. The design flexibility of 3D printers is everlasting; the dental prosthesis of high configuration complexity they generate may be finished in one stage, based on STL file layout, and the last advantage of these printers relies on the capability to be included in the chairside digital technological flow. The assessment of dental prosthesis generated by 3D printing need long term clinical studies concerning the biocompatibility, functional integration, and ecological feedback

HEALING OF CHRONIC PERIAPICAL PERIODONTITIS IN THE ELDERLY: IS IT AGE REALATED?

Endodontic retreatment in elderly patients for healing periapical periodontitis is more often required. Because of the increasing number of older adults in the population and the desideratum to maintain natural teeth for mastication and esthetics, endodontic treatment outcome in elderly people has to become predictable. Our clinical case highlights that even large, multiple periapical periodontitis can be healed in elderly people. Eliminating microbial infection by correct cleaning and shaping and preventing reinfection by proper root canal filling lead to a decrease in the size or even total healing of apical pathosis in relatively healthy elder patients, no matter the age

HIGH RISK IN ROOT CANAL NEGOCIATION IN ELDERLY PATIENTS: CLINICAL CASE SERIES

Several clinical cases outline the difficulties of root canal treatment, due to the morphological changes of the endodontic space in elderly patients. The changes in the shape of pulp chamber and root canal make the treatment more difficult. It is also shown that the pulp chamber diminishes, due to reparative dentin. Calcification of the pulp space makes more difficult the access to the cavity. The obliterated canals lead to a challenging negotiation of the root canals. To avoid errors in the appreciation of the general health condition of the patient, the specialists should have an accurate preoperative radiograph or cone beam computing tomography (CBCT), use magnification (dental operative microscope), safe-ended burs, consider carefully any morphological changes, and apply the most proper techniques

CHRONIC APICAL PERIODONTITIS AND DIABETES MELLITUS RELATIONSHIP IN ORAL REHABILITATION

Diabetes mellitus is one of the most frequent systemic disorders in medically compromised dental patients. Since it seems to be a significant relationship between diabetes mellitus and apical pathology, any diabetic dental patients should be suspected to develop chronic apical periodontitis both in endodontically treated and untreated teeth. A proper follow-up of root-filled teeth associated with periodical glycaemia control is mandatory to increase their survival. The diabetic status of a patient should be a key prognostic factor of decision in conservative endodontic managemen