Pre-congress courses

23JANUARY2020

Shaping difficult root canals with confidence and predictability.

Pr Pierre Machtou, DDS, MS, PhD, FICD

Since the introduction of nickel-titanium for machining endodontic instruments, mechanized shaping is now mainly taught in dental schools (Koch Eriksson et al., 2009) and routinely used by both general practitioners and specialists (Bird Chambers et al. 2009).

As a result, many NiTi shaping systems in continuous rotation or in reciprocation are available and thank to the new thermal treatments of the NiTi alloy, safety has been improved, indications have been expanded and shaping has never been so versatile. Nevertheless, specific strategies are required and must be implemented for the management of difficult root canal anatomy included long, narrow, s-curved canals and apical hooks. In these situations, even with utmost careful attention the slightest mistake can lead to a difficult and often irreversible situation. Canal blockage and/or transportation can occur as early as the initial negotiation step and may compromise the treatment outcome.

This presentation will discuss the causes of these mishaps, the way to avoid them but when present, provides the clinical solutions to treat them.

Aims


The aim of this lecture is:

  • to provide a precise protocol to consistently get a smooth and uneventful flow of the instrumentation process during the cleaning and shaping procedure
  • to identify the mishaps that may occur during cleaning and shaping of difficult canals, how to avoid them and provides the clinical tips to fix them

Objectives

  • To provide a step by step protocol during all phases of the root canal shaping
  • To emphasize the clinical procedures needed for managing sharp apical curvature
  • To analyze the factors involved in mishaps

The role of irrigation in root canal treatment

Irrigation combined with instrumentation is an essential part of the root canal treatment. The aim of the shaping procedure is to create space to irrigant delivery to clean and disinfect the root canal system and then to filling materials placement. The ultimate goal is to eliminate debris and bacteria from the root canal system to expect predictable success. However, research has shown that complete debridement is impossible to achieve with the syringe delivery of irrigants (static irrigation). Indeed, the apical region and the intricacies of complex root canal systems are the most difficult areas to clean with this traditional method. Currently, activation of irrigants (dynamic irrigation) at the end of the cleaning and shaping procedure is advocated to help distribute irrigants into these restricted areas. The objective of this presentation is to review the different irrigating solutions and protocols including the current methods of irrigant activation, assess their pros and cons and consider potential developments for the future.

At the end of the presentation, the participants must:

  • be able to assess the benefits and limitations of the main irrigants used in clinical practice
  • be able to know the limitations of syringe delivery and how to improve it
  • be able to know and assess the pros and cons of the current methods of irrigant activation

3h 00min

Room 1

Pr Pierre Machtou, DDS, MS, PhD, FICD

Prof. Dr. Pierre Machtou graduated 1967 from the Paris7-Denis Diderot University where he also received the MS degree in 1980 and PhD degree in 1997. He had served as Full Professor of Endodontics at the same University from 1997 till 2011, serving as Vice-Dean from 1998 to 2008.
He is a member of numerous national and international endodontic and dental societies, and is a Fellow of the International College of Dentists. In 2006, he was the recipient of the Pierre Fauchard’s Elmer S Best Memorial Award.
Prof. Pierre Machtou has lectured and held seminars extensively in many countries worldwide. He is the author of two books and co-editor of one endodontic textbook. He has published 11 textbook chapters and 70 articles in peer review journals. He launched the endodontic graduate programme in Paris of which he was the clinic director until 2017. He has limited his practice to Endodontics since 1978. He is currently teaching part time at Geneva University

Micro-Apical Endodontic Surgery.

Dr. Mallet Jean Philippe

Endodontic apical surgery may be the solution to remove an apical lesion and treat the endodontic cause of the infection, especially if the lesion is a cyst or if the prosthetic restoration is recent or the retreatment too destructive for a good prognosis.

From few decades and the use of operative microscope the apical surgery procedure is well known and easy to apply.

Dedicated tools and devices facilitate this surgical treatment and their use is easy to leran.

The workshop is organized in order to

  • Understand the decisions to do an apical surgery.
  • Discover Ultrasonic and piezzo devices and their inserts dedicated to the apical surgery procedure, instruments and materials specially used for this technique.
  • Be able to use Loupes and Operative Microscope.
  • Learn how to apply the procedures for an efficient micro-apical surgery: Osteotomy, Apicoectomy, Endodontic preparation and Filling of the canal.

Each participant will prepare several teeth in operative situation.

3h 00min

Room 2

Dr. Mallet Jean Philippe

Dr. Mallet Jean Philippe has a limited practice to Endodontics (Paris, France)
Graduated from the University Paris V – René Descartes (Paris, France). He is the past president of the French Society of Endodontics. He was Past Assistant Professor at University Paris V (France) and at present Teaching Associate at the University Paul Sabatier (Toulouse, France).
Working with an Operative Microscope since more than 30 years, he is co-organizer of a University Diploma on Apical Surgery in Toulouse University.
He is Co-developer of products mainly used in Endodontics.

Strategies for successful Retreatment.

Dr. Walid Nehme


Course outline:


Lecture (1h)

Ultrasonics are considered to be one of the mandatory tools used in Modern Endodontics and particularly useful in retreatment. In this presentation we will discuss the importance of ultrasonics and its indication at different stages of our daily practice.

The most efficient strategies used for coronal disassembly, removal of posts and gaining access to the radicular space will be detailed. A step by step approach for filling material removal will be described in order to address different clinical situation. A special focus on the retrieval of metallic obstructions such as broken files and silver points will be discussed extensively.

Hands on workshop: 2 hrs

This hands-on course is dedicated to clinicians who would like to take their endodontic skills to the next level. The seminar covers practical exercises on the management of coronal obstructions and post removal. Moreover, special techniques to remove GP and to retrieve retained instruments will be described and will be available for use by delegate.

Anticipated Outcomes:

Participants should be able to understand how ultrasonics work and will be aware of its importance in endodontics. They will be able to remove different kind of posts blocking the access to the root canal system. They will get to know the different techniques used to remove filling materials from root canal system. They will understand and apply different techniques for the removal of solid obstructions such as broken files and silver points.

3h 00min

Room 3

Dr. Walid Nehme

Pr Walid Nehme (DDS, MSc, FICD) is a clinical professor at the Endodontic department of Saint Joseph University of Beirut where he received his DDS (1988) and MSc (1994). His academic activities lie within the field of undergraduate and postgraduate endodontic education and emphasizes on clinical training and conduction and surveillance of research projects. Pr Nehme has published scientific, and clinical articles in peer- reviewed journals nationally and internationally on subjects including Root canal anatomy, instrumentation techniques, NiTi files, Irrigation procedures, obturation and retreatment. He is an international member of the American association of endodontists (AAE). He served as President of the Lebanese Society of Endodontology (LSE). He is a founder member and former president of the Arab Endodontic Society (AES). He is a council member at the APEC.
He is an analyst and opinion leader for clinical trials for endodontic manufacturers and have contributed to the elaboration of new files and devices in endodontics. He runs postgraduate endodontic courses and hands on in the Middle East, Africa and Europe and Canada. He works in a referral-based practice limited to endodontics in Beirut, Lebanon and Abu dhabi, United Arab Emirates.

Urgences médicales dans la pratique odontostomatologique.

Pr Mohammed Mouhaoui

L'odontologie est une activité potentiellement à risque car elle a souvent recours à des actes invasifs (anesthésie, incisions, lambeaux...). Le médecin dentiste est un professionnel de santé et, à ce titre, doit être capable de prendre en charge une situation d'urgence médicale survenant dans son cabinet. Cependant, il n'est pas un professionnel de l'urgence médicale et ne rencontre pas ce type de situations quotidiennement.

Devant une situation d’urgence, le médecin dentiste n’est pas censé établir un diagnostic précis, mais plutôt savoir détecter les signes d'alerte et dispenser les premiers soins dans l'attente d'une équipe médicale d'urgence. Pour cela, le médecin dentiste doit être capable à terme d’identifier, d’évaluer et de décrire une telle situation. Il doit aussi avoir des capacités dans la mise en œuvre rapide des gestes et des attitudes adaptée. Enfin, il doit posséder et maîtriser le matériel et les médicaments nécessaires à une prise en charge efficace du patient.

Cet atelier se veut une initiation pour guider le médecin dentiste dans la gestion des situations d’urgence médicale qu’il peut rencontrer dans son cabinet, tout en utilisant des techniques non ou très peu invasives. Il ne doit pas se substituer à une formation pratique sur le terrain, mais peut en être un grand support.

3h 00min

Room 4

Pr Mohammed Mouhaoui

Spécialiste en anesthésie réanimation et médecine d’urgence, professeur de l’enseignement supérieur au département d’anesthésie réanimation de la faculté de médecine et de pharmacie de Casablanca, lauréat de l’université Paris Descartes, expert international en simulation médicale, directeur de l’Emergency Sim Center, coordonnateur du diplôme universitaire de pédagogie et simulation en Santé, président de la Morocco Sim, coordonnateur du diplôme Universitaire de médecine d’urgence et auteur de plusieurs livres, applications et publications nationales et internationales.

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