Synopsis: 

Vital pulp therapy preserves pulp functions including defence against bacteria ingress, sensory functions, and continued maturation of immature teeth. A growing collection of clinical studies had demonstrated that pulpotomy performed in cariously exposed mature permanent teeth can be relatively successful, with success rates rivalling that of conventional endodontic treatment. The success of vital pulp therapy depends on appropriate case selection—yet “reversible” and “irreversible pulpitis” are diagnostic terms that are largely based on subjective symptoms. Biomarkers have been proposed as a surrogate objective measure of pulpal disease severity in recent cross-sectional studies, and few markers have been correlated with the histological status of the pulp. 
In this short lecture, I will introduce findings from the literature regarding biomarkers as a potential diagnostic measure of pulpitis, as well as preliminary findings from an on-going clinical study conducted in the National Dental Centre correlating pulpal inflammatory markers and treatment outcome of partial pulpotomy in cariously exposed mature permanent teeth.

Synopsis:

Over the years, new materials have been developed to facilitate endodontic therapy, such as advances in irrigants, medicaments, root canal sealers and restorative materials. In respect of vital pulp therapy, calcium hydroxide is traditionally used to induce superficial necrosis and dentine matrix formation, while preserving pulpal health. However, it has not consistently produced highly successful outcomes due to its limitations of having high solubility and low mechanical resistance. Hydraulic calcium silicate cements have been developed to overcome such limitations, and also for use across a multitude of applications. Mineral trioxide aggregate (MTA) is currently the material of choice, and its physical properties and biological effects on host tissues have been thoroughly explored in literature. However, MTA has several disadvantages, including the potential risk of tooth discolouration, high cost and a long setting time of up to 4 hours. To overcome these issues, various companies have developed new formulations, including BiodentineⓇ by Septodont, USA. 

We will take a closer look at MTA Repair HP, a new iteration by MTA Angelus, that contains an organic plasticizer to improve handling and to decrease setting time. Bismuth oxide is also replaced by calcium tungstate, which eliminates the problem of discolouration. Although this material is currently distributed in areas such as South America, there is limited research evaluating its effect on pulpal tissues. This talk aims to give a brief introduction to common bioceramics with regards to the physical properties and biological responses, as well as to present findings from my in-vitro study on MTA Repair HP with the use of dental pulp stem cells.

Date: 27 June 2019
Time: 7-8pm
Venue: Alumni Theatrette (Alumni Association, 2 College Road S169850) 
CDE points: 1

Synopsis: 

The ultimate goal of endodontics is to treat apical periodontitis and to prevent the recurrence of infection to the root canal system. In spite of the most ideal of situations, periapical lesions may still persist after initial root canal treatment due to a variety of reasons. Treatment options after failed initial root canal treatment include non-surgical retreatment, surgical retreatment or extraction and replacement with a single tooth implant.

Clinicians are often confronted with difficult choices whether a tooth can be salvaged or extracted and replaced with an implant, and if it can be saved, should it be treated by non-surgical retreatment or endodontic microsurgery. This choice can be challenging, depending on the accessibility to the root canal system, variations in root canal morphology and availability of advanced instruments for predictable outcomes. Periodontal, endodontic and restorative characteristics also need to be carefully evaluated to determine the prognosis and predictability of the treatment plan.

This presentation aims to shed some light on the evaluation of clinical situations and discuss the factors which will guide us through the decision making process on the retreatment of the tooth. 

The lecture will include the following:

1. Clinical outcomes of non-surgical retreatment and surgical retreatment vs. single-tooth implants

2. Prognostic factors of the long term outcome for the various treatment modalities

3. Clinical considerations in nonsurgical vs. surgical retreatment

4. Clinical cases