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The opinions and photographs within this
newsletters are not ours. Authors have been credited for the individual
posts where they are. |
Question: What post do you recommend for a broken down incisor?
Liviu Steier DDM /Mayen / Germany: This is a tough question whose true answer is "it depends"
The role of a post is to anchor the build up for a future prosthetic restoration (case number 1) or in a less invasive traumatic treatment protocol to anchor the direct restoration (case number 2)
Case number 1
Dealing with thin root canal the clinical indication for a tapered post is given. Best will be a glass fiber post. It is important to have a retentive head for the resin build up retention. Very important is the option to shorten the post at no loss of tapered shape. This means a post with two tapers is not an alternative. Actually I like the new design of the tapered FiberKleer posts from Pentron for this application. A wonderful product (not be used ín thin and narrow canals is ParaPost® Fiber Lux (Coltene Whaledent).
Case number 2
To just anchor a restoration woven fibers are indicated. Please make sure that the fibers are cured in the canal perfectly. Material I recommend: Ribbond, alternative is Slint-It (Pentron)
Luting cement: I advocate the use of a dual cement. Keep the cement refrigerated and just take it out of the frige before application in the mouth. Give the injected cement about 55 seconds before starting to mechanically condense. Light cure after at least 1 min.
Material I recomand: ParaCem Universal DC (Coltene Whaledent)
Build up cement: A dual cure glass fiber reinforced composite shows the best values. Here I advocate Build-up (Pentron)
Root canal therapy of an acute cystic apical periodontitis
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3. X ray showing fistula tracing. Guttapercha point introduced into the fistula exit. The fistula canal did not allow a to deep penetration of the Guttapercha point.
4. Magnified direct view (microscop) of the accessed pulpal chamber. The oval configuration of the distal canal is easy to identify. Two mesial canals can be recognised at this stage.
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5. Mesio-buccal canal after optimal access preparation using Gates Glidden files.
6. Mesio – lingual canal after optimal access preparation. - to be continued next week
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According to Daniel Le Pera, DDS, Hackensack, New Jersey, The SpillSeal® washable keyboard is much better than the one that the distributor provides. Action on the keys is great – feels like the old style typewriter – and decreases fatigue on the hand. All of our operatories have computers, and the hot keys help to navigate our computer without having to use a mouse.
Dr. LaPera says that dentists will find the keyboard easy to use and clean. Prior to the introduction of the SpillSeal keyboard, we had to use a barrier, and at the end of day, we would have to take all the keys off and wash it that way. Now, I can wash and rinse the entire keyboard each day.
SpillSeal computer keyboards are manufactured and assembled so that the dome under each key is welded into the key assembly, allowing the keyboard to be cleaned and disinfected using commercial or hospital-grade cleansers and sealing it against liquid entering the keyboard.
“While standard keyboards also incorporate upturned domes underneath each key, the keys are either set in a rubber mat or single and loose, explains Cisneros. However, when liquids are applied – including cleansers – the fluids can easily pass through the key, damaging the equipment and rendering it inoperable. As a result, the keyboards cannot be cleaned and remain in place, getting dirtier with every use until they are finally discarded.
One study found that keyboards can contaminate the fingers of a medical professional – bare or gloved – who could then transfer bacteria to patients. Touching a keyboard even one time was enough to transmit bacteria.
Since most adults report that they had seen a dentist within the past year, this advancement could impact millions of Americans, continues Cisneros, citing a 2003 Public Opinion Survey: Oral Health of the U.S. Population.