Endodontic practice. Basic principles and new technologies.

Endodontic practice today is easier than in the past. In modern dentistry it is possible to perform predictable root canal treatments, in molars, with complex anatomies, in single visit, in most cases by using one single file, without stress for the clinician and the patient and an excellent ratio cost-benefit from a biological and economic point of view. Simplification in root canal shaping is due to the improvement of the nichel-titanium instruments. This revolution, started about twenty years ago, changed the procedures and the protocols of the instrumentation. Recently a new system, in gold alloy, with a revolutionary design, a quadrangular cross-section, a shorter handle, a smaller regressive taper, and a smaller wire have been created to shape with a more conservative approach. Minimally invasive philosophy is involving the medicine in general, but also dentistry, especially endodontics. The goal of this procedures is to preserve healthy dental tissues in order to reduce the structural weakening of the tooth, preventing cracks and fractures and improve the long-term success. The new technologies are mandatory also in solving difficult cases and saving natural teeth. CBCT, Operative Microscope, Bioceramics are essential to manage complex root canal retreatments, but only if the basic principles are respected. A complex root canal retreatment in presence of a large foramen, unusual anatomy, lesion, sinus tract in esthetic area of a young patient is finally described step by step. Experience, common sense, respect of clinical protocols and details are crucial factors to obtain predictable long-term results.

Dr Andrea Polesel

Dr. Andrea Polesel graduated in Dentistry, summa cum laude, at the University of Genoa (Italy) in 1995. Active Member of Italian Society of Endodontics (SIE) and Italian Academy of Restorative Dentistry (AIC), Certified Member of European Society of Endodontology (ESE), International Member of American Association of Endodontists (AAE). He has been Member of the Admission Committee (2014-18) and National Cultural Secretary (2019-20-21-22) of SIE, Member of the Editorial Board (2016-17) and Cultural Commitee (2019-20-21) of AIC, Member of the Cultural Committee (2016-17) of the Italian Academy of Microscopic Dentistry (AIOM). Adjunct Professor of Endodontics at the University of Genoa (2013-14-15-16-17-18-19-20-21). He gave courses in Egypt, Dubai, Bahrain, Lebanon, Qatar, Kuwait. Author of national and international articles on endodontics, aesthetics and adhesive restorative, co-author of the AIC-book “Esthetic Restorative Dentistry” (Quintessence, in press), author of Chapter 13 in "Atlas of Endodontic Anatomy" (Tecniche Nuove 2011), Ch 13 in "Manuale di Endodonzia" (Elsevier 2013), Ch14 in "Manuale di Endodonzia" (Edra 2020), Ch 25 in “Endodontics” (A. Castellucci Edra in press). International and National lecturer on various topics and teacher in courses in Italy and abroad. Private practice in Endodontics, Restorative Dentistry and Surgery in Arenzano (Genoa), Italy.