Join us for an inspiring
day exploring the ins and
outs of MIE.
Our teaching objective is to reduce
the fears and frustration clinicians encounter when making the commitment to extend
the usable life of endodontically-treated teeth. Upon finishing this course, attendees will better understand where and how to apply MIE principles in their everyday practices.
Until recently, we've been forced to balance conservation of tooth structure during RCT with irrigating efficacy. Due to the primitive irrigation tools we’ve had at our disposal, we cut big access and canal preparations out of necessity. Now, equipped with stronger and more flexible tools and faced with the alternative of implant replacement, we ask ourselves, "How do we perform minimally-invasive endodontic procedures without losing our minds?"
As most of us on this path have found, MIE treatment restrictions can actually impact our short-term outcomes, an irony when our aspiration was to increase our long-term success rate. It is very clear that we need new concepts, tools, and techniques designed specifically for MIE. Conceptually, we need to better understand where the law of diminishing returns tells us that further dentin conservation is needlessly complex without increasing the longevity of teeth after RCT. Tool and Technique-wise it's been a difficult reboot for clinicians to cut, clean, and conefit MIE preparations.
Drs. Buchanan and Maupin have been on this journey for a decade and have created this lecture to share the following:
- Designing MIE access cavities with CT-based planning
- Executing MIE access with Dynamic Guidance
- MIE Instrumentation for Irrigation and Obturation
MIE cleaning tools and strategiesa. YSGG Laser - Laser Assisted Irrigationb. Closed-System Negative-Pressure Positive Outflow
- MIE Obturation Techniques
- MIE Restoration
Dr. L. Stephen Buchanan, DDS
Dr. L. Stephen Buchanan has been lecturing and teaching hands-on endodontic continuing education courses for 30 years, both in his state-of-the-art training facility in Santa Barbara, California, as well as in dental schools and meetings around the world.
He currently serves as a part-time faculty member in the endodontic departments at the University of the Pacific's Arthur Dugoni School of Dentistry and the University of California at Los Angeles.
Dr. Buchanan is nationally and internationally known as an expert in the research and development of new technology, instruments and techniques in Endodontics. He also maintains a private practice limited to Endodontics in Santa Barbara, California, and is a diplomate of the American Board of Endodontists and a fellow of the International and American College of Dentists.
Dr. Charles Maupin, DDS
Dr. Charles Maupin has been involved in endodontic education for the past five years. He has lectured nationally at various meetings, study clubs and dental schools currently serving as an adjunct professor at University of California, Los Angeles.
Dr. Maupin has helped to modernize minimally invasive endodontics through dynamic navigation. He has also brought to light the efficiency, efficacy and safety of the use of a YSGG laser for endodontic irrigation leading to enhanced cleaning in a shorter amount of time. He maintains a private practice limited to endodontics and implants in Lubbock, Texas.
He is a diplomate of the American Board of Endodontics and a founding member of the International Academy of Endodontics.
7:00 Buffet Breakfast
8:00 Session I: MIE Access
- Designing MIE access cavities with CT-based micro-treatment planning
- Access burs and ultrasonics
- Hard tissue laser entry
- Dynamic Guidance
10:00 Break with snacks in exhibit area
10:30 Session II: MIE Instrumentation and Conefit
- Shaping Objectives
- GP cones for MIE conefitting
12:30 Lunch is served in meeting room while we have an MIE case competition
1:30 Session III: MIE Cleaning Tools and Techniques
- Laser-Cavitated Irrigation (LCI) with YSGG Laser
- Closed-System Negative-Pressure Positive-Outflow Irrigation
3:30 Break with snacks in exhibit area
4:00 Session IV: MIE Obturation and Post-RCT Restoration
- Conventional and bioceramic sealers
- 3D Condensation Techniques
- Air abrasion and etching pulp chambers and access cavities
- Material and methods for creation of voidless, impervious coronal seals.
6:00 Reception in exhibit area with beverages and appetizers
My journey into minimally-invasive endodontics (MIE) began in 1989, when a prosthodontist told me he wished endodontists could just "suck the pulp out of teeth without cutting any dentin". It's surprising to remember this now, but I was somewhat nonplussed by the idea as this was antithetical to the Schilder School who advocated for big access cavities and widely-cut coronal canal shapes–a necessity with the limited tools of the time. By 1996–because of the strength and flexibility of our endodontic tools–this was an obsolete concept of treatment, but clinicians continued to equate big RCT with excellence in endodontics, borne out by the many rotary file designs that cut large canal shapes that reflected that ignorance. By that time, I had been in practice for 16 years–long enough to see structural failures of my own cases, so when I designed the first variably-tapered files, I gave them a 1mm maximum flute diameter limitation.
The case (left) from 1998 shows typical shapes cut by GT and GTX Files–all three canals were finished with a 20-.06, irrigated with NaOCl for 40 mins, and filled with the Continuous Wave of Obturation Technique. Note the mid-mesial lateral canal and the loop off the distal primary canal.
This tooth had a failing RCT that had been filled with Thermafil Obturators, but the carrier fill was not the etiology; this case failed because the canals were grossly undertreated. The mesial canals were 25.5mm long and the mesial root was narrow enough to be perforated by too much coronal enlargement, contra-indicating the use of most of the files available at that time. A 20-.06 rotary file with a 1mm MFD was used to cut the mesial preps, a 30-.08 w 1mm MFD was used in the distal canal.
Meanwhile, Charles pushing the evelope by turning out incredible MIE RCT's like this case (left), showing excellent demonstration of lateral anatomy cleaned and filled despite the micro-shapes. He has refined the use of YSGG endo lasers to cavitate NaOCl in these shapes–one of the coolest things you will see at this presentation.
Many endodontists have cut smaller than traditional shapes but show no lateral recesses filled when treatment is completed. These mediocre irrigation outcomes are the genesis of multi-visit RCT–definitely a step backward in efficiency and elegance of procedural RCT delivery. Note how his MIE instrumentation preserves the native anatomy of root canal systems, making us all better students of endodontic anatomy.
Both Dr. Maupin and I have been early adopters of dynamic guidance for calcified access–to this day one of the coolest technologies I've ever used during RCT. You will see how a 3D camera system with digital tracking software can make your next heinous case feel like you are playing a video game. I have yet to use guidance in a calcified tooth without thinking, 'This is crazy–I cannot believe it works this well".
...and if you like the new "Look" of twenty-first century endodontics...
Join us at Denver International Airport's Westin Hotel on November 13, 2021 for an intense journey into minimally-invasive RCT without losing your mind and wallet. Our greatest objective for this course is to insprie enthusiasm about saving tooth structure while predictably treating entire root canal systems.
If you cancel 30 days or more prior to the course, you are entitled to a full refund, less a non-refundable $500 deposit. No refunds will be issued if cancellation occurs within 30 days of the event. Questions: email firstname.lastname@example.org or call 805-899-4529.
Dental Education Laboratories ("DELabs") is an ADA CERP Recognized Provider. The current term of recognition extends from November 2017 to December 2021. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to the Commission for Continuing Education Provider Recognition at ADA.org/CERP. AGD PACE Provider ID#: 209120