Endodontology 1: Roots
Endodontology 1: Roots
roots
international magazine of
Vol. 10
Issue 1/2014
endodontology
2014
| CE article
Mineral trioxide aggregate revisited:
A cement for all seasons
| special
A sequence of irrigation
| technique
Fifth-generation technology in endodontics:
The shaping movement
editorial _ roots
Dr Gary Glassman
The Dental Operating Microscope (DOM), and ultrasonics instruments have allowed us to locate
canals with surgical precision while allowing maximum conservation of tooth structure. The design and
metallurgy of nickel titanium files (NiTi files) with its super elastic characteristics allow better maintenance of the original canal anatomy, while the motion, rotary, reciprocation, or a combination of both
produce less extrusion of debris, increased resistance to cyclic fatigue, allow greater cutting efficiency
and reduced time for canal shaping compared to stainless steel files.
Mineral trioxide aggregate (MTA) has been and continues to be a remarkable and biocompatible
restorative material that has become the standard for pulp capping and root perforation, and has
salvaged countless teeth that previously had been considered hopeless.
Methods to improve disinfection in the root canal system has been the focus of perhaps the greatest
international attention in endodontics. Better root canal disinfection may lead to even greater endodontic successes!
But perhaps the greatest boon to our profession and a pivotal tool in the practice of endodontics is
the use of cone beam computed tomography (CBCT). Interpretation of a two-dimensional image of a
three-dimensional object can make the interpretation of radiolucencies, complex dental anatomy and
surrounding anatomic structures very difficult. CBCT technology, with its three dimensional rendering
ability has allowed detection rates of root canal anatomy and detection of periradicular pathology to
be dramatically increased. Although the detection of vertical root fractures is difficult at best with both
conventional radiology and CBCT, CBCT has been shown to be an excellent supplement to conventional
radiography in the diagnosis of root fractures. The differentiation between internal and external resorption; location and size, has allowed diagnosis and subsequent treatment to be more decisive and
predictable. Unnecessary investigative treatment may be avoided now that three dimensional evaluation of these lesions can be achieved. The same pertains to the precise nature of a perforation and the
role that CBCT plays on its subsequent treatment. Post operative healing can be monitored more accurately with CBCT due to its superior resolution compared to conventional radiology and more informed
decisions can be made with respect to treatment planning.
Will the information that the CBCT provides force the clinician to exhaust all efforts to find all the
canals and subsequently address the anatomy? Will it force the clinician to elevate their efforts to provide a better debrided canal and a more thorough obturation? Is Big Brother watching? I believe the
answer to all of the above is YES!!
Dr Gary Glassman
Doctor of Dental Surgery
Fellow of Royal College of Dentists of Canada
roots
1
_ 2014
I 03
content _ roots
page 6
30
I editorial
03
page 14
I industry news
34
36
| Dr Gary Glassman
I case report
10
I CE article
06
page 22
I events
38
40
International Events
I special
14
18
A sequence of irrigation
| Dr Philippe Sleiman
41
42
submission guidelines
imprint
I technique
22
|
|
page 30
04 I roots
1_ 2014
page 36
page 40
Mineral trioxide
aggregate revisited:
A cement for all seasons
Author_ Dr Gary Glassman, Canada
roots
_ce credit
06 I roots
1_ 2014
Fig. 2
_Endodontic revascularization
Treatment of the immature, non-vital tooth with
apical pathology presents several challenges. The
mechanical cleaning and shaping of such a tooth with
a blunderbuss canal is difficult, if not impossible, to
achieve predictably. The thin, fragile lateral dentinal
walls can fracture during mechanical filing, and the
large volume of necrotic debris contained in a wide
root canal is difficult to completely disinfect.12
A new technique is presented to revascularize immature permanent teeth with apical periodontitis.
The canal is disinfected with copious irrigation and a
Fig. 3ad_EndoVac apical negative
pressure delivery system
(Axis/SybronEndo, USA).
Fig. 3a
Fig. 3b
Fig. 3c
Fig. 3d
roots
1
_ 2014
I 07
Fig. 4
combination of three antibiotics. After the disinfection protocol is complete, the apex is mechanically irritated to initiate bleeding into the canal to produce a
blood clot to the level of the cementoenamel junction.
A double seal of the coronal access is then made,
first with MTA over the blood clot and then a bonded
composite. The combination of a disinfected canal, a
matrix into which new tissue could grow, and an effective coronal seal appears to have the ability to produce
an environment necessary for successful revascularization.13 The development of normal, sterile granulation tissue within the root canal is thought to aid in
revascularization and stimulation of cementoblasts or
the undifferentiated mesenchymal cells at the periapex, leading to the deposition of a calcific material at
the apex as well as on the lateral dentinal walls.12
08 I roots
1_ 2014
Fig. 5
Fig. 6
At the one-year follow-up appointment, the radiograph revealed that treatment had been performed
on this tooth by another dentist, different from her
original dentist who made the initial referral. The new
dentist, not familiar with revascularization treatment
performed, had entered the root canal space, cleaned
it out and obturated it with gutta-percha and sealer.
Fortunately, the treatment was successful (Fig. 7).
_Conclusion
The future of endodontics is bright as we continue
to develop new techniques and technologies that will
allow us to perform treatment painlessly and predictably and continue to satisfy one of the main objectives in dentistry, that being to retain the natural
dentition wherever possible and wherever practical._
_References
1. Kakehashi S, Stanley HR, Fitzgerald RJ. The effects of surgical
exposures of dental pulps in germ-free and conventional
laboratory rats. Oral Surg Oral Med Oral Pathol 1965; 20;
340349.
2. Moller AJR, Fabricius L Dahlen G, Ohman A, Heyden G. Influence of periapical tissues of indigenous oral bacterial and
necrotic pulp tissue in monkeys. Scand J Dent Res 1981; 89;
475484.
3. Torabinejad M, Pitt Ford TR. Root end filling materials: a review.
Endod Dent Traumatol1996;12:161178.
4. Ribeiro DA. Do endodontic compounds induce genetic damage? A comprehensive review. Oral Surg Oral Med Oral Pathol
Oral Radiol Endod 2008;105:251256.
5. Enkel B, Dupas C, Armengol V, et al. Bioactive materials in
endodontics. Expert Rev Med Devices 2008;5:475494. That
is hard tissue conductive (7).
6. Moretton TR, Brown CE Jr, Legan JJ, Kafrawy AH. Tissue
reactions after subcutaneous and intraosseous implantation
of mineral trioxide aggregate and ethoxybenzoic acid cement.
J Biomed Mater Res 2000;52:528533., hard tissue inductive, and biocompatible.
7. Torabinejad M, Hong OU, Pitt Ford TR. Physical properties of a
new root end filling material. J Endodon 1995; 21; 349353.
8. Dentsply Tulsa Dental. ProRootTM MTA Root canal repair material; Material safety data sheet (MSDS).
Fig. 7
roots
Gary D. Glassman, DDS, FRCD(C), graduated from the University of Toronto, Faculty of Dentistry in 1984; and graduated
from the Endodontology Program at Temple University in
1987, where he received the Louis I. Grossman Study Club
Award for academic and clinical proficiency in endodontics.
The author of numerous publications, Glassman lectures
globally on endodontics, is on staff at the University of Toronto,
Faculty of Dentistry, in the graduate department of endodontics,
and is adjunct professor of dentistry and director of endodontic
programming for the University of Technology, Jamaica. He is a fellow of the Royal
College of Dentists of Canada and the endodontic editor for Oral Health dental journal.
He maintains a private practice, Endodontic Specialists, in Toronto, Ontario, Canada.
He can be reached through his website, www.rootcanals.ca
roots
1
_ 2014
I 09
_Abstract
_Introduction
Fig. 1
10 I roots
1_ 2014
Fig. 2
Fig. 3
_Case report
A 14-year-old female patient suffering from
painful symptoms caused by her maxillary central incisors was examined in the Department of Pediatic
Dentistry and Orthodontics of Al-Quds University in
Jerusalem for evaluation and treatment.
Fig. 4
When the patient was referred to our department, extra- and intra-oral examinations (including
roots
1
_ 2014
I 11
Fig. 5
_Discussion
The traditional use of Ca(OH)2 apical barriers has
been associated with unpredictable apical closure,
extended time taken for barrier formation, difficulties
in patient compliance, and the risk of reinfection resulting from the difficulty in creating long-term seals
with provisional restorations and susceptibility to
root fractures arising from the presence of thin roots
or prolonged exposure of the root dentine to Ca(OH)2.7
Thus, the one-visit apexification technique is gaining
popularity. One-visit apexification has been defined
as the non-surgical condensation of a biocompatible
material into the apical end of a root canal. The rationale is to establish an apical stop that would enable
the root canal to be filled immediately. Torneck et al.8
found that when apical closure takes place clinically
with Ca(OH)2, there is incomplete bridging of the
apex histologically. Periapical inflammation persists
around the apices of many teeth because necrotic tissue exists in the corners and crevices of the bridge.
A major target area of biomedical research is the
restoration of lost bone. To this end, a resorbable tri-
12 I roots
1_ 2014
Fig. 6
and to produce a hard-tissue matrix. A number of animal studies have demonstrated a more predictable
healing outcome when MTA is used compared with
teeth treated with Ca(OH)2.14 In a prospective human
outcome study, 57 teeth with open apices were obturated with MTA in one appointment. Forty-three of
these cases were available for recall at 12 months, of
which 81% of cases were classified as healed.15
Despite its good physical and biological properties,
its extended setting time has been a disadvantage.
Calcium chloride has been used to stimulate the
hardening process of MTA and studies have shown
that both its physico-chemical properties and sealing ability were improved by the addition of calcium
chloride.
_Conclusions
Based on this studys results, the following conclusions can be made:
_MTA showed clinical and radiographic success as
a material used to induce apical closure in necrotic
immature permanent teeth.
_MTA is a suitable replacement for Ca(OH)2 for the
apexification procedure._
_authors
I
roots
Abu-Hussein Muhamad,
DDS, MScD, MSc, DPD, is
a visiting clinical professor
at the University of Naples
Federico II in Italy.
Abdulghani Azzaldeen,
DDS, PhD, is an assistant
professor at Al-Quds University.
Abu-Shilabayeh Hanali,
DDS, MSc, is a lecturer at
Al-Quds University.
_contact
Dr Abu-Hussein
Muhamad
123 Argus St.
10441 Athens, Greece
abuhusseinmuhamad@
gmail.com
AD
Biological &
Conservative
FKG Dentaire SA
www.fkg.ch
A sequence of irrigation
Author_ Dr Philippe Sleiman, Lebanon
Fig. 1
14 I roots
1_ 2014
It has been proven that there is a close correlation between these two types of preparation. In fact,
apical preparation with a larger tip size and smaller
taper, for instance ISO size 35.04 can help to reduce
the level of colony-forming units dramatically compared with apical preparation of tip size 25.06. This
outcome confirms that by performing a larger tip
size apical preparation we can disrupt the biofilm
mechanically, thus facilitating the work for the
chemicals. Also, such apical preparation will allow
for a greater quantity and stable concentration of
the irrigating solution, which will therefore better
eliminate the organic component and the smear
layer from the root canal system walls. The files can
clean only parts of the root canal system. They create a reservoir that can hold various irrigating solutions that will access and clean portions of the root
canal system, which the instruments cannot reach.
The access cavity, having four walls, will create a
reservoir for the irrigating solutions to be frequently
and continuously refreshed, which can be done
safely with the EndoVac system (SybronEndo; Fig. 1)
using the Master Delivery Tip for 20 to 30 seconds
each time.
In endodontics, the most commonly used irrigating solution is sodium hypochlorite (NaOCl). It has
many desirable qualities and properties. It has bactericidal cytotoxicity characteristics and it dissolves
organic matter, while providing minor lubrication.
However, NaOCl alone is not sufficient for complete
cleaning of the root canal system. NaOCl has no effect on the smear layer and its high surface tension
does not allow it to clean and disinfect the totality
of the root canal system. For this reason, and depending on the specific clinical situation, one has to
use other irrigants in combination with NaOCl.
The various irrigants that can be used consecutively
and according to the clinical situation are as follows:
_17% EDTA (SmearClear, SybronEndo);
_0.2% chlorhexidine;
_5.25% NaOCl;
_50% citric acid; and
_distilled water.
Fig. 2
In this clinical situation, we have to face the challenge of treating the complexity of the different components of the pulp, and eventually the presence of
Fig. 3a
Fig. 3b
roots
1
_ 2014
I 15
Fig. 4a
Fig. 4b
16 I roots
1_ 2014
eral canals, isthmuses and the whole root canal system, allowing for proper chemical preparation of the
root canal system. Also, 17% EDTA plays an important
role in the reduction of inflammatory reaction by
inhibiting the affinity of macrophages to the vasoactive peptides in the pulpal tissue. The total exposure
time of 4 to 5 minutes for EDTA inside the canal must
not be exceeded.
After using the SM1 file (TF Adaptive sequence,
SybronEndo), we need to neutralise the acidity of the
EDTA in order to avoid a chemical interaction between
the acid and the base. (As a general rule, one should
always avoid any kind of chemical interactions inside
the root canal. Saline or distilled water can be used to
wash out the previous chemical prior to the use of a
different one.) Specifically, an acid and a base interaction leads to the formation of gas bubbles, which
can create the so-called dead water zone, or vapour
lock, not only at the end of the main canal or at the
entry to a lateral canal, but also anywhere inside the
root canal system. The interaction can also form a
small protective layer of air bubbles on the surface of
the collagen fibres, preventing their good contact
with NaOCl for a better dissolving action.
Irrigation with NaOCl for 30 seconds is performed
with the Master Delivery Tip, followed by rinsing with
saline or distilled water prior to the next application
of EDTA and the use of the SM2 file. Once the file has
been used, the acid is neutralised, and EndoVacs
MacroCannula is used to remove and deeply neutralise the previous chemical. Then, another 30-second irrigation with NaOCl is performed in each canal
prepared with the SM2 file with the MacroCannula.
The idea is to create an area of negative pressure
inside the root canal system to draw the NaOCl delivered into the access cavity deeper into the system
safely, thus creating a current of fresh irrigant inside
the root canal system for a more efficient chemical
interaction and organic tissue dissolution.
_Discussion
Many types of irrigants can be used, such as hydrogen peroxide, anaesthetic solutions, physiological serum, and deionodised water. What is proposed
is an irrigation sequence that may be more complex
depending on the clinical situation. The alternation
between irrigants (NaOCl, chlorhexidine, distilled water, and EDTA) is essential for the cleaning of the root
canal system.
The reduced preparation time when using rotary
NiTi instruments is balanced by copious irrigation for
better cleaning of the root canal system, which will
contribute to the increased success rate of endodontic treatment.
The chemical preparation will help us succeed in
adequate cleaning of the main canal and its systems.
Cleaning is followed by 3-D obturation to fill all the
cleansed and prepared canals.
_Conclusion
The irrigation procedure is often dismissed as simple during endodontic treatment; however, it must
not be overlooked, since it is crucial to the success of
endodontic treatment.
Irrigation, which is too often reduced to a needle
on the tray, has to be systematically evaluated in order
to become an endodontic entity with a precise time
schedule and procedural systematisation._
_author
roots
Dr Philippe Sleiman
Advanced American Dental
Center
Al Bateen Area
P.O. Box: 41269
Abu Dhabi
UAE
roots
1
_ 2014
I 17
PHAST PIPS:
The photoacoustic
wave of the future?
Author_ Dr Reid Pullen, USA
Fig. 1a
Fig. 1b
18 I roots
1_ 2014
_Case 1
A 20-year-old female patient presents to the
office with instructions from her dentist stating:
Please remove the file and finish the root canal.
The patients dentist initiated root canal treatment
on #37 two days prior and separated a rotary instrument in the apical one-third of the distal canal
(Fig. 1a).
Clinical testing revealed a temporary crown with
percussion and bite sensitivity. Probing, palpation
and mobility were within normal limits. Endodontic therapy was initiated on tooth #37 with a diagnosis of previously initiated therapy with symptomatic apical periodontitis.
Upon access, it was noted that the coronal shape
was underprepared. The coronal flare was com-
Fig. 2a
Fig. 2b
_Case 2
Fig. 3a
Fig. 3b
roots
1
_ 2014
I 19
Fig. 4a
Fig. 4b
_Case 3
A male patient presents to the office with a history of chewing pain and a constant ache on #26
of one-week duration. Clinical tests reveal #26 is
percussion, bite-stick and cold-test negative, and
a diagnosis is listed as pulp necrosis with symptomatic apical periodontitis.
20 I roots
1_ 2014
_Case 4
A male patient presents to the office with
an on-and-off toothache of approximately 10
months duration. Clinical tests reveal a percussion- and bitestick-sensitive maxillary first bicuspid. The tooth does not respond to cold tests. The
diagnosis is listed as pulp necrosis with symptomatic apical periodontitis. Radiographs show an
apical and lateral radiolucency.
Root canal treatment was initiated on tooth
#14, and two necrotic canals were located. The
coronal flare or opening was completed, and a
30-second PIPS cycle with 6 per cent sodium
hypochlorite was initiated. Working length and
glide path were obtained, and the canals shaped
with the WaveOne Primary (DENTSPLY) reciprocating file. During the shaping procedure, a 30second PIPS bleach cycle was completed.
The canals were obturated with a zinc oxide
eugenol sealer and gutta-percha using a warmvertical technique. The post-operative radiographs showed a lateral canal filled with guttapercha leading to the lateral radiolucency (Figs.
4a & b).
_Conclusion
Along with mechanical debridement, the PIPS
Lightwalker Er:YAG irrigation technique shows
great potential in debridement of the root canal
system, including main canals, lateral/accessory
canals, isthmuses and dentinal tubules (why to
use PIPS). Various studies1, 2 show that the PIPS
technique greatly reduces bacterial flora. As always, ongoing research is needed to show how
much the PIPS Lightwalker Er:YAG can really accomplish in debridement.
The PIPS Lightwalker Er:YAG technique works
best when the dental assistant irrigates the access continuously while suctioning any excess
solution running from the area. The trick is to
keep the access chamber full of solution so that
the 4 mm unsheathed portion of the PIPS tip stays
submerged in fluid. This can be accomplished by
the dental assistant moving the surgical suction
closer or farther away from the access to allow
just the right amount of solution (how to use
PIPS).
I recommend using the PIPS Lightwalker
Er:YAG technique to enhance chemical debridement after the coronal flare, once during the
cleaning and shaping phase and just prior to obturation (when to use PIPS).
roots
roots
1
_ 2014
I 21
Fifth-generation
technology in endodontics:
The shaping movement
Authors_ Drs Clifford J. Ruddle, John D. West & Pierre Machtou, USA
Fig. 1a
Fig. 1b
22 I roots
1_ 2014
Fig. 1c
Fig. 1d
Fig. 2
Fig. 3
As such, the perceived advantages of electropolishing were offset by the undesirable inward pressure
required to advance a file to length. Excessive inward
pressure, especially when utilising fixed-taper files,
promotes taper lock, the screw effect and excessive
torque on a rotary file during work.9 In order to offset deficiencies in general, or inefficiencies resulting
from electropolishing, cross-sectional designs have
increased and rotational but dangerous speeds are
advocated.
Third generation
Improvements in NiTi metallurgy became the hallmark of what may be considered the third generation
of mechanical shaping files. In 2007, some manufacturers began to focus on using heating and cooling
methods for the purpose of reducing cyclic fatigue
in and improving safety with rotary NiTi instruments
Fig. 4
roots
1
_ 2014
I 23
Fig. 5
Fig. 6
Fourth generation
Another advancement in canal preparation procedures was achieved with reciprocation, a process that
may be defined as any repetitive up-and-down or
back-and-forth motion. This technology was first introduced in the late 1950s by a French dentist. Recent
brands that use equal clockwise (CW) and counterclockwise (CCW) degrees of rotation in their moveFig. 7_The five ProTaper Next files.
Most canals in posterior teeth can be
optimally shaped using two or three
instruments.
Fig. 7
24 I roots
1_ 2014
Fig. 8a
_ProTaper Next
There are five ProTaper Next (PTN) files in different
lengths available for shaping canals: X1, X2, X3, X4
and X5 (Fig. 7). These files have yellow, red, blue, double black, and double yellow identification rings on
their handles, corresponding to sizes 17.04, 25.06,
30.07, 40.06, and 50.06. The tapers are not fixed over
the active portion of the files. Both the X1 and X2 files
have an increasing and decreasing percentage taper
on a single file, whereas the X3, X4, and X5 files have
a fixed taper from D1 to D3, then a decreasing percentage taper over the rest of their active portions.
Fig. 8b
roots
1
_ 2014
I 25
Fig. 8c
Fig. 8d
26 I roots
1_ 2014
Fig. 8e
Fig. 8f
_Discussion
From a clinical standpoint, the PTN rotary system
is a convergence of the most proven and successful
generational designs, coupled with the most recent
advances in critical path technology. This brief discussion will consider the influence of design on performance.
The most successful generational design is the mechanical concept of utilising a progressive percentage
taper on a single file. The patent-protected ProTaper
Universal NiTi rotary file system utilises an increasing
or decreasing percentage taper on a single file. This
design feature serves to minimise the contact between a file and dentine, which decreases the risk of
taper lock and the screw effect while increasing efficiency.8 Compared with a fixed-taper file of similar
size, a decreasing percentage taper design, strategically improves flexibility, limits the shaping in the body
of the canal, and conserves two-thirds of coronal
dentine.
Following this mechanical design, PTN also features progressive tapers on a single file. This design
has contributed to the ProTaper system becoming the
top-selling file in the world, the file choice of endodontists, and the leading system taught to undergraduate students in dental schools internationally.16
roots
1
_ 2014
I 27
Fig. 9
_Conclusion
Fig. 10
28 I roots
1_ 2014
_Acknowledgement
The authors would like to recognise Dr Michael J.
Scianamblo for his work in the field of critical path
technology, which led to the development of ProTaper
Next._
Editorial note: This article originally appeared in Dentistry
Today in April 2013. A list of references is available from the
publisher. Drs Ruddle, Machtou, and West have a financial
interest in the products they design and develop, which
includes the ProTaper Universal system.
_contact
roots
Dr Clifford J. Ruddle
is Founder and Director
of Advanced Endodontics,
an international educational
source, in Santa Barbara,
California, USA.
He can be contacted at
[email protected]
Fig. 1
30 I roots
1_ 2014
Fig. 2
wide to fit them between the rubber stop and handle in canals longer than 22mm. Test leads attached
to files during negotiation dampen tactile feedback,
increasing the risk of damaging tortuous apical
anatomy.
If you still have trouble keeping files from shorting, cut heat-shrink tubing (RadioShack) into 9mm
lengths and place them on your initial negotiating
files and the procedure can go on. A little practice and
this will no longer be necessary. Not to brag, but I
dont have any greater difficulty using EALs through
metallic restorations or crowns and would
rather do that than work on teeth
devastated by caries.
Use of lubricant
Fig. 3
File size
roots
1
_ 2014
I 31
Fig. 4
roots
32 I roots
1_ 2014
P R O F E S S I O N A L
M E D I C A L
C O U T U R E
34 I roots
1_ 2014
_contact
VDW
Fax: +49 89 62734 304
[email protected]
www.vdw-dental.com
roots
www.DTStudyClub.com
Y education everywhere
and anytime
Y live and interactive webinars
Y more than 500 archived courses
Y a focused discussion forum
Y free membership
Y no travel costs
Y no time away from the practice
Y interaction with colleagues and
experts across the globe
Y a growing database of
scientific articles and case reports
Y ADA CERP-recognized
credit administration
Register for
FREE!
ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providersof continuing dental education.
ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.
36 I roots
1_ 2014
_contact
Planmeca Oy
Asentajankatu 6
00880 Helsinki, Finland
www.planmeca.com
roots
Registration information:
17 July 2014 to 22 November 2014
Details on www.TribuneCME.com
Collaborate
on your cases
University
of the Pacic
Latest iPad
with courses
100
ADA CERP
C.E. CREDITS
Tribune America LLC is the ADA CERP provider. ADA CERP is a service of the American Dental Association to assist dental professionals
in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors,
nor does it imply acceptance of credit hours by boards of dentistry.
I events _ AAE
AmericanAssociation of Endodontists
organised Root Canal Awareness Week
for the seventh time
_During its seventh annual Root Canal Awareness Week, which was held from 17 to 23 March, the
American Association of Endodontists (AAE) aimed to
dispel myths surrounding root canal treatment and
encourage general dentists to involve endodontists in
case assessment and treatment planning to save patients natural teeth.
Ninety-four per cent of general practitioners
agree that endodontists are partners in delivering
quality dental care, said AAE immediate past President Dr James C. Kulild. By working together, general
dentists and endodontists can treat patients comfortably and save their natural teeth.
_contact
roots
American Association of
Endodontists
www.aae.org
38 I roots
1_ 2014
I events _ meetings
International Events
2014
AAE Annual Session
30 April 3 May, 2014
Washington, USA
www.aae.org
DGET Spring Meeting
910 May, 2014
Witten, Germany
www.dget.de
SFE Congress
1214 June 2014
Nice, France
www.endodontie.fr
Asia Pacific Dental Congress (APDC)
Improving quality of life through better
dental care
1719 June 2014
Dubai, UAE
www.apdentalcongress.org
18th World Congress on Dental Traumatology
1921 June 2014
Istanbul, Turkey
www.iadt-dentaltrauma.org/2014conference/
index.html
40 I roots
1_ 2014
submission guidelines:
Please note that all the textual components of your submission
must be combined into one MS Word document. Please do not
submit multiple files for each of these items:
_the complete article;
_all the image (tables, charts, photographs, etc.) captions;
_the complete list of sources consulted; and
_the author or contact information (biographical sketch, mailing
address, e-mail address, etc.).
Image requirements
Please number images consecutively throughout the article
by using a new number for each image. If it is imperative that
certain images are grouped together, then use lowercase letters
to designate these in a group (for example, 2a, 2b, 2c).
Please place image references in your article wherever they
are appropriate, whether in the middle or at the end of a sentence.
If you do not directly refer to the image, place the reference
at the end of the sentence to which it relates enclosed within
brackets and before the period.
In addition, please note:
Should you require a special layout, please let the word processing
programme you are using help you do this formatting automatically. Similarly, should you need to make a list, or add footnotes
or endnotes, please let the word processing programme do it for
you automatically. There are menus in every programme that will
enable you to do so. The fact is that no matter how carefully done,
errors can creep in when you try to number footnotes yourself.
Questions?
Magda Wojtkiewicz (Managing Editor)
[email protected]
roots
1
_ 2014
I 41
roots
international magazine of
endodontology
Publisher
Torsten R. Oemus
[email protected]
CEO
Ingolf Dbbecke
[email protected]
Published by
Oemus Media AG
Holbeinstrae 29
04229 Leipzig, Germany
Tel.: +49 341 48474-0
Fax: +49 341 48474-290
[email protected]
www.oemus.com
Printed by
Members of the Board
Jrgen Isbaner
[email protected]
Lutz V. Hiller
[email protected]
Managing Editor
Magda Wojtkiewicz
[email protected]
Executive Producer
Gernot Meyer
[email protected]
Designer
Josephine Ritter
[email protected]
Copy Editors
Sabrina Raaff
Hans Motschmann
Editorial Board
Fernando Goldberg, Argentina
Markus Haapasalo, Canada
Ken Serota, Canada
Clemens Bargholz, Germany
Michael Baumann, Germany
Benjamin Briseno, Germany
Asgeir Sigurdsson, Iceland
Adam Stabholz, Israel
Heike Steffen, Germany
Gary Cheung, Hong Kong
Unni Endal, Norway
Roman Borczyk, Poland
Bartosz Cerkaski, Poland
Esteban Brau, Spain
Jos Pumarola, Spain
Kishor Gulabivala, United Kingdom
William P. Saunders, United Kingdom
Fred Barnett, USA
L. Stephan Buchanan, USA
Jo Dovgan, USA
Vladimir Gorokhovsky, USA
James Gutmann, USA
Ben Johnson, USA
Kenneth Koch, USA
Sergio Kuttler, USA
John Nusstein, USA
Ove Peters, USA
Jorge Vera, Mexico
Copyright Regulations
_roots international magazine of endodontology is published by Oemus Media AG and will appear in 2014 with one issue every quarter. The magazine
and all articles and illustrations therein are protected by copyright. Any utilisation without the prior consent of editor and publisher is inadmissible and liable
to prosecution. This applies in particular to duplicate copies, translations, microfilms, and storage and processing in electronic systems.
Reproductions, including extracts, may only be made with the permission of the publisher. Given no statement to the contrary, any submissions to the
editorial department are understood to be in agreement with a full or partial publishing of said submission. The editorial department reserves the right to
check all submitted articles for formal errors and factual authority, and to make amendments if necessary. No responsibility shall be taken for unsolicited
books and manuscripts. Articles bearing symbols other than that of the editorial department, or which are distinguished by the name of the author, represent
the opinion of the afore-mentioned, and do not have to comply with the views of Oemus Media AG. Responsibility for such articles shall be borne by the author.
Responsibility for advertisements and other specially labeled items shall not be borne by the editorial department. Likewise, no responsibility shall be assumed
for information published about associations, companies and commercial markets. All cases of consequential liability arising from inaccurate or faulty
representation are excluded. General terms and conditions apply, legal venue is Leipzig, Germany.
42 I roots
1_ 2014
roots
international magazine of
endodontology
Subscribe now!
Signature
Notice of revocation: I am able to revoke the subscription within 14 days after my order by sending a written cancellation to OEMUS MEDIA AG, Holbeinstr. 29, 04229 Leipzig, Germany.
roots 1/14
Signature
OEMUS MEDIA AG
Holbeinstrae 29, 04229 Leipzig, Germany, Tel.: +49 341 48474-0, Fax: +49 341 48474-290, E-mail: [email protected]
Planmeca ProMax 3D
3HUIHFWYLVXDOLVDWLRQRIWKHQHVWGHWDLOV
A world rst
One imaging unit,
three types of 3D data.
All in one software.