I am a great fan of you. I am from Bangladesh, a general dentist, Working as a Dental Surgeon in a govt. Hospital. I have learned many thing from your video. Best of luck and best wishes for you.
Dr. Nasseh, thanks for doing these procedure to save the vital pulp. I want to have this procedure for one of my molars. Do you know someone in Mexico City that does it. Thanks.
Technically, and logically it should be equivalent. At least a study in dogs comparing the two shows equivalent results in apicoectomy/retrofill using histology or CBCt. So, it’s reasonable to infer similar results with VPT.
Very well executed as always...but I have a concern regarding the longevity of BC liner as permanent restoration as it has to face the occlusal forces directly from opposing teeth.How good is it when compared with modern hybrid composites as a permanent restoration???
I was in lecture and the doctor was strictly against this. He says when you injure the pulp in a tooth with finished root development by removing part of it, the rest is going to have hyperemia and swelling, which will compress the veins in the foramen fysiologicum and cut off the blood supply and the pulp is going to die anyway. He only does it with unfinished root development because the foramen is wide and wont choke the blood supply. What do you think about this?
We’ll, he may be right but the current published research in this area shows a different picture than what he said. I think academic and practical answer to this will end up becoming more clear as more real world results are shown. Currently, the academic research shows that it works in adults when done correctly with the right diagnosis and all decay is removed. We have to wait and see if it works as well in everyday practice by the average clinician. The key is total removal of decay.
That's a good question. I don't know if there have been any studies on that... but that's a valid point... I assume if it's not a significant one and if all caries has been removed, once healing and bridging has taken place there isn't a reason why it shouldn't withstand it as long as the prep technique doesn't add a ton of heat and torque to the tooth and is done atraumatically (like all crowns should be anyway!) So... my assumption is that the quality of the VPT will determine that answer. I hope it makes sense. Cheers! :)
This is a age old question and I have watched your video on root canals. However I still having the posing question of Is it worth it? I'm 20 years of age and I don't want to have any tooth my mine extracted.
So, you answered your own question. If you don't want to have your tooth extracted then the solution is a root canal. Saving your own tooth is your best chance compared to having anything artificial or a hole in your mouth. Since you're young it may not last forever but nothing does. Your best bet is to keep your own tissues for as long as you can. Good luck.
It depends. Usually, PA Radiolucency only means bone loss. This is an inflammatory reaction involving Osteoclasts. Whether this is induced by tissue necrosis due to hypoxia alone or ensuing infection of the necrotic tissues depends on whether the trauma causes infection necrosis or subsequent microbial infection. But clearly, when there's microbial infection there's a faster and greater bone loss.
@@AANasseh True that, I had a patient with periapical radiolucency and she had a crown on that tooth, so I said, it appears the tooth is infected (abscess!!), she went to another dentist and he said it's not infection, it is inflammation. This patient of mine is a PhD and now she questioned why I said infection and not inflammation. I told her, the only way to know if it's really infected is to perform a bacterial culture of the exudate, rest is subjective, as often times the symptoms overlap.
I am a great fan of you. I am from Bangladesh, a general dentist, Working as a Dental Surgeon in a govt. Hospital.
I have learned many thing from your video.
Best of luck and best wishes for you.
I think this is gonna be the standard of care in near future. Thank you dr.allen
Thank's for your beautyfful and meangfull vedeo.All love love from Algeria♥️
Aus dental student here. I'm a massive fan of all your videos. Thank you so much!
This I call translating basics into practice. Good luck!
Glade that you are back
Dr. Nasseh, thanks for doing these procedure to save the vital pulp. I want to have this procedure for one of my molars. Do you know someone in Mexico City that does it. Thanks.
Really very nice topic thank you for sharing dr Allen all love from Egypt ❤️
Great information. I was always wondering if possible for vital pulp therapy to use Root canal BC sealer instead of MTA and how successful it will be.
Technically, and logically it should be equivalent. At least a study in dogs comparing the two shows equivalent results in apicoectomy/retrofill using histology or CBCt. So, it’s reasonable to infer similar results with VPT.
Great video. How often would you consider reviewing for vitality? Once a year? Less ?
First after 8 weeks, then six months. 👍
Very well executed as always...but I have a concern regarding the longevity of BC liner as permanent restoration as it has to face the occlusal forces directly from opposing teeth.How good is it when compared with modern hybrid composites as a permanent restoration???
I was in lecture and the doctor was strictly against this. He says when you injure the pulp in a tooth with finished root development by removing part of it, the rest is going to have hyperemia and swelling, which will compress the veins in the foramen fysiologicum and cut off the blood supply and the pulp is going to die anyway. He only does it with unfinished root development because the foramen is wide and wont choke the blood supply. What do you think about this?
We’ll, he may be right but the current published research in this area shows a different picture than what he said. I think academic and practical answer to this will end up becoming more clear as more real world results are shown. Currently, the academic research shows that it works in adults when done correctly with the right diagnosis and all decay is removed. We have to wait and see if it works as well in everyday practice by the average clinician. The key is total removal of decay.
Do you use a microscope dental?
Also, I did this with the BC liner and seems like it worked, patient has not returned ;)
Hello sir Which RVG Sensor you have use ?
Hi sir, could you comment on jmorita Zx2 endomotor
Do you think the pulpal tissue after vital pulp therapy will be able to withstand a crown preparation ?
That's a good question. I don't know if there have been any studies on that... but that's a valid point... I assume if it's not a significant one and if all caries has been removed, once healing and bridging has taken place there isn't a reason why it shouldn't withstand it as long as the prep technique doesn't add a ton of heat and torque to the tooth and is done atraumatically (like all crowns should be anyway!) So... my assumption is that the quality of the VPT will determine that answer. I hope it makes sense. Cheers! :)
This is a age old question and I have watched your video on root canals. However I still having the posing question of Is it worth it? I'm 20 years of age and I don't want to have any tooth my mine extracted.
So, you answered your own question. If you don't want to have your tooth extracted then the solution is a root canal. Saving your own tooth is your best chance compared to having anything artificial or a hole in your mouth. Since you're young it may not last forever but nothing does. Your best bet is to keep your own tissues for as long as you can. Good luck.
@@AANasseh Very logical answer :)
Is Periapical radioluscency following trauma sterile?
It depends. Usually, PA Radiolucency only means bone loss. This is an inflammatory reaction involving Osteoclasts. Whether this is induced by tissue necrosis due to hypoxia alone or ensuing infection of the necrotic tissues depends on whether the trauma causes infection necrosis or subsequent microbial infection. But clearly, when there's microbial infection there's a faster and greater bone loss.
@@AANasseh True that, I had a patient with periapical radiolucency and she had a crown on that tooth, so I said, it appears the tooth is infected (abscess!!), she went to another dentist and he said it's not infection, it is inflammation. This patient of mine is a PhD and now she questioned why I said infection and not inflammation. I told her, the only way to know if it's really infected is to perform a bacterial culture of the exudate, rest is subjective, as often times the symptoms overlap.