Root canal treatments are one of the most common procedures in dentistry, but some dentists, especially general practitioners and those who are new to the profession, are still unfamiliar with the process or may miss crucial steps that could save patients’ time and money.

To help guide these dentists, Professor Simone Grandini, Chair of Endodontics and Restorative Dentistry, Head of the Department of Endodontics and Restorative Dentistry and Dean of the School of Dental Hygienists at the University of Siena in Italy, and his colleagues have developed a workflow reference for the treatment.

The workflow, which consists of 10 steps and includes two options depending on the tooth’s condition, begins with diagnosis and treatment planning. “This is a very important step because you need to assess whether the tooth is restorable. If it is not, there is no point in doing the root canal treatment. It is also essential that dentists decide what to do, and what’s going to happen to the tooth, before starting treatment,” said Prof Grandini.

The next five steps are, in order: access and interim restoration; shaping; irrigation; dressing and temporary restoration; and obturation. The final four steps depend on whether there is enough tooth structure left. If so, dentists should perform matrix placement, bonding, bulk filling and, finally, capping, finishing and polishing. If not, they should first build up the core of the tooth and place a post in it, then take an impression or scan, and finally conduct temporisation and cementation.

Since developing the workflow in 2017, Prof Grandini and his colleagues have presented it to dentists at conferences in Europe, Australia, Africa and Asia, including in Singapore, Malaysia, Thailand, Indonesia and Hong Kong. They will also launch it in the United States soon. He said: “Almost everyone whom we’ve spoken to have been enthusiastic and excited about it, and we’ve also received emails from dentists who have used the workflow with great success. We think it could be very useful for the profession and look forward to presenting it at IDEM in April.”

Prof Simone Grandini will be presenting at IDEM Singapore from 13 – 15 April 2018. For more information on IDEM Singapore, click here

Peri-implantitis is one of the most frequent pathological conditions that dentists and dental hygienists face. A systematic review of epidemiology published in the Journal of Clinical Periodontology in 2015, for example, found that 22 percent of patients were affected by it. To date, however, there is no gold standard of treatment, nor randomised clinical trials in the literature comparing surgical and non-surgical treatment.

To combat the condition, Dr Magda Mensi, Assistant Professor of Periodontology, Oral Surgery and Implantology at the University of Brescia’s Dental and Hygiene School in Italy, embarked on a pilot study in 2013 to determine whether a combination of low-abrasive powder, topical antibiotic and curettage could be more effective against severe peri-implantitis than conventional manual or mechanical debridement.

After one year, Dr Mensi and her colleagues observed 4 millimetres of pocket probing depth reduction, more than 3.7 millimetres of attachment level gain, and only 6.5 percent of bleeding on probing at level site in their study’s 15 patients’ 27 implants. These results were better than those of the conventional treatments. Furthermore, in the four years since the study began, only one patient has had a reoccurrence of peri-implantitis, and that was likely due to the patient missing several control and maintenance appointments and taking immunosuppressive drugs, as well as a worsening of her general health.

Dr Mensi’s Multiple Anti-Infective Non-Surgical Therapy (MAINST) protocol consists of using topical 14 percent doxycycline delivered by a biodegradable controlled released vehicle to solve the peri-implantitis acute phase, a session of full mouth air-polishing therapy with erythritol powder delivered sub-gingival with a special nozzle, curettage of the internal pocket line with a piezoceramic device with PEEK-coated tips and, finally, a second application of the doxycycline gel.


The patients also underwent quarterly maintenance sessions and were instructed to use personalised home care instruments, such as sonic toothbrushes, interdental brushes and floss. “This is very important. The patients have to be educated in plaque and calculus removal, motivated to carry out this maintenance at home, and show up for their dental sessions. If they come back only when there is a problem, it will be too late,” said Dr Mensi.

She added that the results from her study so far indicate that her MAINST protocol could be a gold standard of treatment for peri-implantitis. She said: “The only surgery that really works for peri-implantitis is regenerative, reconstructive surgery, but our protocol can be a better, non-surgical alternative. We are going to conduct a randomised control study to validate this hypothesis.”

Dr. Mensi will speak in depth about the non-surgical approaches to peri-implantits at IDEM 2018 in April in Singapore. For more information on IDEM Singapore, visit


Kesehatan gigi adalah salah satu aspek penting dalam menjaga kesehatan fisik dan psikologis. Tentunya setiap orang mengetahui bahwa perawatan gigi yang baik dapat mempertahankan gigi lebih lama di dalam mulut. Seringkali, penyakit yang dimulai dari gigi atau di dalam mulut, dapat mempengaruhi kerja sistem imun, yang akan menjadi masalah seiring dengan bertambahnya umur.


Bau Mulut

Masalah gigi yang sering terjadi pada suatu populasi masyarakat, adalah bau mulut. Bau mulut disebut juga halitosis, adalah suatu gejala dari buruknya kesehatan gigi. 85% orang dengan bau mulut, memiliki masalah kesehatan gigi. Banyak faktor yang dapat menyebabkan bau mulut, jadi jangan terlalu mudah menebak penyebabnya dan memperbaikinya. Penyakit gusi, gigi berlubang, mulut kering, bakteri pada lidah, dan kanker mulut dapat menyebabkan halitosis. Seseorang dengan bau mulut sebaiknya konsultasikan dengan doker giginya.

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