Update on Endodontic Surgery
Giovedì 3 Novembre
h. 14.00 / 18.00
JEAN PHILIPPE MALLET
– Micro Endodonzia Chirurgica: nuove tendenze e chiavi di successo per una chirurgia minimamente invasiva
– Micro Endodontic Surgery: New trends and keys of success for a Minimally Invasive Surgery
– Come risolvere le complicanze endodontiche chirurgiche del seno mascellare
– How to Solve Endodontic Surgical Complications Related to Maxillary Sinus
Micro Endodontic Surgery: New trends and keys of success for a Minimally Invasive Surgery
JEAN PHILIPPE MALLET
Endodontic Microsurgery may be a solution to remove an apical lesion and treat the endodontic cause of the infection, especially if the lesion is a cyst or if the retreatment too destructive for a good prognosis. Introduction of CBCT analysis allow a pre-study to analyze the surgical approach of the lesion.
In the Area of “minimally invasive dentistry” the soft tissue management associated to a lower bone destruction would be the best approach for endodontic surgery. Thus, the choice of a contemporary flap design and the use of piezo and ultrasonic instrumentation should be parts of the responses. Piezo Endo Surgery is certainly the best approach to increase the hemostasis during the surgery and the “quality of life” after surgery.
Also the “Cortical Bone Window” approach can be the minimally invasive solution. For example, on lower molars, the access must be difficult or very invasive with a thick mandibular bone (external oblique line), and on upper molars the sinus apical projection may make the access more complex, thus with a CBW the visibility and the access of the lesion for the root preparation and filling would be more predictable. To be released, the quadrilateral piece of cortical bone will be cut with piezo inserts in order to be more precise, less invasive and safe with the non-body anatomical structures. Added to a PRF preparations (clots and membranes) the stable re-seating of the window will allow a better and quicker bone healing.
On Endodontic Surgery, Piezo Surgery and more specifically the “Cortical Bone Window” technique may allow the operator an easier surgery and a quicker healing with a high regenerative healing potential, especially on molar operative site.
Key learning point
By the end of this presentation attendees will be able to:
- Analyze the indication of the “Cortical Bone Window” technique on Endo- Surgery.
- Describe the surgical approach of the Piezo Endodontic Surgery and “Cortical Bone Window” technique
- Give benefits of the Piezo Endodontic Surgery and “Cortical Bone Window” technique added to a PRF preparation.
How to Solve Endodontic Surgical Complications Related to Maxillary Sinus
The endodontic surgery has evolved from a conventional surgery to a microsurgery. Instruments and retro filling products have also benefited from this progress made in order to increase the rate of success. However, the prognosis can be affected by the presence of serious anatomical elements such as the maxillary sinus.
Endodontic infections that develop in the maxillary posterior teeth can easily spread into the maxillary sinuses causing pathological effects.
The relationship between dental infections and sinus disease is widely recognized in both the dental and medical literature. The treatment depend if it is a granuloma, a large cyst or a benign tumor like odontogenic keratocyst.
The procedure differ if we have an apical periodontitis near or in direct contact with antral mucosa will typically produce a localized mucosal tissue edema and the infection may progress and occlude the entire maxillary sinus with obstruction of other nasal exit in that case the Microendodontic surgery and the sinusitis treatment will be done at the same time but in case of a clear mucosa with complete cortical sinus floor and a direct contact with the apical area the new procedure will be like two in one: Microendodontic surgery combined with elevation of the sinus membrane to create more space at the apical area.
The surgical procedure will be descript step by step for the different type of situation.
JEAN PHILIPPE MALLET
Dental practice limited to Endodontics in Paris (France). Graduated from the University Paris V – René Descartes (Paris, France). At present: Teaching Associate at the University Paul Sabatier (Toulouse, France). Past Assistant Professor at University Paris V. Member of the editorial board of ENDO (Quintessence). Past President of the French Society of Endodontics.
DDS, DESE Endodontist and Oral Surgeon. Clinical Professor at St. Joseph University School of Dentistry, Department of Endodontics, Beirut, Lebanon. Graduated in 1983 from St. Joseph University, Beirut Lebanon. Postgraduate in Endodontics in 1994 from St. Joseph University, Beirut Lebanon. Training courses in Endodontic Microsurgery in 1999 from University of Pennsylvania USA. Training courses in Endodontic Microsurgery in 2000 from Loma Linda University USA. Certificate in Implantologie and Advanced bone grafting from California Implant Institute USA. Received the Qana Scientific Award twice: 2001 and 2005, for his scientific work. Development of a new bone trepanation procedure already published. Development of a surgical kit of seven retractors made by HU-FRIEDY: C. ALLAM RETRACTORS. International lecturer: presented many national and international lectures ,hands-on and courses in different countries at international meetings: AAE, ESE, IFEA. Many international articles were published. Member of the American Association of Endodontists. Member of the European Society of Endodontology. Member of the Froncophone Society of Microdentistry. Member and Past President of the Lebanese Association of Endodontists.
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