Very informing about a debatable issue. Thank you Dr Nasseh & the team of RealWorld Endo. Please can you post the link for the second video .
@AANasseh
2 жыл бұрын
Please find part II here: kzitem.info/news/bejne/mpeMnWmokYxoe34
@YEah9152
3 жыл бұрын
I would love to see your progress with Vital Pulp Therapy, and I hope you’ll be able to document future cases for us to learn and see. Great video as always Doc!
@mareya3865
3 жыл бұрын
The beginning of video is amazing those few seconds let me watch all the video dr you are always amazing .
@daniep3100
3 жыл бұрын
Appreciate this.
@monthernuman558
3 жыл бұрын
That great news. would love to see vital pup therapy succeed always thought that RCT is comparatively aggressive procedure since majority of direct and indirect pup capping are unsuccessful.
@AANasseh
3 жыл бұрын
That's true. I'm worried the research may not reflect actual clinical outcomes. We'll have to wait and see based on people's responses and outcomes. Cheers!
@YEah9152
3 жыл бұрын
It is crazy how much more research is needed in the world of Endodontics. Hopefully at some point in the near future we could reach almost bulletproof guidelines that don’t encourage over-treatment.
@AANasseh
3 жыл бұрын
I agree. What's scary is that this lack of research is not limited to endodontics. It's applicable to many areas of both dentistry and medicine!
@kavityphiller4891
2 жыл бұрын
I appreciate that you acknowledge that diagnosis is tough- there are many gray areas- we are trying to diagnose complex and variable biological conditions with very crude tools: cold, tapping on the tooth- on top of that, there’s a lack of good research on things as simple as how radiographic appearance of interproximal decay correlated with actual cavitation- it can lead to a situation of group think and (at worst) faddishness that isn’t found among medical doctors. Thanks for your humble and measured approach.
@monthernuman558
3 жыл бұрын
Hi Allan , could you kindly make a video on how to place a post in already BC sealer obturated canal . My best regards and appreciation
@djamelabdelouahed726
3 жыл бұрын
Thanks for what you do
@michaellupu2080
2 жыл бұрын
I'm absolutely thrilled by this! I remember the first time I heard about this approach in a Domenico Ricucci seminar and how impressed I was. It was beyond eye opening. It was a paradigm shift for me. When I saw him lecture about this approach at the latest (34th) University of Michigan board review meeting I felt this might send shockwaves towards the specialty of endo and now we have this statement. Phenomenal! Just to clarify: does this statement refer to the procedure in which progressive "shaving" of the pulp until healthy pulp that stops bleeding easily is met (apical limit is the orifice level, at which point pulpectomy would be advised)?
@AANasseh
2 жыл бұрын
Yes. This is a generalization where necrotic, infected, and inflamed pulp is removed and the healthy pulp is capped at that level with the hope that it will survive. This is the beginning of the era of vital pulp therapy. Endo will always be needed due to patients' procrastination; but this could be a possibility for some patients that are more vigilant.
@michaellupu2080
2 жыл бұрын
@@AANasseh I agree! A follow up, if I may: How much would you charge for such an intervention? It could be argued that such a service to the patient should cost as much as a complete root canal treatment (excluding hardware costs like files), when you consider the fact that it serves the patient as a conventional RCT (i.e. if not for this therapeutic approach, a full RCT would be necessary). High magnification and bioceramics are mandatory, which could further justify a high price.
@daktariwameno
3 жыл бұрын
Thank you very much for your review! A link to the original AAE document would be nice. And just to mention it - I found the video cut somtimes a bit hectic, but I assume you did this intentionally.
@AANasseh
3 жыл бұрын
Thanks for that feedback. I'm trying to cut to the young kid's taste of fast change!! LOL!!! I guess not a good idea for this kind of material though! Thanks! Here's the position paper: bit.ly/3wVnsD2
@daktariwameno
3 жыл бұрын
@@AANasseh Thanks a lot!
@armanarmani5328
3 жыл бұрын
Thanks a lot. I just have a question about blood coagulation. if cotton pressure causes blood to clot or does 1% sodium hypochlorite cause blood to coagulate?
@AANasseh
3 жыл бұрын
Great question. It's a combination of both. Both hypochlorite and pressure help create the clot.
@musharrafdog
Жыл бұрын
If radiographs show dentin between caries and pulp and tooth has neither lingering sensitivity nor pain, yet there has been swelling in neck and cheek which came under control with amoxicillin, is VPT still at all possible?
@aksisoylenemez
3 жыл бұрын
is that a real fire place or ethanol in the background? (great content thanks !! )
@savitasalvi2834
3 жыл бұрын
Great presentation. A question, Is it necessary to use bio ceramic base or Calcium hydroxide will be good enough? And what is the time period?
@AANasseh
3 жыл бұрын
Studies show calcium silicates do better than Calcium Hydroxide. You can either place the final restoration right away or place the Liner and wait 8 weeks. I'll explain that in the next video.
@amritachawla7055
3 жыл бұрын
We need to bring out ways to decrease the subjectivity on the diagnosis and treatment planning front to improve the success rate of VPT. Any thing to add to this ? Would be helpful please
@AANasseh
3 жыл бұрын
That's true. Unfortunately until we have better testing, and more importantly better chair side assay tests we're left with whatever is available for now.
@practicaldentistry384
3 жыл бұрын
Good morning, We have been doing VPT for 2-3 years with 94%+ success. there are couple of points to add. first unlike the traditional belief the size of exposure does not matter as much as the status of pulp matters. needless to say there are obvious cases that need RCT but when you deal with inflamed pulp, VPT can be use. first and most important thing is to use rubber dam***. 2. we decided 2-3 minutes of 3% NACLO on sterile cotton pallet for Heme control( cause if you even leave the blood in contact with air for 10 min and it will clot) then our professor Dr. R.Lemon has come up with a clinical chair side test to confirm the pulp status! we use the side of our perio prob's tip and very gently brush or pass it on the capillary bed of the pulp( exposure side) and evaluate the Heme! the rate of blood perfusion can be one indication, how fast and hard the pulp bleed. 3. before putting MTA or other trioxide aggregate make sure the Heme has stopped.4- we cover the MTA with Surefill SDR,( use explorer tip to prevent voids) and then you can etch and bond on the Surefill to put your direct restoration or BU. As for diagnosis the Irreversible pulpitis should also be divided into early and late stages of inflammation. The earlier stage has a higher chance of success. Hope this help
@AANasseh
3 жыл бұрын
@@practicaldentistry384 Thank you Hourdad for sharing your thoughts. You're lucky to be working with Dr. Lemon. Take advantage of that opportunity. That's pretty much the technique, just using other materials in your case. Cheers!
@mansoorkhan8272
3 жыл бұрын
Is naocl available in gel formulation?
@trickjacko8482
3 жыл бұрын
Probably in trauma cases vpt would be a better option in terms of predictability whereas in deep caries cases I would be more doubtful about the long term prognosis.
@AANasseh
3 жыл бұрын
It's possible since there's less microbial contamination during trauma. But historically, we've waiting for trauma to become necrotic before doing endo... so, how do you propose that we do this in traumatic cases before they are necrotic?
@trickjacko8482
3 жыл бұрын
@@AANasseh if I understand the question property, it would be in those cases that arrive with pulp exposure, for instance a maxillary incisor. There you could perform a Cvek pulpotomy followed by a direct capping with biodentine.
@AANasseh
3 жыл бұрын
@@trickjacko8482 yes of course. Those are obviously indicated. I thought you were talking about subluxations, where outcomes are dubious in adults and problems occur at the apex first. 👍
@dccjaipur
3 жыл бұрын
I think somewhere the success or failure of VPT is basically heavily dependent on the age of tooth and this criteria is easy to apply clinically, of course experience of clinician is also important.
@optimus4618
3 жыл бұрын
any tip on how to work efficiently with indirect vision?
@AANasseh
3 жыл бұрын
You mean using a mirror?! The only tip is having a good assistant and lots and lots of practice! Don’t give up and prioritize on efficiency. Developing the mindset is half the battle. The rest is practice .
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