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n Endodontic procedures that only require one rotary instrument are causing controversy amongst spe- cialists worldwide. Endodontists are actively discussing the pros and cons of the new procedure in Inter- net forums. So-called single reci- procating file systems have been launched by several dental manu- facturers over the last few months. Originally developed by Cana- dian and Lebanese scientists, the single file endo concept is claimed torequireonlyonereciprocatingfile and no glide path or initial instru- mentation for the majority of root canals. According to the manufac- turers, the technique reduces work- ing time and lowers cross-contami- nation amongst patients, a common problem associated with the use of multiple files. However, specialists are not so sure. “This current trend in file design and philosophy is the equi- valent of doing brain surgery with a hammer and chisel. Anyone, who truly believes that Hess-type ana- tomy can be dealt with by using one rotary file is delusional,” a specialist in an US-based endo forum ob- served. “The technique requires a new motor, which will turn off many dentists who are already working with conventional rotary NiTi instru- ments,” a German Internet blogger commented. “The bottom line is that the system has to offer considerable advantagesoritwillberejectedbythe market despite its clinical potential.” In a recent Dental Economics article,Manhattan-baseddentistand endo specialist Dr Barry Musikant said that the technique could create a new standard for instrument use in endodontics. “Common sense says that single usage is a rationalisation to compensate for the weaknesses of rotary NiTi.” Most single reciprocating file systems are already available in major markets. 7 trends12 Show Preview IDS Cologne 2011 AD Specialists quarrel over‘single file endo’ Reciprocalmotionapromisingmethodforcanalpreparation n The upcoming International Dental Show will be a comprehensive plat- form for dentists and dental techni- cians to find out all the latest develop- ments in tooth retention and how to implement complex endodontic treat- ment systems into dental surgery. Endodontic measures, which duetodemographicshiftsare becomingincreasinglyimpor- tant, provide a reliable base forlong-termandlastingtooth retention. Latest clinical evi- dencehasconfirmedsurvival rates of endodontic treated tooth of up to 85 per cent. In recent years, the field has introduced new methods of conservation therapy in- cluding manual or mecha- nised root canal preparation, efficientrinsingmethodsdur- ing disinfection and the use of modern instruments and materialsforobturation.With the help of advanced root pin systems, nowadays even the treatment of front teeth with fractured crowns and roots has became possible. In case a root canal revision should be the only clinical option, en- dodonticexpertshavearange of minimally invasive micro- surgical concepts for even the treat- ment of complex endo-periodontal lesions to their disposal. “The impressive scientific and technological progress in the field of endodontics has improved the odds of long-term tooth retention tremen- dously and puts this speciality at the centre of a prophylactic-conserva- tionist approach in dentistry,” says Dr MartinRickert,ChairmanoftheBoard of the Association of German Dental Manufacturers (VDDI). The long years of intense collabo- ration between a large number of en- dodonticsspecialistsandtheindustry have resulted in improved instrument and new material that improved diag- nosis and, above all, improved treat- ment of root canal lesions. Modern im- aging techniques, for example, allow for a more precise visualisation of the root canal and thus enable both endometryuptotheapexandalsothe exact determination of the file posi- tionduringpreparation.DigitalX-rays and digital volumetric tomography are also becoming increasingly impor- tant in endodontics. High-resolution intraoralcameras,forexample,canbe usednotonlyfortherapeuticpurposes but also for online documentation. Another important trend is the in- creased use of mechanised root canal preparation. Computer-designed file geometries with optimised conicities and cutting edges have particularly improve safety and efficiency. Ad- vanced materials such as nickel-tita- niumortitanium-niobiumalloys,have significantly increased the durability of rotating preparation and revision files that allows evenly conical prep- aration even in the case of severe- ly curved root canals. High-perform- ance, electronically controlled drive units with torque control are helping to eliminate fracturing when using mechanised files. Technological process has also been made in other areas of endodontics. The working length is determined either by means of X-rays or with the help of modern electromet- ric measuring methods, with the latter causing no addi- tional exposure to radiation. Effective chemical prepara- tions, the action of which can be enhanced via ultrasound- supported or hydrodynamic methods, are used for root canal irrigation which fre- quentlydecidesthesuccessof the procedure. Modern sealer adhesives and cements based on composites are available for bacteria-tight obturation. Classic methods, such as gutta percha techniques have also seen significant progress. New equipment systems for warm vertical condensation now ensure better adaptation of the thermally plasticized gutta percha to the canal walls. Besidesroutinetasksthatcanalso be performed by a general dentist, en- dodontics offers a challenging work- ing field for specialists that includes complexrevisionwork,rootendresec- tions and the restoration of teeth with fractured crowns and roots. To accom- plish this task, experts are able to use loupesystemsorsurgicalmicroscopes that permit minimally invasive micro- surgical endodontic surgery. 7 (Source: Koelnmesse/Edited by Daniel Zimmermann, today international) Enhanced treatment concepts in endodontics on display IDS will present new techniques and instruments for lang-lasting tooth retention 5 Surgical microscopes allow minimally invasive endodontic treatment. (DTI/Photo courtesy of Koelnmesse, Germany) n With IDS only a few weeks ahead, it is cer- tainly a perfect opportu- nity to get acquainted with new trends and de- velopments in the field ofendodontics.Although the basic goals of en- dodontic treatment in- cluding the chemome- chanical eliminiation of microorganisms and the following apical and coronal sealing of the root canal system have not changed much over the years, new and ad- vanced products are certainly going to be presented in Cologne. An increasing number of our den- tal colleagues are currently jumping ontheendobandwagon throughcongresses,con- tinuing education and master programmes and wanting to educate themselves in the field. Looking also at the numerous articles that havebeenpublishedon endodonticissuesinthe national and interna- tionaltradepress,these development and offer- ings will benefit our pa- tients in the long-run. Despite the rapid developments in the field of im- plantology, preserving natural tooth substance through high-quality en- dodontic therapies remains a priority as these minimal-invasive procedures can save patients from extensive and risky treatment with tooth replace- ments for the time being. It is not surprising that the indus- try has further extended its offerings as a result from this increasing in- terest in endodontics. At this point, however, it seems an impossible task to mention all new products that are goingtobereleasedduringIDS.There- fore, I only want to focus on a few innovations in the field of root canal preparation. It has been a long-term goal for endodontists to make mechanical preparationwithNiTiinstrumentsnot only easier, faster and more economi- cal but, up and foremost, safer. At IDS, several systems will be launched to “Preserving natural tooth substance remains a priority” ByDrChristianGernhardt,UniversityofHalle/Saale,Germany ➟ 5 Dr Christian Gernhardt