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Published by: jaime09783069 on Feb 18, 2011
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internationalmagazine of
case report
Open-apex retreatmentunder the operating microscope
Endodontic success: The pursuit of our potential
 An interview with MICRO-MEGA 
issn 1616-6345
 Vol. 6
Issue 4/2010
 w w w.re vo-s.com
 We invent, you succeed!
 Your range of essentials!
APEX Pointer
+: High precisionelectronic apex locator.
MM-Paste: Calcium hydroxid paste.
MM-Seal: sealer for root canal filling.
MM-GP Points: Gutta percha.
 Totally safe manualexploration!
First indispensable step to anysuccessful endodontic treatment.
Extreme precision and simplicity.
For use in combination with apexlocators (Apex Pointer™+).
No more constraints!
Coronal flaring.
Elimination of the coronal strains.
Easier insertion of preparationinstruments.
Revolutionize your Endo with only3 instruments!
Its asymmetrical cross sectioninitiates a snake-like movement ofthe instrument inside the canal!
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I 03
editorial _
Prof José F. Siqueira Jr.
Endodontics is fascinating.
I will put aside the romantic view that endodontics is an art andassume that it is an ever-growing science that requires a great deal of study and training to reach ahigh-level clinical performance. I dare say that no other clinical discipline in dentistry requires such avast knowledge of and integration with so many other clinical and basic disciplines.As a clinical health-care discipline, endodontics is concerned with the promotion of oral health andprimarily deals with prevention and treatment of apical periodontitis. Every patient who enters our officeis confident that we are well prepared to apply the most effective treatment protocol available to reachthat goal. Unfortunately, this may not be true. Epidemiological studies reveal a very low success rate (40to 60%) of endodontic treatment in the general population. The majority of failed (or diseased) teethare poorly treated. The need for a complex background of knowledge and the technically demandingnature of endodontic procedures may help explain such an overall poor performance. However, the po-tential for success is very high (85 to 95%), as demonstrated by well-controlled, university-based stud-ies. This rate is amongst the highest for any treatment in any health-care discipline. This keeps our hopeshigh. The challenge for the specialty now is to transfer this high success rate to the general population.One of the possible solutions is to encourage the development of treatment procedures or protocolsthat are user-friendly and effective in order to allow more clinicians to be able to offer optimal out-comes. This would make endodontics more ‘democratic’ in terms of predictability. In a thought-provoking paper by Morgan and Alexander published in
2/10, the authors discuss the issue of applying scientific knowledge to improve clinical practice. Dr Irving Naidorf had discussed this 40 yearsago and it is still significant today. Integrating scientific knowledge and clinical practice is certainlyrequired to maximise the success rate, but this approach might well also be used to develop alternativesto improve the quality (and consequently the outcome) of treatment in the overall population.In spite of the huge amount of scientific information about the aetiology and pathogenesis of apical periodontitis generated over the last three decades, this knowledge has not been translated intoa significant improvement in endodontic treatment outcomes. This is because clinical technology andtreatment protocols have not been devised or even slightly modified on the basis of this boomingbiological knowledge. Science has provided a great deal of information on the nature of the problem, sothe time has come for this knowledge to be used by endodontic scientists and clinicians to find a better,affordable and less technically demanding approach that can still predictably treat our patients. In anideal world, there should be no dichotomy or dispute between research and clinical practice. In a clinicaldiscipline like endodontics, research should be mostly intended to find and test ways for the best treat-ment and to improve the quality of life, while clinicians should use this scientific knowledge to improvetheir practices. Denying the importance and advances of the other is arrogant, nonsense, selfish andcounterproductive.In contrast to the many Doomsday prophets, we can foresee a bright future for endodontics.It’s up to us.Yours faithfully,Prof José F. Siqueira Jr.Professor and Chairperson, Department of Endodontics, Estácio de Sá UniversityRio de Janeiro, RJ, Brazil

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