Dental India
Newsletter dated 14th August 2005... Choice of 22000 dentists
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This week
Assistant Scope
Strange location for MB2
Advancing Aesthetics
MClinDent course staff visit to India
-
Help us to update our database
Keep this immensely informative website going. My
best wishes for the fabulous job you people are doing to update us on a
variety of subjects pertaining to Dentistry. Dr Sharad Jhingran -
Guwahati(Assam)
This is one of the most informative and useful
exclusive dental website i have browsed. Excellant layout and featuristic
site.
Keep it up! Your web site never ceases to amaze
me.! Wonderful work and
keep up the constant updates.- Best wishes -
Dr. Murali Srinivasan,
Dubai.
Assistant Scope
| The opinions and photographs within this newsletters are not ours. Authors have been credited for the individual posts where they are. - Photos courtesy of Matt, Fred - ROOTS |
Is this worth 30% less than the guy next door who does
not use a scope or ultrasonics?
Sorry for my intro., it is kind of annoying talking to
the insurance folks who asked us what the difference was between a retreat
and a root canal. How do you convey value to these people? Just drop
them?
At any rate this nice lady broke her distolingual cusp
off last night and had her restorative dentist patch it with some IRM
and luckily we were able to get her in today, of course they did not know
this when he placed the IRM. I was able to clean everything up and
get her comfortable.
Dad has been videoing the operatory so we can study my
assistant and I's efficiency or should I say lack of. It is amazing to
record what happens under the scope and compare it with the operatory and get it
all together. There is a lot of wasted
motion. Courtesy: Matthew Brock
- ROOTS
 |
 |
as usual Matt beautiful work - can I ask what instruments you used, I like
the fact that the shape is not too over prep'd and you have continued the
curve so well on the distal with so little tooth off the inside of the curve. My
guess is a landed file system.
Also what are you using on the coronal seal - I have taken to sealing them
below the level of bone as I believe it helps stop leakage - any
comments? = tim silbert
Dear Tim,
Thanks for the comments. I start most cases
with a 25/.06 K3 as my scouting file, this allows you to remove the
initial 1/2 to 2/3 of the pulp and get an initial idea of where your
curvature is in each canal. Knowing where the curvature is really allows
you to divide the tooth into zones and more efficiently clean and shape the
canal system. I then follow with a Quantec SC 15/.02 to an estimated
WL. Then a 25/.04 K3 until resistance. I now get working length, and
am home free. Generally a RaCe 35/.08 as an orifice opener followed by
Quantec SC 25/.02 to length. A few files in between, depending on what the
case requires. I will generally end with 25/.04 K3 to length, then RaCe
30/.06 to length and apical prep with the appropriate Quantec LX in .02
taper. By switching these rotary files I am getting the maximum from each
file design, no one is good or bad they just have different pros and cons.
Our objective as practitoneers should be to maximize the use of the file at its
best and minimize it use at its known weak points.
I agree with minimal tooth
reduction as someone has to restore this after we are done, otherwise what is
the point in doing the endo.
P.S. I use a cotton pellet and glass ionomer
(Ketac) as my provisional on 75% of my cases. The other 25% my referring
dentist ask that I place the build-up and or post.
Matthew Brock
Matt,
Coming from me you’ll probably think this just landed from Mars, but there are different ways to do things. I completely understand why the assistant scope is popular with John, Gary, and others. Like you, I hate it for conventional endo. Why? because of the functions I expect my assistants to perform. My assistants precisely and rapidly precurve my files and if their head was in a scope it would completely disrupt the tempo required to smoothly proceed through multiple recapitulations with hand files. If I picked up each file, precurved it myself, and allowed my assistant to glue her eyes n the scope it would take me 10 hours to complete a complicated cases achieving the deep shape I expect. If you use an all rotary technique and don’t’ want to spend as much effort addressing deep apical anatomy with multiple recapitulations with hand files, the assistant scope would probably work out great. I’m sure it works great for surgery and makes occasional procedures like separated instrument removals more efficient, but I’m certainly not going to spend thousands of dollars for something I would load on the scope once a month for a minor ergonomic advantage on these occasional cases. In many respects I’m a little annoyed with the Canon camera on the scope but the pictures and images provide such great documentation of each case I’m willing to have it clumped on the scope.
I also tried the assistant scope for a few months. It was nice for the few surgeries I did but it was a complete pain in the ass for the way I like to perform conventional endo.
To each his own; I wouldn’t assume you’re missing out on anything. - Terry
Strange location for
MB2...at 9:00 position. - Fred (ROOTS)
Advancing Aesthetics
As patients become increasingly demanding in their quest for that perfect smile, we speak with dentists leading in the aesthetics field to ask their views on the future of aesthetic dentistry and upcoming techniques
As patients become increasingly demanding in their quest for that perfect smile, we speak with dentists leading in the aesthetics field to ask their views on the future of aesthetic dentistry and upcoming techniques
It seems
patients have ever-higher expectations of the appearance they can achieve if
they throw enough money at it. I blame magazine tips and instant make-over shows
where they are told that the trick to looking young and healthy is to put on
clever make-up, painstakingly style their hair and choose carefully tailored
clothes. The aim seems to be that at the end of an hour, they can leave the
house looking as though they just ‘threw’ something on, but end up looking a
million dollars. Those who have abused their body for years expect to turn back
the clock on wrinkles and saggy bulges with a pot of cream, a crimper and a
stylist. Likewise, dentists are seeing more and more people who have neglected
their teeth for years, expecting that they can buy a perfect, natural-looking
smile.
Cosmetic dentistry isn’t as instant as a makeover, of course, but it starts with the same principles. We have to work very hard behind the scenes, using the very latest techniques, equipment and materials, to produce a mouth that looks like it was just born perfect. The days of patients asking for gold caps to show off their wealth are over. Now the wealthiest patients want a smile that’s not so dazzlingly white that it looks fake…they want ‘natural’ beauty.
This leaves dentists with the challenge of matching patients’ expectations with what there is to work with in the patient’s mouth. The patient may not be able to afford to turn back the clock on all their discoloured or damaged teeth, and although the appearance isn’t wonderful, the clinician may find there are vital, viable teeth, that shouldn’t be touched just to make a nearby restoration look better.
Here’s where the latest science meets art, suggests Dr William Mopper, who lectured on how to achieve superior aesthetic results with direct resin bonding at the Clinical Innovations Conference in May. 'There are easy solutions to the problems that most dentists have in doing aesthetic bonding,' said Dr Mopper. 'Any dentist who has the desire can easily achieve beautiful, aesthetic, lifelike and physiologic results through direct bonding.'
He says that when done properly, direct resin bonding is truly the most creative dental treatment that today’s dentist can render, but says most problems arise because dentists don’t know which materials to use for each individual situation. Most dentists who dread bonding, due to the unpredictability of the results, worry most about achieving a realistic colour – the thing that most patients will notice first and complain most strongly about. Dr Mopper’s methods go way beyond matching colour and opacity to the existing dentition. He has developed specialist techniques for creating maverick colours, white spots, diffuse hypoplasia and craze and check lines. In Dr Mopper’s opinion, it’s this kind of attention to detail that changes a mouth from a slightly too perfect smile to a realistically natural one.
'Because colour development continues to remain the dentist’s primary concern in bonding procedures, other features are often overlooked or underemphasised,' he says. 'However, we have to get back to the art-form of bonding, using all the techniques at our disposal – looking at proper application, sculpting, finishing and polishing techniques to enhance the realism our patients crave.'
'We are just in the infancy period of aesthetic dentistry by the artistic dentist, and we all should become familiar with it. It truly makes dentistry more rewarding and enjoyable for both the patient and the dentist. It certainly has changed my life.'
Going one step further is Dr. Nasser Barghi, Professor and Head of the Division of Aesthetic Dentistry at San Antonio Dental School, in Texas. He says, 'The once impossible task of making aesthetically pleasing porcelain veneers for severely discoloured teeth is now easily attainable with new ceramic materials and composite resins. A decade and a half of experience and progress with bonded porcelain restorations and new knowledge provides us with a unique opportunity to advance the quality of these life-like restorations from good to excellent.'
Dr Barghi agrees with Dr Mopper that selection of the correct material is essential to achieve a life-like appearance, but he’s also an advocate of specialist methods of communicating with the laboratory, whether you are matching to on-discoloured, mildly discoloured or severely discoloured teeth. He is also speaking at the conference, and will be providing a step-by-step hands-on workshop to help dentists achieve the life-like porcelain veneers their patients are asking for.
Cosmetic dentistry isn’t as instant as a makeover, of course, but it starts with the same principles. We have to work very hard behind the scenes, using the very latest techniques, equipment and materials, to produce a mouth that looks like it was just born perfect. The days of patients asking for gold caps to show off their wealth are over. Now the wealthiest patients want a smile that’s not so dazzlingly white that it looks fake…they want ‘natural’ beauty.
This leaves dentists with the challenge of matching patients’ expectations with what there is to work with in the patient’s mouth. The patient may not be able to afford to turn back the clock on all their discoloured or damaged teeth, and although the appearance isn’t wonderful, the clinician may find there are vital, viable teeth, that shouldn’t be touched just to make a nearby restoration look better.
Here’s where the latest science meets art, suggests Dr William Mopper, who lectured on how to achieve superior aesthetic results with direct resin bonding at the Clinical Innovations Conference in May. 'There are easy solutions to the problems that most dentists have in doing aesthetic bonding,' said Dr Mopper. 'Any dentist who has the desire can easily achieve beautiful, aesthetic, lifelike and physiologic results through direct bonding.'
He says that when done properly, direct resin bonding is truly the most creative dental treatment that today’s dentist can render, but says most problems arise because dentists don’t know which materials to use for each individual situation. Most dentists who dread bonding, due to the unpredictability of the results, worry most about achieving a realistic colour – the thing that most patients will notice first and complain most strongly about. Dr Mopper’s methods go way beyond matching colour and opacity to the existing dentition. He has developed specialist techniques for creating maverick colours, white spots, diffuse hypoplasia and craze and check lines. In Dr Mopper’s opinion, it’s this kind of attention to detail that changes a mouth from a slightly too perfect smile to a realistically natural one.
'Because colour development continues to remain the dentist’s primary concern in bonding procedures, other features are often overlooked or underemphasised,' he says. 'However, we have to get back to the art-form of bonding, using all the techniques at our disposal – looking at proper application, sculpting, finishing and polishing techniques to enhance the realism our patients crave.'
'We are just in the infancy period of aesthetic dentistry by the artistic dentist, and we all should become familiar with it. It truly makes dentistry more rewarding and enjoyable for both the patient and the dentist. It certainly has changed my life.'
Going one step further is Dr. Nasser Barghi, Professor and Head of the Division of Aesthetic Dentistry at San Antonio Dental School, in Texas. He says, 'The once impossible task of making aesthetically pleasing porcelain veneers for severely discoloured teeth is now easily attainable with new ceramic materials and composite resins. A decade and a half of experience and progress with bonded porcelain restorations and new knowledge provides us with a unique opportunity to advance the quality of these life-like restorations from good to excellent.'
Dr Barghi agrees with Dr Mopper that selection of the correct material is essential to achieve a life-like appearance, but he’s also an advocate of specialist methods of communicating with the laboratory, whether you are matching to on-discoloured, mildly discoloured or severely discoloured teeth. He is also speaking at the conference, and will be providing a step-by-step hands-on workshop to help dentists achieve the life-like porcelain veneers their patients are asking for.
This article first appeared in The Dentist
magazine
Dear colleague
I have arranged two seminars for prospective students who are
interested to apply for the Masters in Clinical Dentistry
(Prosthodontics). The seminars will give the chance for us to meet and
I will be able to address questions relating to this distance learning
programme. You will be able to receive application forms and specific
information regarding this MClinDent course you will have the
opportunity to ask any questions.
This is also an opportunity to bring along your original qualification
certificates (as well as a photocopy of these documents) and have them
signed and verified by myself there and then. The signed copy can be
used to speed up the application procedure and it is sent to the
University when you apply for a place, together with the application
form.
The venues will be:
Wednesday 7th September 2005 at 7pm
Taj Residency Hotel
41/3 M G Road
Bangalore 560001.
OR
Saturday 10th September 2005 at 7pm
Taj Mahal Hotel
Number One, Mansingh Road
New Delhi. 110011
Places are limited, so I would request that you indicate your interest
and choice of venue by return e mail.
Yours Sincerely
Dr Subir Banerji
Postgraduate Tutor & Consultant
MClinDent (Prosthodontics)
Distance Learning
----------------------
Unit of Distance Education
Guy's, King's and St Thomas' School of Dentistry
King's College London
Denmark Hill Campus
Caldecot Road
Fourth Floor, Rooms 433-435
London SE5 9RW
UK
Email: m.clindent@kcl.ac.uk
Tel +44 (0) 20 7346 3597
Fax +44 (0) 20 7346 3496
I have arranged two seminars for prospective students who are
interested to apply for the Masters in Clinical Dentistry
(Prosthodontics). The seminars will give the chance for us to meet and
I will be able to address questions relating to this distance learning
programme. You will be able to receive application forms and specific
information regarding this MClinDent course you will have the
opportunity to ask any questions.
This is also an opportunity to bring along your original qualification
certificates (as well as a photocopy of these documents) and have them
signed and verified by myself there and then. The signed copy can be
used to speed up the application procedure and it is sent to the
University when you apply for a place, together with the application
form.
The venues will be:
Wednesday 7th September 2005 at 7pm
Taj Residency Hotel
41/3 M G Road
Bangalore 560001.
OR
Saturday 10th September 2005 at 7pm
Taj Mahal Hotel
Number One, Mansingh Road
New Delhi. 110011
Places are limited, so I would request that you indicate your interest
and choice of venue by return e mail.
Yours Sincerely
Dr Subir Banerji
Postgraduate Tutor & Consultant
MClinDent (Prosthodontics)
Distance Learning
----------------------
Unit of Distance Education
Guy's, King's and St Thomas' School of Dentistry
King's College London
Denmark Hill Campus
Caldecot Road
Fourth Floor, Rooms 433-435
London SE5 9RW
UK
Email: m.clindent@kcl.ac.uk
Tel +44 (0) 20 7346 3597
Fax +44 (0) 20 7346 3496
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