Clinical Endodontics Professional Training

Restoration of Endodontically Treated Teeth

Programme outline: The Principles of Occlusion in Advanced Restorative Dentistry. Occlusion Examination. Post and Core Techniques. The restorative endodontic Interface. Plastic restoration, posts, intra and extra-coronal restorations, cuspal coverage amalgam vs composite. Adhesive Techniques for Restoration of the Root-Filled Tooth.

Hands-on training: Occlusal examination. Facebows and jaw registration. Shenker, Duralay & Fibre post preps. Posterior Class 1 and Class 2 composites for posterior root-filled teeth. Posterior porcelain onlays for posterior root-filled teeth. Placement of core restorations and post-retained restorations.

DAY 1

Title: The Principles of Occlusion in Advanced Restorative Dentistry 

Topics

•     History
•     Balanced occlusion
•     Gnathology v’s PMS
•     5 principles of occlusion
•     Levers
•     Bruxism

Aims

(Attending this course module will help students...)

•     Discuss the events precipitating the study of occlusion
•     Appreciate the limitations of a balanced occlusion
•     Understand the distinctions between Gnathology and Pankey Mann Scheiler theories
•     Introduce the concepts of RCP, ICP, and RAP
•     Define how the dentition distributes lateral and vertical loading
•     Describe the concepts of anterior and posterior guidance
•     Understand the classification of levers and how this applies to occlusion
•     Consolidate the theory and implications of bruxism
•     Classify the options for lateral and protrusive guidance
•     Consider the consequences of non-working side interferences
•     Establish the three components of posterior stability

Objectives

(By the time the delegate has completed this module he/she will...)

•     Manipulate the mandible to arc around its terminal hinge axis
•     Confirm the tooth contact to register the retruded contact position
•     Evaluate the vertical and horizontal components of the RCP –ICP slide
•     Demonstrate the examination for a mutually protected occlusion
•     Identify the consequences of class II leverage in the occlusal scheme
•     Record the guidance for a given occlusal scheme
•     Critique the guidance and prescribe any adjustment
•     Illustrate the protocol to identify non-working side interferences
•     Conceptualize the impact of removing non-working side interferences
•     Appreciate the treatment modalities for working, balanced and non-working side guidance

Course outline

The morning session will consist of a seminar on occlusion and will cover the following topics:

•     The 5 principles of occlusion
•     RAP V centric relation
•     Mutually protected occlusion
•     The importance of anterior guidance
•     Non-working side interferences
•     Posterior stability

The afternoon session will be a hands-on practical (Adam Toft). This will cover face bows and jaw registration.

Agenda

DAY 2

Title: Occlusal Examination

Topics

•     Adaptation
•     RCP-ICP slide
•     ICP stability
•     VH
•     HV
•     Bruxism
•     Dahl appliance
•     Confirmative
•     Reorganized

Aims

(Attending this course module will help students…)

•     Define the mechanisms of occlusal adaptation
•     Recognise that social and medical history may influence occlusal harmony
•     Appreciate how the anatomy of the glenoid fossa influences the mandibular movement
•     Assign a classification and values to condylar movements
•     Discriminate the opportunities to prescribe a Dahl appliance
•     Understand how anterior tooth shape and position influence the condylar movement
•     Appreciate why vertical and horizontal elements of the slide influence treatment planning

Objectives

(By the time the delegate has completed this module he/she will…)

•     Establish the protocol for occlusal examination
•     Deliberate the consequences of an unstable ICP
•     Evaluate the Bennett angle and Bennett movement
•     Confirm the orbiting and rotating condyles during mandibular movements
•     Conceptualize condyle position for working and non-working side excursions
•     Describe the impact of bruxism with class II leverage
•     Evaluate all information to prescribe a reorganized or confirmative treatment plan

Course outline

The morning session will consist of an occlusal examination seminar and the afternoon session will consist of an occlusal examination practical.

Agenda

DAY 3

Title:  Modern Adhesive Techniques for Restoration of the Root Filled Tooth Seminar and Practical 

Course Aims & Objectives

• Revision of posterior tooth anatomy
• Introduce the principles of PKT carving
• Present the criteria for the use of Nayyar cores
• Expanded armamentarium to include PKT and Frahm’s carving instruments
• Understand the various ways to restore Posterior root Filled teeth
• When to restore with filling or onlay
• Techniques for different onlay preparations
• Learn modern Adhesive techniques
• Understand how 'C Factor' influences your filling technique
• Metal onlay v Porcelain onlay v Composite onlay
• Choosing different types of ceramic
• Use of sectional matrix bands
• Layering techniques to minimize stress

Course Outline

The morning session will consist оf: First Part- seminar, Second Part- practicals (Adhesion and Posterior Composites).

The afternoon session will consist оf: First Part- seminar, Second Part- practicals (Posterior Porcelain Onlays).

Agenda

DAY 4 

Title: Modern Post and Core Techniques

Topics

• Long and thin
• Tapered v’s parallel
• 5 x criteria
• Ferrule
• Shenker post
• Nayyar cores
• Split cast post and core
• Duralay direct post and core
• Impression technique
• Material choice
• Anti-rotation grooves

Aims

(Attending this course module will help students…)

• Discuss the advantages/disadvantages of the various post morphologies
• Introduce the 5 criteria which influence the success of a post
• Revise the principles of Shenker post design
• Understand the stages required for accurate impression taking
• Appreciate the importance of the ferrule in a post’s prognosis
• Awareness of the technique for a direct Duralay post and core
• Evaluate the techniques available for treating multi rooted teeth
• Understand the implications of material choice on aesthetics and prognosis
• Discuss anti-rotation grooves, their placement, and instrumentation

Objectives

(By the time the delegate has completed this module he/she will...)

• Identify the material of choice for a clinical scenario
• Evaluate the criteria for post success in a clinical scenario
• Demonstrate the use of the Nayyar core for multi rooted teeth
• Prepare a Shenker post and provide a suitable impression
• Fabricate a Duralay direct post and core for anterior teeth
• Produce a split cast post and core using the ‘bead-on’ technique
• Examine the stages in cementation of carbon fiber posts

Course outline

The morning session will consist of a seminar covering posts and the afternoon session will be a hands-on practical covering shenker, duralay, and fibre post preps.

Agenda