Hello. In my office: 1. sandblasting with aluminium oxide to clean pulp chamber from guttapercha and sealer, if i dont have sandblaster microbrush with alcohol working very well too. 2. etching enamel 30s(if there is some enamel), and dentin 10-15 s, rinse with water 30 s, lightly dry with air, then primer 2 times , drying with air very well, then bond in thin layer and light air and then light curing. After that i use some core composite. Thank you for your videos and greetings from Czech republic :)
Hi Maxim! Thank you for the rubberdamology online masterclass. What I do to prepare the pulp chamber for adhesive procedure is the following: 1. I remove gutta percha and sealer (Total FIll in my case) remains from the walls by AquaCare in prep mode. 2. When I have enamel I etch as I use totall etch technique if I don't have enamel I use self etching. I actively etch by using ultrasound tip without touching the walls to ensure contact with fresh orthophosphoric acid and I rinse. 3. I apply adhesive by brushing into dentin.
Hi from Bulgaria. When im obturated wiht warm condensation and ah+, i clear the pulp chamber with hipo and aqua care and dry, then etching gel and selfetch bond, pink flow composite to cover the orifs. Then i use bulk fill to finish in this case and after prepare for crowns. In other cases after i have covered orifs with selfetch bond and color flow, then ever-x, bulk fill and another color for best anatomy (D,AO,B,E).
I want to ask the same question. My waiting list is extremly long, I don't have free appointment next day...sometimes even not next month. So how can I prevent developing of acute pain between the procedures? And one more question: how do you perform temporary crown in such a case. I guess CEREC tech (milled)? Many thanks for your great work!
Anna Ševecová such a cases are planned in advance considering possibility of multiple appointments. BTW, if you fully booked month in advance - you need to rise your prices ;) It is not a joke but good marker
@@Belogradacademy :-))) Thank you very much for your advice and encouragement. To tell the truth, I am 80% booked next 6 months, the 20% is for emergency cases. I still didin´t have "the guts" to rise prices dramatically, I didn´t fell good, experienced or skilled enough. I have small practise - one doctor and an assistent. But as I started to look around, the office can be compared to any other :-) And if I compromise time, I can´t achieve the best possible results. So wish me luck...I am getting on my way to the next level (of course with great help of your videos and master classe :-) Best regards from Slovakia. Anička
Anna Ševecová rising prices you decrease number of patients and stress, but increase time for procedures and quality of treatments. It is simple like it is :)
Hello Maxim from Cyprus! The protocol I use before adhesive procedures for pulp chamber is the following: 1. Clean with alcohol on microbrush 2. Clean with glycine in airflow device 3. Clean with water and dry
Hi Maxim, Greetings from Nepal My protocol 1. Clean the pulp chamber space with citric acid, scrub with micro brush for effective clearing of resin cement ( AH plus ,in my case) If its Bioceramic only cleaning with water and ultrasonic. 2. Then follow the proper restorative procedure ( total etch,dry,bond and restore )under strict isolation .
Yesterday pt come to me with broken tooth. B wall was the only wall avillibale and the rest was 1mm above gingiva so I decided to make intentional endo. To insert fiber post to retain the core Is it my decision right?
Hello from Slovakia! I even hadn't finish the video (I came later) and I must admit... It halpens almost daily! Large filling, patient is ok, except of the X-ray and the fact, that the tooth is necrotic. And one patient owns often several of these treasures. :-( Often I try to fix IT, byť there are situations I cross my fingers and say "Well, there are some problems, but since you don't complain, I suggest to starts with something simple, such as small filling" ....
For the contest, First of all no adhesion without isolation. 1. Remove excess guttapercha using low speed bur or ultrasonic tip without cooling or heat system or if you make pack filling leave the orifice flushed or 1 mm free of guttapercha. 2. Remove sealer using, cotton moist with alcohol or citric acid or carvene, carvene makes the guttapercha softer so pack it again after washing but it's like magic. Sometimes I use sodium hypochlorite on cotton. 3. You can use sandblasting with 50 micron aluminum oxide. 4. Use chlorhexidine . 5. Etching using phosphoric acid and universal adhesive system. 6. Apply the bond in a rubbing motion . Now it's ready for bonding.
Clean the sealer with alcohol Clean 1mm of the coronal part of the canal with low speed round bur from gutta percha and sealer and seal it and the floor of pulp chamber with glass ionomer cement to obtain coronal seal. Then etch and bond like any dentin (10s etch ) And then use core build up compost Note: most of time in this cases of very weak tooth I use fiber post and core buildup and crown preparation 😇
With rubber dam already on I fill the canal with vertical condensation and AdSeal. But I dont fill all the way up to the canal orifice (the coronal part) but leave 1 mm without GP. Then I use alcohol and microbrush to remove the sealer. Sometimes I also use ultrasonic with diamond tip and water to further clean and smooth the walls. But if I use bioceramic sealer i just rinse it with ultrasonic and water. Then I etch enamel (15-30s) and then dentin (15s). Rinse, dry, bond with OptiBond FL. Then I fill the 1mm of the root canal orifice with PURPLE/blue/green flow to create a hermetisation effect .Sometimes on the bottom ofmthe cavity too, so then I know when to stop drilling if I need to do reendo in the future -this helps me find the canals. Then I just fill the cavity with Build-IT Dual cure composite material, leave it to self cure for a while and then light cure for 60 sec.
What is the best way to prepare pulp chamber for adhesive restoration once endodontic treatment is finished? 1) Try to isolate tooth with rubber dam. 2) Clean excess GP & sealer with a slow speed round burr and alcohol. 3) Microetch the dentine with airabrasion. Remove the excess aluminium oxide chips with EDTA. 4) Scrub the pulp chamber with sodium hypochlorite. Rinse with water. 5) Place a matrix band around the tooth. Etch and bond with a dual cure adhesive. 6) Squirt the dual cure composite resin into the pulp chamber to the brim
To prepare pulp chamber for adhesion I do these steps : 1) With ultrasonic or slow speed bur I'll remove excess sealer and gutta percha since I don't have tools for CWC. 2) wipe the acess with chorohexidine solution then dry. 3)etch the enamel margin with 37% phosphoric acid. 4)apply universal bond to dentin and etched enamel then cure.
and the answer of the task: 1)remove excess of sealer - pele tim (a piece of soft foam) soaked in alcohol, air blow (causes dehydratation!, so rinse than and airbolw again) 2)sand blasting (not the one hygienist uses, but 50 micro aluminium oxid) 3)no enamel in the pulp chamber, so etching only 10s, rinsing, pele tim soaked in CHX (chlorhexidin) for one minute, soft airblow, don´t dry too much, primer - 2times, airblow, bond, airblow, light cure 4)alternative option - self adhesive system such as Geainal bond should work ok (isolated for the pulp chamber) followed by totoal etch on the enamel - for example indirect composite overlay with extended walls
hello thank you for the content wonderful work. realy like what you said about multidisciplinary clinics and how to divide the big procedure, also agree about the decision making and about who should decide Our clinic protocol: 1. isolation with rubber dam 2. remove provisionals, sealer and gutta percha mainly with ultrasonic scaler 3. using the aquacare twin 52 micron aluminium-oxide and rinse 4. 0.2% CHX is applied 5.selective etching enamel with phosphoric acid 37% 6.rinse and dry (desiccation do not need to be considered*) 7.applying 3m single bond universal and cure *Effects of moisture content and endodontic treatment on some mechanical properties of human dentin* Author links open overlay panelTzzy-Jou G.HuangBMD, MSD1HerbertSchilderDDS2DanNathansonDMD, MSD3. thx again
Hello. In my office: 1. sandblasting with aluminium oxide to clean pulp chamber from guttapercha and sealer, if i dont have sandblaster microbrush with alcohol working very well too. 2. etching enamel 30s(if there is some enamel), and dentin 10-15 s, rinse with water 30 s, lightly dry with air, then primer 2 times , drying with air very well, then bond in thin layer and light air and then light curing. After that i use some core composite.
Thank you for your videos and greetings from Czech republic :)
Vitezslav Kucera Thanks for your answer.
Here is free access to online master-class
en.belograd.com/direct-posterior-restorations/
Hi Maxim! Thank you for the rubberdamology online masterclass.
What I do to prepare the pulp chamber for adhesive procedure is the following:
1. I remove gutta percha and sealer (Total FIll in my case) remains from the walls by AquaCare in prep mode.
2. When I have enamel I etch as I use totall etch technique if I don't have enamel I use self etching. I actively etch by using ultrasound tip without touching the walls to ensure contact with fresh orthophosphoric acid and I rinse.
3. I apply adhesive by brushing into dentin.
airb3 very nice and detailed explanation
airb3 Thanks for your answer.
Here is free access to online master-class
en.belograd.com/direct-posterior-restorations/
Thanks alot learned alot much appreciated 😍
Thank you for being with us!👍🏻
Hi from Bulgaria. When im obturated wiht warm condensation and ah+, i clear the pulp chamber with hipo and aqua care and dry, then etching gel and selfetch bond, pink flow composite to cover the orifs. Then i use bulk fill to finish in this case and after prepare for crowns. In other cases after i have covered orifs with selfetch bond and color flow, then ever-x, bulk fill and another color for best anatomy (D,AO,B,E).
Никол Караджова Thanks for your answer.
Here is free access to online master-class
en.belograd.com/direct-posterior-restorations/
Without negotiation and dressing the canals, wouldn't the patient develope some pain between pre Endo build up and actual negotiation and cleaning?
I want to ask the same question. My waiting list is extremly long, I don't have free appointment next day...sometimes even not next month. So how can I prevent developing of acute pain between the procedures?
And one more question: how do you perform temporary crown in such a case. I guess CEREC tech (milled)?
Many thanks for your great work!
minimalist traveler if patient had no pain before treatment (teeth were asypthomatic) , the risk to get pain is super minimal
Anna Ševecová such a cases are planned in advance considering possibility of multiple appointments.
BTW, if you fully booked month in advance - you need to rise your prices ;) It is not a joke but good marker
@@Belogradacademy :-))) Thank you very much for your advice and encouragement. To tell the truth, I am 80% booked next 6 months, the 20% is for emergency cases. I still didin´t have "the guts" to rise prices dramatically, I didn´t fell good, experienced or skilled enough. I have small practise - one doctor and an assistent. But as I started to look around, the office can be compared to any other :-) And if I compromise time, I can´t achieve the best possible results. So wish me luck...I am getting on my way to the next level (of course with great help of your videos and master classe :-)
Best regards from Slovakia. Anička
Anna Ševecová rising prices you decrease number of patients and stress, but increase time for procedures and quality of treatments. It is simple like it is :)
Hello Maxim from Cyprus! The protocol I use before adhesive procedures for pulp chamber is the following:
1. Clean with alcohol on microbrush
2. Clean with glycine in airflow device
3. Clean with water and dry
George Themistokleous Thanks for comments!
George Themistokleous Thanks for your answer.
Here is free access to online master-class
en.belograd.com/direct-posterior-restorations/
Hi Maxim,
Greetings from Nepal
My protocol
1. Clean the pulp chamber space with citric acid, scrub with micro brush for effective clearing of resin cement ( AH plus ,in my case) If its Bioceramic only cleaning with water and ultrasonic.
2. Then follow the proper restorative procedure ( total etch,dry,bond and restore )under strict isolation .
suman gautam Thanks for your answer.
Here is free access to online master-class
en.belograd.com/direct-posterior-restorations/
Yesterday pt come to me with broken tooth. B wall was the only wall avillibale and the rest was 1mm above gingiva so I decided to make intentional endo. To insert fiber post to retain the core Is it my decision right?
Hello from Slovakia! I even hadn't finish the video (I came later) and I must admit... It halpens almost daily! Large filling, patient is ok, except of the X-ray and the fact, that the tooth is necrotic. And one patient owns often several of these treasures. :-(
Often I try to fix IT, byť there are situations I cross my fingers and say "Well, there are some problems, but since you don't complain, I suggest to starts with something simple, such as small filling" ....
How long did this case take you including the pre-endodontic build up and both RCT?
For the contest,
First of all no adhesion without isolation.
1. Remove excess guttapercha using low speed bur or ultrasonic tip without cooling or heat system or if you make pack filling leave the orifice flushed or 1 mm free of guttapercha.
2. Remove sealer using, cotton moist with alcohol or citric acid or carvene, carvene makes the guttapercha softer so pack it again after washing but it's like magic.
Sometimes I use sodium hypochlorite on cotton.
3. You can use sandblasting with 50 micron aluminum oxide.
4. Use chlorhexidine .
5. Etching using phosphoric acid and universal adhesive system.
6. Apply the bond in a rubbing motion .
Now it's ready for bonding.
Eslam Ali نون لطب وتجميل الاسنان Thanks for your answer.
Here is free access to online master-class
en.belograd.com/direct-posterior-restorations/
Clean the sealer with alcohol
Clean 1mm of the coronal part of the canal with low speed round bur from gutta percha and sealer and seal it and the floor of pulp chamber with glass ionomer cement to obtain coronal seal.
Then etch and bond like any dentin (10s etch )
And then use core build up compost
Note: most of time in this cases of very weak tooth I use fiber post and core buildup and crown preparation
😇
Dr.Omar Al-Essawi Thanks for your answer.
Here is free access to online master-class
en.belograd.com/direct-posterior-restorations/
With rubber dam already on I fill the canal with vertical condensation and AdSeal. But I dont fill all the way up to the canal orifice (the coronal part) but leave 1 mm without GP. Then I use alcohol and microbrush to remove the sealer. Sometimes I also use ultrasonic with diamond tip and water to further clean and smooth the walls. But if I use bioceramic sealer i just rinse it with ultrasonic and water. Then I etch enamel (15-30s) and then dentin (15s). Rinse, dry, bond with OptiBond FL. Then I fill the 1mm of the root canal orifice with PURPLE/blue/green flow to create a hermetisation effect .Sometimes on the bottom ofmthe cavity too, so then I know when to stop drilling if I need to do reendo in the future -this helps me find the canals. Then I just fill the cavity with Build-IT Dual cure composite material, leave it to self cure for a while and then light cure for 60 sec.
Martin Zinek Thanks for your answer.
Here is free access to online master-class
en.belograd.com/direct-posterior-restorations/
What is the best way to prepare pulp chamber for adhesive restoration once endodontic treatment is finished?
1) Try to isolate tooth with rubber dam.
2) Clean excess GP & sealer with a slow speed round burr and alcohol.
3) Microetch the dentine with airabrasion. Remove the excess aluminium oxide chips with EDTA.
4) Scrub the pulp chamber with sodium hypochlorite. Rinse with water.
5) Place a matrix band around the tooth. Etch and bond with a dual cure adhesive.
6) Squirt the dual cure composite resin into the pulp chamber to the brim
acash93 Thanks for your answer.
Here is free access to online master-class
en.belograd.com/direct-posterior-restorations/
To prepare pulp chamber for adhesion I do these steps :
1) With ultrasonic or slow speed bur I'll remove excess sealer and gutta percha since I don't have tools for CWC.
2) wipe the acess with chorohexidine solution then dry.
3)etch the enamel margin with 37% phosphoric acid.
4)apply universal bond to dentin and etched enamel then cure.
Amr Ahmed Thanks for your answer.
Here is free access to online master-class
en.belograd.com/direct-posterior-restorations/
and the answer of the task:
1)remove excess of sealer - pele tim (a piece of soft foam) soaked in alcohol, air blow (causes dehydratation!, so rinse than and airbolw again)
2)sand blasting (not the one hygienist uses, but 50 micro aluminium oxid)
3)no enamel in the pulp chamber, so etching only 10s, rinsing, pele tim soaked in CHX (chlorhexidin) for one minute, soft airblow, don´t dry too much, primer - 2times, airblow, bond, airblow, light cure
4)alternative option - self adhesive system such as Geainal bond should work ok (isolated for the pulp chamber) followed by totoal etch on the enamel - for example indirect composite overlay with extended walls
Anna Ševecová Thanks for your answer.
Here is free access to online master-class
en.belograd.com/direct-posterior-restorations/
hello
thank you for the content wonderful work.
realy like what you said about multidisciplinary clinics and how to divide the big procedure, also agree about the decision making and about who should decide
Our clinic protocol:
1. isolation with rubber dam
2. remove provisionals, sealer and gutta percha mainly with ultrasonic scaler
3. using the aquacare twin 52 micron aluminium-oxide and rinse
4. 0.2% CHX is applied
5.selective etching enamel with phosphoric acid 37%
6.rinse and dry (desiccation do not need to be considered*)
7.applying 3m single bond universal and cure
*Effects of moisture content and endodontic treatment on some mechanical properties of human dentin*
Author links open overlay panelTzzy-Jou G.HuangBMD, MSD1HerbertSchilderDDS2DanNathansonDMD, MSD3.
thx again
דותן טורג'מן thanks for such a great and didactic comment
Dotan Turgeman Thanks for your answer.
Here is free access to online master-class
en.belograd.com/direct-posterior-restorations/