Prof.Filippo Cardinali

Abstract:

Ledge prevention and management

Endodontic treatment is a predictable procedure with high success rates: shaping plays a very important role in the outcome of the therapy.

During the shaping, the original anatomy respect allows preparing the canal saving radicular dentine, creating an ideal shape for a deep cleaning and a three-dimensional obturation. The execution of shapes that fit and meet the original anatomy decreases the risk of creating alterations of the root canal itself, such as ledges or transport, regarded by the international scientific literature as factors leading to the failure of the therapy. The respectful shaping of the root canal system is achievable using a proper shaping technique and getting the benefits of the evolution of the rotary file systems: thanks to the heat treatment of the rotary files, a totally mechanical shaping can be safely performed by the clinician, getting high quality and original anatomy respectful shaping, even in complex anatomies and even using a reduced number of instruments. The creation of a ledge during the shaping is the most common iatrogenic damage to the endodontic anatomy and it can be created by manual and rotary files. Once created, its management is crucial to complete the shaping the cleaning and the obturation at the proper working length to not decrease the outcome of the treatment. Aim of the lecture is to focus first the attention on the proper use of the rotary files in order to get a shaping respectful of the original endodontic anatomy, sharing protocols and tips to manage complex anatomies in the daily practice; the second part of the lecture focus on the ledge management, showing tips to ease the re-negotiation of the canal up to the working length.

Aim of the lecture is to highlight how the knowledge of the shaping techniques are more important than the rotary files, sharing protocols and tips to manage even iatrogenic mishapes once created.

Pre-mixed “Bioceramic” sealers from science to clinical outcomes: trend, option or clinical necessity?

The obturation of the root canal system is a real important step of the root canal system in order to achieve a positive outcome of the therapy.

As a matter of fact an high percentage of the endodontic failures are associated with incomplete root canal obturation.

The Warm Gutta Percha techniques fixed the problems arising from the cold techniques, allowing the clinician to properly seal the root canal system in a three dimensional way.

Warm gutta percha techniques represent the “golden standard” of obturation, but in the last years the introduction of bioceramic sealers are changing the scenario. These sealers were deeply investigated in literature and this class of sealers represents a real game changer in obturation. Thanks to their properties these class of sealer make the cold techniques more modern and predictable.

The proper use of bioceramic sealer give even more options to the clinician in order to treat easily even challenging situation as perforation, stripping, open apex.

Aim of this lecture is to highlight how the Cold Technique – thanks to bioceramic sealer – became a very interesting option when it comes to carry out high quality root canal obturation.