To Pull or Not to Pull

Friday, 2:00pm - 5:00pm
Classroom:  Solana D

What alternative treatment options should be considered when the "Initial" Endodontic (Surgical and/or Non-surgical)

Failure occurs? With the introduction of new techniques and a systematic approach for the diagnosis and treatment of compromised teeth, the attendee will be able to more accurately determine the long term prognosis with multiple treatment options. Advancements in both surgical and non-surgical procedures have resulted in success rates that can be equivalent to the success rates for an implant replacement. The title of the presentation does not only involve teeth. We will also describe when it is ideal to remove an implant and approaches to reduce the incidence of peri-implantitis. Prosthetic and surgical approaches for interdental papilla enhancement will be described. A description of a technique for previously thought of non-restorable teeth will be shown with long term positive results. Will will also review how data from recent publications about hemi-sected and periodontally compromised teeth have been improved. A discussion about treatment planning with an emphasis on bone physiology and physics will be reviewed.

Learning Objectives:
- Be able to differentiate between an Endo/Perio vs. Perio/Endo lesions and understand the difference as it relates to a long term prognosis
- Know when it is NOT ideal to remove a tooth and replace it with an implant
- Recognize how the location of a sinus tract can be a key critical diagnostic indicator for the long term prognosis
- Appreciate how the use of a surgical guide can significantly reduce complications. ie minimizing Peri-implantitis and Early Crestal Bone loss
- Learn the statistical difference in the long term Prognosis for Root Canal Treatment vs. Apical Surgery vs. Removal and Implant Placement
- Become aware that many long held and generally accepted principles do not always hold up over time ie: Long term prognosis for Hemi-sected teeth and long term prognosis for teeth with 50% bone loss.
- Develop new approaches to Treatment Planning incorporating principles of physics and bone physiology
- See how the development and incorporation of Sinus Augmentation has changed our approach to Treatment Planning.
- Elaborate on how to Prosthetically perform both Crown Lengthening and Papilla Enhancement
- Gain knowledge about the different Biotypes and the effect on Implant Esthetics and Long Term Osseous Changes along with an appreciation of the potential complications associated with each.