Let's Talk Endodontics
Let's Talk Endodontics
Dr. Howard Bittner from Langley Endodontics shares Endodontic Tips and Techniques, Case Reports and JOE Article Reviews.
Dr Howard Bittner

An accurate determination of the status of the pulp is a critical element in achieving the correct diagnosis and treatment plan.  An important part of making that diagnosis is determining whether the pulpal tissue of the tooth in question is vital or necrotic.  One of the most well-established...  Read More
In the November 2017 newsletter, I talked about cold testing teeth to determine pulpal vitality.  The cold test is by far the most commonly employed of the pulp tests and for the most part the easiest to use.The hot test, while used less frequently, is another important pulp vitality test.  As with...  Read More
Endodontic irrigation is the second leg of chemo-mechanical cleaning and shaping of the root canal system (RCS). Both mechanical shaping of the canals and chemical disinfection of the shaped canals are critical to a successful endodontic protocol and a comfortable patient outcome. Mechanical...  Read More
This patient was referred to our Langley Endodontics office earlier this year for evaluation, diagnosis, and treatment as needed, for tooth #11.Periapical Image of Tooth #11The patient was asymptomatic at the time of their visit to their dentist for routine maintenance. A history of trauma to the...  Read More
Journal of Endodontics, 41:12, 1985-1990, 2015 A. Azarpazhooh, C. QuinonezPatient autonomy has received more emphasis in the last 20 years as we, in Dentistry, have moved from an authoritative to collaborative model of clinical decision making. The Canadian Dental Association’s Patient...  Read More
I recently attended a course, hosted by the Fraser Valley Dental Society, on medical emergencies in the dental office. One of the many topics we covered was local anesthetic (LA) emergencies. It was clear from speaking with other attendees and the questions that arose with our speaker, Dr. David...  Read More
New to our newsletters this year is the Case Report. As an Endodontist, I see a wide variety of interesting cases that are rarely seen by the general dentist. Our goal with these case reports is to share some of these more unusual and interesting cases with our dental community.In mid-January 2016,...  Read More
International Endodontic Journal, 48, 95-102, 2015 L. Wan et alThe inter-relationship of periodontal and endodontic diseases has been a subject of speculation because of the close connections between the periodontium and pulp tissue in embryonic origin, anatomy, and function.  The literature...  Read More
The literature contains a number of studies showing association between chronic apical periodontitis (CAP) and systemic health issues such as diabetes and cardiovascular diseases. Research from the field of periodontics has suggested that periodontitis in pregnancy is a risk factor for low birth...  Read More
In the 1970’s in North America, dentists were faced with a huge onslaught of patients with periodontal disease and caries. The large cohort baby boomers grew up in the 25 cent coke and a chocolate bar era and their dental health reflected it. Organized dentistry responded to this challenge...  Read More
Disinfection of the root canal system is the primary goal of endodontic treatment. Schilder coined the term root canal system in the 1960’s to acknowledge the complexity of endodontic treatment. During tooth development, Hetrwig’s epithelial root sheath directs the formation of the...  Read More
The idiom “red herring” is used to refer to something that misleads or detracts from the actual or otherwise important issue. In the dental office, a red herring is a set of signs and symptoms which can confuse or obfuscate the diagnosis resulting in a course of treatment which does not...  Read More
Endodontically treatedanterior teeth are always of concern to the restorative dentist and endodontist alike. Anterior teeth are the most likely teeth to be affected by both accidental trauma and parafunctional occlusal forces. Anterior teeth which are biomechanically compromised, whether through...  Read More
Endodontic treatment has three objectives: remove bacteria and bacterial by-products from the root canal system; prevent bacterial re-contamination from the oral environment; and entomb any remaining viable bacteria within the system.The classic endodontic triad of cleaning, shaping, and obturation...  Read More
I have received a few calls and emails recently asking about sealers, particularly the “new” EndoSequence® BC Sealer. It has been marketed as “a revolutionary premixed bioceramic sealer which chemically bonds to both dentin and our bioceramic...  Read More
Endodontic treatment may be one of the most challenging of the dental disciplines. Root canals systems (RCS) are extremely complex and highly variable within the human population. Microbiologic techniques to date have identified over 750 different bacteria involved in the development of apical...  Read More

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