NYTT OG NYTTIG OM ENDODONTI NEF Årsmøte 5. til 7. Juni 2008 Tromsø Faglig og Sosialt Program 1
FAGLIG PROGRAM Torsdag 5. Juni Universitet i Tromsø (UiT) 12.00 - Ankomst/registrering ved Institutt for klinisk odontologi TANN, UiT. Servering: Kaffe/te enkel lunsj 12.45-13.45 - Omvisning på Tannbygget ved prof. Harald Eriksen 14.00-14.15 - Åpning - Nina Wiencke Gerner, NEF leder 14.15-15.15 - Endodontic retreatment vs. apicoectomy. When and why? - Gilberto Debelian 15.15-17.15 - Persistent orofacial pain after dental treatment: clinical perspectives, mechanisms and management strategies - Thuan Dao, Canada 17.30 - Buss tilbake til hotellet Fredag 6. Juni Grand Nordic Hotel 9.00-10.15 - The Success of Endodontic Therapy Healing and Function, del1 (75 min), Shimon Friedman, Canada 10.15-10.45 - Kaffepause og utstilling 10.45-12.15 - Shimon Friedman del 2 (90 min) 12.30-13.30 - Lunsj (1 time) 13.30-14.15 - Shimon Friedman del 3 (45 min) 14.15-14.30 - Kasuspresentasjon med Nicolai Orsteen, UiO -ledes av HaraldPrestegaard 14.30-15.00 - Kaffepause og utstilling 16.00-17.00 - Nytt og nyttig fra produsentene: Unident A/S, Technomedics Norge A/S, Lic Scandenta A/ S, Bergmann A/S, Jacobsen Dental, Colténe Whaledent, Norsk Dental Depot, Opus Dental, FKGDentaire. 17.00-17.15 - Pause 17.15-18.30 - Årsmøte i NEF Lørdag 7. Juni Grand Nordic Hotel 08.30-09.30 - Kasuspresentasjon - Thomas Myrhaug og Knut Årving, UiO - ledes av Gilberto Debelian 09.30-10.30 - From pulpitis to chronic pain - Inge Fristad, UiB 10.30-11.45 - Kaffe pause og utstilling 11.45-12.30 - The dental circulatory system - from basic research to clinical endodontics - Ellen Berggreen, UiB 12.30 - Avslutning - Nina Wiencke Gerner 13.00-14.00 - Lunsj 2
SOSIALT PROGRAM Torsdag 5. Juni 17.30 - Buss tilbake til hotellet 18.30 - Vi samles ved hotellet før avgang båttur. Båttur med MS Cetacea og servering om bord av Havets Festbord med drikke. Fredag 6. Juni 19.15 - Avreise med buss kl. 19.15 til Fjellheisen med middag og senere konsert Ishavskatedralen. Retur med buss til hotellet etter konserten. Lørdag 7. Juni 14.00 - Tid til egen disposisjon 17.15 - Avgang til Macks ølhall og senere middag på Sjøgata Mat og Vinhus kl. 20.00 3
ABSTRAKTER Endodontic retreatment vs. apicoectomy - when and why? Gilberto Debelian, dr. odont., spesialist i endodonti, UiO Follow-up studies have demonstrated excellent outcomes for endodontic treatment if performed based on biologic principles. However, cross-sectional studies of endodontic treatment on the general population show a large incidence of disease associated with these teeth (posttreatment endodontic disease - PTED). Thus, PTED is a consistent challenge to the general practitioner and endodontist. Healing of PTED will be predictable only if the etiological factor/s (intra and/or extra-radicular infection) is/are eliminated or substantially reduced. When a tooth with PTED is not considered to be extracted, retreatment and apical surgery are the two available therapies. Since both treatments can lead to successful results, the decision-making of which therapy to choose can sometimes be difficult for the clinician and for the patient. The treatment choice depends on several biological and clinical factors which involve the tooth to be treated, the operator and the patient. The purpose of this presentation is to give an overview of the biological and technical factors associated with teeth with PTED and also suggest when and why retreatment and/or apicoectomy should be the treatment of choice. Persistent orofacial pain after dental treatment: clinical perspectives, mechanisms and management strategies Thuan Dao, D.M.D., Ph.D., University of Toronto, Canada Persistent orofacial pain that is experienced after dental treatment can occur in the absence of a noxious stimulus, persist beyond the healing time, or spread to normal teeth and anatomical structures adjacent or distant to it. The poor localization of pain can lead to misdiagnosis of its source and result in mistreatment without improvement in patient comfort. During this session, clinical scenarios of unusual orofacial pain will be presented, and basic mechanisms of persistent pain associated with peripheral nerve damage will be reviewed. This will improve the clinician s ability for pain diagnosis, and provide the basis for understanding the evidence-based management of neuropathic pain. 4
ABSTRAKTER THE sucess of endodontic therapy- Healing and function Shimon Friedman, D.M.D., University of Toronto, Canada The outcome of endodontic therapy has been challenged, because of inconsistent reports that contrast with the consistently favourable reports for implant-supported single-tooth replacement. Indeed, the inconsistency of the endodontic outcomes has caused considerable confusion in the profession. Inherent to establishing the outcome is a definition of success in relation to the goals of therapy, and a review process geared towards identifying studies that satisfy design and methodology criteria consistent with acceptable level of evidence. This lecture will define the expected outcomes of endodontic therapy, identify outcome studies that comprise the best available evidence, and highlight the outcomes of non-surgical and surgical endodontic treatment in regards to healing and asymptomatic function of the treated teeth. From pulpitis to chronic pain Inge Fristad, dr. odont., spesialist i endodonti, UiB Primary afferent nerve fibres and neurons at higher levels form the basis for the transmission of pain from teeth. This lecture gives an overview over the pulpal nerve supply and the pathways of pain from teeth and surrounding tissues. The dental pulp is an end organ enclosed in hard tissues, lacking a collateral blood and nerve supply. These features make teeth susceptible to inflammatory pressure changes, witch often occur following caries, dental treatment and trauma. Inflammation may have a dramatic effect on the pulpal nerve fibres, resulting in both primary and secondary hyperalgesia. Inflammatory nerve changes, with emphasis on changes in the primary afferent nerve fibres and changes in the brain stem, are discussed. Nerve damage, resulting from dental procedures such as dental surgery and pulpectomy, also has an effect on the primary afferent nerve fibres and second order neurons in the brain stem. Such changes usually normalise after healing, but may in some instances persist resulting in chronic pain disorders. Mechanisms behind such disorders are discussed. 5
ABSTRAKTER The dental circulatory system - from basic research to clinical endodontics Ellen Berggreen, dr. odont., UiB The dental circulatory system is composed of the blood system and the lymphatic system. The lymphatic system is important for immune barrier function and for tissue fluid balance. Only lymphatics can remove protein and macromolecules from the tissue. During inflammation, new lymphatic vessels are formed to remove excess interstitial fluid and proteins derived from plasma by increased vascular permeability. In addition, the lymphatic vessels remove foreign invaders from the peripheral tissue, and therefore represent a transport system that can spread infections. Using specific lymphatic markers we have demonstrated an extensive dental lymphatic system. In molars, initial lymphatics were found in the coronal pulp, whereas in incisors they were found only in the apical part. In molars lymphatic vessels exited the pulp through the apex and lateral canals. In interdental bone, transverse lymphatics were found, raising the possibility that an infection can spread from the pulp to the periodontal ligament and to a neighbor tooth. In the dental pulp, arteriolar pulsation and bulk swelling of the interstitium may cause lymph propulsion, whereas in the periodontal ligament lymph propulsion can be achieved by tooth movement in the alveolar socket. Lymphangiogenesis take place in the pulp during inflammation, and macrophages are suggested to contribute in vessel formation. 6
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