This month’s column focuses on the wild and wonderful world of endodontics. There has been a tremendous boom in products and systems that make endodontics for the general practitioner and specialist faster, easier, and better. You would think that with all the innovations, the endo on Mrs. Jones’ tooth would be done before you even walk into the room! No, it hasn’t become that easy, but it’s much better than before.
One simple way to do faster endodontics is to be able to see what you are doing. Magnification is a must for all dental procedures today, especially endodontics. Finding those small canals is easier and faster when you can see. For those of you who started with magnification years ago, you probably have 2.5x magnification. It is time to get yourself a pair of 4.0x magnification or higher. Orascoptic (Kerr), Denmat, and Designs for Visions are good examples of companies that make excellent surgical telescopes.
One very innovative system that was recently introduced is InnoEndo by Heraeus Kulzer. This system is an addition to what is commonly called “adhesive endodontics.” With Resilon™ technology, which chemically bonds to both the cement and tooth, the filler and the gutta percha are sealed to the inside of the canal walls. This reduces microleakage to a fraction, or completely eliminates it by preventing microorganisms from passing from the oral cavity into the root canal. This helps reduce postoperative complications.
The real innovation with the InnoEndo System is the delivery of a fiber-core obturator or post with the gutta percha attached. Not only does the gutta percha get bonded to the canal walls, so does the fiber-core tapered carrier or fiber-core post, which strengthens the tooth structure for the final restoration. This rigid and adaptable obturator serves as support for the root and can be the post for the core buildup.
I lecture on controlling overhead, and I contend that when you save time in the dental office, you save money and overhead goes down. The InnoEndo System is a perfect example of this. Not only do I complete the endodontics therapy, I cement in a post, do the crown buildup, and in just a few quick minutes, am ready to begin my crown preparation, impression, and make the temporary - all in the same appointment.
Another big advantage is that the fiber-core post associated with the InnoEndo System is a white esthetic post. This gives me the ability to place an all-ceramic crown on an anterior tooth without the metallic, gray, or black color of a post shining through the build-up material and porcelain. Not only do we have an endodontic system that is in the realm of adhesive endodontics, we are finally entering the realm where endodontics and esthetic dentistry meet.
One-appointment endodontics is fairly common these days for general dental practitioners and endodontists. There are many advantages - less postoperative problems, more efficient treatment, and patients who love one-time endo treatment. The general dentist has a one-appointment post and core and crown preparation, after which an impression is taken, which allows the patient to leave with a temporary. This is a huge savings in chairside time, and allows patients to receive needed dental treatment in a minimal amount of time.
We know that most patients prefer to be any place other than a dental chair, and the less time they have to spend there, the better. Products like InnoEndo are what make dentists more efficient at delivering endodontic care, give us the advantage of adhesive endodontics, and save time and money in the office - a winning system all the way around!
Dr. Louis Malcmacher is an international lecturer and author known for his comprehensive and entertaining style. An evaluator for Clinical Research Associates, Dr. Malcmacher is a consultant to the Council on Dental Practice of the ADA. For close to two decades, Dr. Malcmacher has inspired audiences to truly enjoy practicing dentistry by providing the knowledge necessary for excellent clinical and practice-management skills. His group dental practice has maintained a 45 percent overhead since 1988. For details about his speaking schedule, Dr. Malcmacher can be reached at (440) 892-1810, or via e-mail at [email protected].
