The Palestinian International Dental Conference
Last month I gave a lecture at The Palestinian International Dental Conference. I have to start this post thanking particularly to the BAIRD Academy and the Palestine Dentistry Society for inviting me to the congress and make me feel like I was at home. I want to thank especially Dr. Hassan Maghaireh, Dr. Raed Junaidy, Dr. Anan Amro, and Dr. Ahmad Abd El-Ghani for all their help and for showing me the most beautiful areas of Jordan, Palestine and Jerusalem.
The topic I covered was about Magnification, Cumulative Trauma Disorders (CTDs), Ergonomics and 4 Handed Workflow. For me, all those 4 concepts, are intimately related.
Our manual capacity is limited by our own eyes. It’s because of that why we cannot be more precise, simple as that. To be able to see fine details, we have to bring the object closer to the eye. This is why dentists have to bend down over the patient’s mouth, and this is why dentist have back problems.
The use of magnification is the way to overcome our eye’s limitations. This will also make us work in a neutral and healthy position resulting in long lasting professional career.
4 handed workflow is the masterpiece which completes the ergonomic puzzle. Here you have a couple of videos where I show basic movements which you can start using till you develope your own technique. The first video has been recorded in 30 minutes with an assistant with no previous experience at all; and the second one with a new assistant after one month training. Watch in HD.
“Make it a point to do something every day that you don’t want to do. This is the golden rule for acquiring the habit of doing your duty without pain.” Mark Twain.
PhD. MSc. Dr. Pablo Salmeron.
In this post I’m going to talk about vertical fractures regarding a case I had a few months ago, the one on the right picture. This maxillary first premolar was ready to get a root canal therapy but presented a mesiodistally vertical coronal fracture that continued to the furca which divided the tooth in two roots, bucal and palatal. The tooth had an old restoration on the distal side that was not in occlusion and that probably let the fracture appear on the mesial area where you can see the line fracture. The tooth was also sensitive to vertical percussion and had some mobility, however, there wasn’t significant evidence or bone loss on the radiographic tests.
Most of the vertical fractures are due to excessive concentration of loading over some areas of the root canal. Studies have shown that the curvature of the root canal seems more important than the external morphology of the root, in terms of stress concentration, the remaining thin dentin increases the magnitude but not the direction of the stress generated by forces. In fact as thinner the mesiodistal dentin walls are, the concentration of forces on the lingual and bucal walls increase the risk of fracture in this direction contrary to what one might think at first, more dentin thickness the harder it is to break in that direction, well… it is not like that.
Diagnosis vertical fractures are a challenge for the dentist because the symptoms are similar to a failed root canal treatment and usually radiographic test doesn’t show evidence of a fracture clearly. Another problem in endodontically treated teeth is often the filling materials doesn’t allow us to see the fracture line on the radiograph as they’re in the same plane. Patients may experience anxiety to thinking that the endodontic treatment is not working when, in fact, the problem is a fracture prior or post to the root canal treatment.
Discipline is any training intended to produce a specific character or pattern of behaviour. Discipline is nothing but point a goal and achieve it through a protocol, discipline is consistency, discipline is hit the stone always in the same place, always with a good guidance of course.
