D.M.D. University of Pennsylvania SDM
Advanced specialty certificate (Endodontics) University of Pennsylvania SDM
Director, Endodontic Microsurgery, Albert Einstein Medical Center, Phila., PA
Director, Endodontic Microsurgery, Harvard University, Boston, MA
Consultant, Walter Reed National Medical Center, Bethesda, MD
Consultant, Army Post-Graduate Endodontic Section, Fort Gordon, GA
“Virtual Surgery™”: the impact on Non-surgical Retreatment
The two devices that have had the most profound impact on the modern endodontic practice are the Surgical Operating Microscope and the “Virtual Operating Microscope”; the Cone-Beam CT. Together, they have elevated both the level of precision, and the degree of confidence, in a selected procedure, allowing the clinician the prospect of successfully navigating and treating some of the more complex and challenging case presentations. Pre-operatively, we are now afforded the opportunity of “virtually dissecting” a tooth in three dimensions, disclosing unusual anatomy, untreated spaces and hidden periapical pathoses. This expedites a more definitive and decisive treatment plan, streamlining the operative approach for patient and clinician alike. This is especially critical in the instances of non-surgical retreatment, where the natural landmarks, clinically and radiographically, may have been altered or obliterated.
Armed with that knowledge, the SOM enables for a more focused effort in the non-surgical retreatment arena, expanding treatment possibilities and improving outcomes. The increased magnification/illumination supports a more “conservatively” aggressive approach to case selection and, coupled with instruments designed for the operative task, more focused “revision” of the previous therapy. These concepts are presented using multi-media and case presentation formats.
At the end of the presentation, the participant should:
1. Appreciate the advantages of 3-D imaging in pre-operative diagnosis and treatment planning.
2. Be familiar with the techniques for locating missing and “calcified” canals.
3. Understand the concepts and limitations of object retrieval (posts, separated instruments, root canal filling materials) from within the canal space.