С 6 по 9 октября в Афинах, Греция состоялся 8-ой Всемирный Конгресс Международной Федерации Эндодонтических ассоциаций.
Программа на русском языке.
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Prof. Ken Hargreaves (USA)
«AN OVERVIEW OF REGENERATIVE ENDODONTICS»
Considerable excitement exists for developing dental applications that employ post-natal stem cells and concepts of tissue engineering. Although much remains to be done to advance this field, progress has been made in clinical regenerative endodontic procedures: literally, saving teeth by regenerating a pulp-dentin complex. This program will describe the current status of regenerative endodontic procedures, their potential and predictors of healing success. Both clinical and basic studies will be reviewed to provide the practitioner with the latest information on this field with an emphasis on practical steps to be apply these procedures in treating selected patients.
At the completion of this course, the practitioner should be able to:
1. Describe the three major steps in tissue engineering and how they apply to regenerating the pulp-dentin complex.
2. Understand the clinical principles needed for regenerative endodontic procedures.
3. Be able to describe clinical outcomes of successful regenerative endodontic procedures..
Prof. Paul V. Abbott (Australia)
«ROOT CANAL FILLING CONCEPTS, TECHNIQUES AND MATERIALS – DO WE HAVE THE EVIDENCE TO SUPPORT WHAT WE DO?»
Lateral condensation, lateral compaction, vertical compaction, thermoplastic techniques, warm lateral condensation, gutta percha, resin-based materials, cements, sealers, solvent softened techniques, carrier-based systems – which should I use? Traditionally dentists have assessed endodontic treatment by viewing radiographs of the completed root canal filling.
This is largely a result of early research projects that attributed “failure” of treatment to so-called “apical percolation”, even though those studies did not test this concept of “percolation”. They essentially graded root fillings on whether they completely filled the root canal or not, based on their radiographic appearance. This research then led to a plethora of studies that attempted to assess the “apical seal” of root canal fillings using a variety of methods but subsequent studies have demonstrated that the vast majority of these earlier works were invalid due to experimental errors and/or lack of controls. To date, no correlation has been established between the apical penetration of fluids and the clinical performance of root canal fillings.
Despite all this, many changes and recommendations regarding root filling techniques, instruments and materials have been made with clinicians and manufacturers claiming superiority of their product or technique over others. More recently, the focus has shifted to the coronal restoration of the tooth and its effect on treatment outcome. In this presentation, some of the history behind the development of techniques and materials will be reviewed in light of the research.
A review of the concepts of root canal fillings and why canals are filled will lead to a discussion of how root fillings can then be assessed in the clinical setting. What is the most important aspect of Endodontics – is it the radiographic appearance of the root filling or is it how the final result is achieved? Do we have the evidence to show that one technique is better than another? What are we trying to achieve? If we can answer these questions, then perhaps Endodontics is not so complicated or difficult after all and we can concentrate on the important aspects of treatment rather than what makes it look nice!! But then … the problem will be to change the thinking of the members of our profession who have for so long judged endodontic treatment from radiographs!
Prof. J. Craig Baumgartner (USA)
«HOW EFFECTIVE IS ROOT CANAL DEBRIDEMENT AND DISINFECTION?»
Debridement and disinfection of the root canal system are key to successful endodontic treatment. Innovative research methods have recently discovered many previously unknown putative endodontic pathogens. We now know that the oral cavity is colonized with hundreds of species of bacteria. A selective process allows bacteria to colonize the root canals of teeth with exposed or necrotic pulps and produce an endodontic infection. In addition to bacteria, fungi, viruses, and possibly prions may be present in infections of a root canal system. These microbes can also exchange genes for various virulence factors. The population of microorganisms varies from one geographical area of the world to another and even from one person to another. Aggregates of microorganisms and the production of biofilms make root canal disinfection difficult.
Although instruments have greatly improved shaping of the canal system, we rely primarily on irrigation to clean (debride and disinfect) the root canal system. Innovative needles, apical controlled delivery systems, and the use of sonics or ultrasonics have been recommended. Sodium hypochlorite (NaOCl) remains the most commonly used irrigant; however, there is concern for the safety of the patient. Various concentrations of NaOCl have been evaluated for safety, efficacy of debridement, and ability to disinfect the root canal system. Researchers have evaluated many irrigants including ethylene-diamine-tetra-acetic acid (EDTA), chlorhexidine, citric acid, MTAD, other solutions, and even ozone gas. In addition, the efficacy of lasers and other forms of photodynamic energy have been evaluated. An evidence-based approach will be used to compare and contrast the efficacy of various methods used for root canal debridement and for eradicating microbes from the root canal system.
Prof. Dr. Edgar Schafer (Germany)
«AN EVIDENCE-BASED APPROACH ON MECHANICAL PREPARATION OF THE ROOT CANAL SYSTEM»
This lecture provides a detailed comparison between hand instruments (both stainless steel and NiTi) and modern rotary NiTi systems. Based on a critical evaluation of the current literature, differences in shaping of even severely curved root canals, root canal cleanliness, and the tendency of the instruments to extrude debris into the periapical tissues between hand and rotary NiTi instruments will be pointed out. Based on the currently best available evidence, the impact of these instruments on the clinical outcome of root canal treatment will be discussed.
Moreover, the suitability of different types of root canal instruments for the management of some usual clinical problems (e.g., initial negotiating of sclerosed and/or severely curved root canals, bypassing of intracanal ledges, and enlargement of root canals with irregular cross-sections) will be assessed. Finally, a comparison of the pros and cons of these different types of instruments will be given to summarize the presentation.
Prof. Dr. Shimon Friedman (Canada)
“THE CURRENT BEST EVIDENCE FOR ENDODONTIC TREATMENT OUTCOMES”
The outcome of endodontic therapy has been challenged because of inconsistent reports that contrast with the consistently favourable reports for implant-supported single-tooth replacement. This is particularly true for treatment of persistent endodontic disease by way of Retreatment and Apical Surgery. Consequently, clinicians often overlook these viable treatment procedures as being unpredictable.
The inconsistency of the endodontic outcomes reported has indeed caused considerable confusion in the dental profession. Two critical steps are required to eliminate this confusion: (1) The “success”, or outcome must be defined based on the goals of therapy, and (2) studies representing the current best evidence must be identified and used as reference for treatment outcomes.
This lecture will define the appropriate outcomes of endodontic therapy, identify outcome studies that comprise the current best evidence, and highlight the outcomes of endodontic treatment modalities – Initial Treatment, Retreatment, Apical Surgery – in regards to healing and asymptomatic function of the treated teeth. For each treatment modality, clinical factors will be discussed that may influence the outcome. In addition, selected Retreatment and Endodontic Surgery strategies and techniques will be highlighted, to illustrate the full scope of possibilities offered by these modalities.
Dr. John I. Ingle (USA)
Dr. Ingle is a pioneer, educator, mentor and international leader in the field of Endodontics. He was born in 1919 in Colville, Washington and received his DDS degree from Northwestern University in 1942, and a MSD from the University of Michigan. After serving as a dentist for four years in the U.S. Army Air Force during World War II, Dr. Ingle joined the faculty at the University of Washington in Seattle for 16 years where he was Professor and then Chairman of Periodontics and Endodontics.
In 1964 he was appointed Dean of the School of Dentistry at the University of Southern California where he served as professor and dean for 8 years. This appointment was followed by six years service for the Institute of Medicine at the eminent National Academy of Sciences in Washington, D.C.
Dr. Ingle has played a significant role in the advancement of the endodontic specialty.
He is widely known as the author of the authoritative textbook, Endodontics, first published in 1965 and followed by numerous editions. In addition to his textbook, Dr. Ingle has published over 75 articles and has lectured extensively around the world.
Dr. Ingle is a Diplomate and founding member of the American Board of Endodontics and a Diplomate of the American Board of Periodontology as well. He served as President of the American Association of Endodontists (AAE) from 1966-1967. In 1987 he received the AAE’s Ralph F. Sommer Award, and in 1999 its highest honor, the Edgar D. Coolidge Award. In 2001 he was inducted into the USC School of Dentistry’s Hall of Fame, the highest honor the school bestows on an individual. He is presently President of Palm Springs Seminars in California, one of the nation’s leading institutions of dental continuing education and lives together with his wife Joyce in San Diego, California.
Prof. Syngkuk Kim (USA)
“ENDODONTIC MICROSURGERY. AN EVIDENCE-BASED APPROACH”
Dr. Kim is the Louis I. Grossman Professor and chairman of the Department of Endodontics at the School of Dental Medicine, University of Pennsylvania. He earned his dental degree and certificate in Endodontics from the School of Dental and Oral Surgery at Columbia University in New York. Dr. Kim also received his Ph.D. degree in circulatory physiology from the Department of Physiology at the Medical School, Columbia University. In 2002 he received an Honorary Medical Doctor degree from the University of Graz, Austria.
Dr. Kim is well known and respected for his research in dental pulp physiology and microcirculation and the AAE has awarded him the Louis I. Grossman Award for outstanding research and the Ralph F. Sommer Award as principal author of "publications of significance in the science and art of endodontics." He is also the 1991 recipient of the Endodontic and Pulp Biology Research Awards from the IADR. When he joined the Dental School at the University of Pennsylvania in 1992 as chairman of the Department of Endodontics, Dr. Kim not only brought the department into the "New Age" of the Microscope but also established the Microscope Training Center at the School. For this new field in endodontics he developed a series of endodontic instruments for endodontic microsurgery, specifically the KiS ultrasonic tips and a complete microsurgical instrument set. Since its inception, leaders in endodontic education and clinical practitioners from the USA, South America, Europe, Asia and Australia have been trained at the Center.
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