State-of-the-art Endo

New materials and technologies are changing the world of endodontics. A panel with a combined 142 years of experience discussed these advances at Friday’s program, State-of-the-Art Endodontics.

Moderator Dr. Noah Chivian (pictured) kicked off the conversation with endo-related research before handing it over to the first speaker, Dr. John West.

Dr. West talked about success in endodontics and hit on the three major changes in the field: microscope technology, rotary instrumentation and digital radiography.

“As dentists, we need to know the latest and greatest,” Dr. West said. “But we need to master these things without forgetting the principles that got us here.”

Panelist Dr. Joseph Maggio discussed what dentists need to know to use a bonded root canal obturation material, and also touched on coronal leakage and its role in endodontic success.

A key development in recent years – Resilon material being used to replace gutta-percha – provides dentists with the opportunity to seal the root canal space from the orifice to the apex.

“With Resilon we have the first application of adhesive technology to the inside of a root canal,” Dr. Maggio said.

The material is gaining in popularity in recent years and Dr. Maggio stressed that there is no need for dentists to alter their present obturation technique when implementing Resilon in place of the long-used gutta-percha.

Dr. Chivian, who has worked closely with DPR over the years in helping develop endodontics survey questions, spoke on mineral trioxide aggregate (MTA). He covered how and why MTA works and explained how to use it. He focused on situations where it made the difference between retaining a tooth and extraction.

“There are many clinical applications for MTA, which was developed in the early ’90s by Tulsa Dental,” Dr. Chivian said. “Today we will focus on periapical seals, pulp capping and perforation repair.”

Dr. Chivian’s presentation featured a number of cases in which this treatment successfully avoided tooth extractions.

Dr. Martin Trope followed up Dr. Chivian’s presentation with another innovative topic. He spoke on the revascularization of immature teeth with apical periodontitis. He explained the requirements for success for vital pulp therapy: healthy “stem” tissue, lack of bacteria challenge and scaffold.

With the field of endodontics booming, especially as many GPs are getting more involved, the panelists received a number of questions from attendees. These questions and answers can be found online at

~ by cwaring on May 17, 2008.

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