Restodontics – better together
Some practitioners are still unaware of the benefits of using the ‘same system’ or materials from the same manufacturer, and with so many different products and manufacturers on the market it’s not surprising there is confusion. This can result in many dentists continuing to use their regular supplier, thereby basing choices on loyalty or cost, rather than opting for systems specifically designed for a procedure.
There are products out there using inferior materials, unsupported by ongoing research and clinical evidence, and this should be a concern for practitioners. Solid research, clinical evidence and a good customer support record should be the important factors when considering a supplier or manufacturer, and it is those criteria that are the best guarantee for quality, reliable materials providing the best possible outcome to their patients.
Endodontics and restorative dentistry are often seen as two separate procedures, but they actually go hand-in-hand, as the optimal outcome for the patient relies on both a successful root canal treatment and a viable restoration; thus both aspects require equal care and attention. The compatibility of products contributes significantly to the overall outcome of a case and choosing products from the same manufacturer gives clinicians the confidence that the combination of the materials they have selected will work in harmony for a successful clinical outcome. This ‘one system’, same manufacturer, approach to endodontics and restorative dentistry (known as restodontics), is supported by leading manufacturer Dentsply, providing a range of tried and tested endodontic and restorative materials and equipment.
A perfect endo…
The primary aim for any practitioner undertaking endodontic treatment is to make the process as easy and predictable as possible, thus increasing the chances of success. So, when selecting an endodontic file system, it is important to make the choice based on your experience and preferences, as well as the demands of the case. This process has been simplified by Dentsply, which supplies leading brands of Niti files. Those less experienced in endodontics, or looking to move from hand files to a rotary based system, would benefit from a single file system. The ability to feel in control is normally one of the top priorities for those new to endodontics or for those switching from a manual system, and Waveone employs a reciprocating movement, which means that the canal is shaped only when pressure is applied, leaving the user in complete control of the instrument.
Even when faced with more complex cases, products such as the Protaper next file system offers a versatile, flexible and simple system to handle the vast majority of root canal treatments. Featuring an off-centred rectangular cross section, this system creates a ‘swaggering’ movement to enhance canal shaping efficiency by reducing binding whilst creating an enlarged space for debris removal. Constructed of M-wire nickel-titanium alloy, a two file clinical sequence for even complex canal shaping allows for faster shaping time and more time for chemical cleaning and irrigation to remove bacterial and tissue debris. With properly shaped and sized canals any potential risk of insufficient cleaning of debris, leading to treatment failure, is virtually eliminated.
Using a dedicated endodontic motor that features reciprocation, torque control and auto reverse throughout treatment will enhance success, as these combined options will ensure the motor is suitable for all file types.
…needs a perfect restoration
For practitioners, the balance between streamlined procedures and clinical efficacy must be maintained and the benefit of simplified treatment protocols must not come at the price of lower-quality restorations. One of the challenges for practitioners is finding materials that enable you to treat cases in the most efficient way possible, both in terms of commercial viability and patient comfort.
Smart Dentine Replacement (SDR) is a flexible material that can be used to complete an endodontic case in the restorative procedure, acting as a root canal sealer, bonding material and a composite that will guarantee a tight seal of both the margins and the obturated canals. Whether the restoration requires a core build up as preparation for a crown or restoration of the access cavity, this user-friendly material can successfully complete the procedure in a short amount of time. Suitable for use in a range of indications, SDR can be layered in 4mm increments. Its flowability and self levelling features reduce the occurance of voids and bubbles, which in turn lessen the possibility of post-operative sensitivity.
The way forward
Dr Mike Horrocks, lead clinician and senior partner at Simplyendo, is an advocate of the one system approach. He said: ‘A well fitting hermetic coronal seal is critical for long-term endodontic success. The final coronal seal always starts with the restoration of the access cavity post endodontic treatment, creating a core for the coronal seal. The sooner this core is placed, the better, as this reduces the risk of contamination of the obturation. The best time to place the core is straight after obturation. SDR allows me to do this in an easy, quick and predictable manner creating a void free bonded core that acts as an ideal base for crowns, onlays and all other intra coronal restorations. I use SDR on all posterior cases now as it gives me reassurance that I will achieve a strong core that is highly resistant to microleakage.’
Practitioners are faced with numerous opportunities to implement a one system restodontics approach. Using a dedicated family of products that takes into account both the endodontic and restorative aspects of a case not only offers complete confidence, for both practitioner and patient alike, but is also imperative to the smooth running and clinical efficiency of any modern practice.
For more information contact Dentsply UK on 0800 072 3313 or visit www.dentsply.co.uk. Earn Dentsply rewards £s to spend on more of the products you love at www.dentsplyrewards.co.uk and access free CPD webinars and product demonstrations at www.dentsplyacademy.co.uk.
Facebook: DENTSPLY UK Twitter: DENTSPLY_UK