powerpoint hf remover dealers en - coltene

POWERPOINT_HF_REMOVER_DEALERS_EN_V1

ENDODONTIC

RETREATMENTS

WHY, WHEN, HOW?

1


AGENDA

DEFINITION

CAUSES FOR FAILURES

SUCCESS RATES

ENDODONTIC RETREATMENT

WHY & WHENAN INCREASING

POTENTIAL

COMPETITIVE LANDSCAPE

WHY A NEW COLTENE FILE?

2


ENDODONTIC RETREATMENT

WHY & WHEN?

3


DEFINITIONS

NONSURGICAL RETREATMENT INCL. REMOVAL OF THE FILLING MATERIALS +

CLEANING & SHAPING

A procedure to remove root canal filling materials from the tooth, followed by cleaning, shaping and obturation

of the canals (AAE)

Non surgical retreatment is an endodontic procedure whose goals are "to remove materials from the root canal

space and, if present, address deficiencies or repair defects that are pathologic or in iatrogenic origin" (C.J

Ruddle)

ENDODONTIC

RETREATMENT

4


WHY RETREATING A

TOOTH?

1. In case of failure of the initial Root Canal Treatment (RCT)

2. The initial treatment was successful but a new problem appears (new decay, broken

crown, tooth fracture…)

3. In case of a new restoration (technical retreatment)

ENDODONTIC

RETREATMENT

5


CAUSES FOR FAILURES OF

INITIAL RCT

Improper selection of the treatment strategy

Incorrect oral examination

Misinterpretation of radiographs

Operative causes

ENDODONTIC

RETREATMENT

6


ACCESS

PREPARATIO

N

01

CANAL

PREPARATION

IRRIGATION

OBTURATION

OTHER CAUSES

OF FAILURES

Perforation

Under or overextended

preparation

CAUSES FOR

FAILURES OF

RCT

Operative causes : failure to obtain

biomechanics and biological

objectives ACCESS

PREPARATION

7

Source : aae.org


CANAL

PREPARATIO

N

02ACCESS

PREPARATI

ON

IRRIGATION

OBTURATION

OTHER

CAUSES

Perforations

Ledge formation

Canal blockage / Untreated

calcified canal

Missed canal

Instrument separation

CAUSES FOR

FAILURES OF

RCT



objectives

CANAL

PREPARATION

8

Source : aae.org


IRRIGATION

03ACCESS

PREPARATI

ON

CANAL

PREPARATIO

N

OBTURATI

ON

OTHER

CAUSE

S

Incorrect irrigants

Not enough disinfection of

the root canal

CAUSES FOR

FAILURES OF

RCT



objectives IRRIGATION

9


04ACCESS

PREPARATI

ON

CANAL

PREPARATI

ON

IRRIGATIO

N

OTHE

R

CAUSE

S

OBTURATIO

N

Overextended filling

Underextended filling

Periodontal involvement –

lateral and accessory

canals

CAUSES FOR

FAILURES OF

RCT



objectives

OBTURATION

10


OTHER

CAUSES

05ACCESS

PREPARATI

ON

CANAL

PREPARATI

ON

IRRIGATION

OBTURATIO

N

Poor coronal restoration

Resistant bacteria

Economic constraints

Inadequate sterilization of

instruments

CAUSES FOR

FAILURES OF

RCT



objectivesOTHER CAUSES

OF FAILURES

11


In other cases, a new problem can jeopardize

a tooth that was successfully treated.

For example:

New decay can expose the root canal filling

material to bacteria, causing a new infection

in the tooth

A loose, cracked or broken crown or filling can

expose the tooth to a new infection

A tooth sustains a fracture

CAUSES FOR

FAILURES OF

RCT

12

Source : aae.org


Figures on the outcome of initial Root Canal Treatment

(RCT)

Success rate of initial RCT varies from 74,7% (1) to 94% (2)

Most studies report an average success rate of 90% between 1 and 5 years (2), dropping at 73%

after 20 years (3)

Even with evolution of technique and materials (switch from handfiles to rotary Niti for e.g), there

were no improvement in success rate over the years (4)

SUCCESS RATE

13



(RCT)

The success rate is influenced by the type of

Operator

Tooth

Obturation

Coronal restoration

Patient

SUCCESS RATE

14


Figures on the outcome of initial Root Canal Treatment (RCT)

Type of Operator

Better success rate at 5 years is achieved for RCT performed by endodontists (98,1%) than GDPs

(89,7%) (5)

4 times more chance for good outcome if treatment is performed by a graduate dentist rather than a

student (6)

SUCCESS RATE

15



(RCT)

Type of tooth

Multi-rooted teeth, and particularly molars, have a lowest success rate (7, 11) due to a more complex

anatomy and less accessibility thus the treatment is more difficult

The success rate of infected teeth (periapical lesion) is decreased by 10%-20% compared to non-

infected teeth (8, 10)

SUCCESS RATE

16



(RCT)

Type of obturation, tooth and patient

Vertical compaction would have better outcome according to Chevigny et al. (2008) compared to lateral

condensation (12)

For tooth with coronal leakage of the restoration, the success rate is reduced by 20 (3, 9, 11)

For patients with auto immune diseases (diabetes, arthritis), the success rate is reduced by 8 (13)

SUCCESS RATE

17


Figures of retreatment

Success rate of retreatments goes from 92% to 98% if no apical pathology (16)

If apical pathology = 64-70% (16)

SUCCESS RATE

18

Example of a case addressed to an

endo-specialist



Other factors that may affect the success rate of retreatments:

Quality of the overall initial RCT

According to Chevigny et al. (2008) (14) and Farzaneh et al. (2004) (15), poor initial RCT will allow a

retreatment with increased success rate

SUCCESS RATE

19



Other factors that may affect the success rate of retreatments:


Quality of the first root canal obturation (17)

SUCCESS RATE

0

0,225

0,45

0,675

0,9

Bad QualityGood Quality

87%68%

-20%

20 Example of a case addressed to an endo-specialist



Other factors that may affect the success rate of

retreatments:


Quality of the first root canal obturation (17)

If altered anatomies: zipping, perforation, internal

resorption, canal transportation (18)

SUCCESS RATE

0

0,225

0,45

0,675

0,9

Original anatomyrespected

Original anatomyaltered

86%

48%

-40%

21

Example of a case

addressed to an endo-

specialist


As a conclusion…

No apical pathology = 92 – 98%

Apical pathology = 64 – 70%

Poor initial obturation = 87%

Good initial obturation = 68%

Original anatomy respected = 86%

Altered anatomy = 48%

SUCCESS RATE

22


WHY A NEW COLTENE FILE

FOR RETREATMENT?

23


TRENDS & STATISTICS ON

RETREATMENT

Globally, the trend is moving to retreatments

In average 30% retreatments (growing) and 70 % RCT with GDPs

In average 80% retreatments and 20 % RCT with endo specialists

WHY A NEW FILE ?

24


PRODUCT PORTFOLIO

ENLARGEMENT

Propose a comprehensive retreatment solution as no file specifically

dedicated to the retreatment yet

WHY A NEW FILE ?

25


THE VARIOUS TECHNIQUES OF

RETREATMENT

Handfiles: time consuming, risk of breakage

Ultrasound tips: mostly used for broken file removal, help the retreatment but not for the whole

procedure

Rotary NiTi files: no significant innovation since 2010

Reciprocating NiTi files

WHY A NEW FILE ?

26


THE VARIOUS TECHNIQUES OF

RETREATMENT

Rotary NiTi files and Reciprocating NiTi files from competition

WHY A NEW FILE ?

27


NUMBER OF FILES TO

REMOVE THE OBTURATION

MATERIAL

NUMBER OF USES

ACTIVE TIP ?

DIMENSIONS

OBTURATION MATERIAL

HyFlex

REMOVER

DENTSPLY SIRONA

PROTAPER UNIVERSAL

RETREATMENT

D1 D2 D3

VDW

RECIPROC,

RECIPROC BLUE

?

3

CANALS2 TO 8

CANALS

?

CANALS

1 3

CANAL INSTRUMENT

FOR TREATMENTS USED

FOR RETREATMENTS.

≃ 1

30. 07

L19 OR L2330. 09 25 .08 20 .07 ?

GUTTA PERCHA

GUTTA PERCHA POINTS, OBTURATORS

OR, EUGENOL BASED SOLUBLE PASTE.

THEY CANNOT BE USED TO UNFILL

RESINE TYPE PASTE

GUTTA-PERCHA

AND CARRIER-

BASED ROOT

CANAL FILLINGS

28

COMPETITION ANALYSIS


HyFlex REMOVER:

Single file

Heat treatment: to bypass previous ledges and efficient for removing the old obturation material

Non active tip

Mini-invasive wire diameter

Length: 19 and 23 mm

WHY A NEW FILE ?

29

A file specifically designed to REMOVE the obturation material


REMOVE

GUTTA PERCHA

30

HyFlex

REMOVER

POWERPOINT_HF_REMOVER_DEALERS_EN_V1 31

HyFlex

REMOVER


Complexity of retreatment procedures, especially removing the old filling material

Learning a new instrumental technique

Using excessive solvant, dangerous for patients

END USER CONCERNS

32


HyFlex REMOVER

TECHNICAL FEATURES &

BENEFITS

33


SINGLE FILE

HyFlex REMOVER : JUST ONE FILE TO REMOVE THE

OBTURATION MATERIAL

FEATURES & BENEFITS

HEAT TREATMENT

Flexibility

Cyclic fatigue resistance

Respect of the original

anatomy

PROTOCOL

WL*-3mm

Keeps the apical part

safe

34

*Working length


HyFlex REMOVER : JUST ONE FILE WITH UNIQUE FEATURES

SPECIALLY ADAPTED FOR REMOVING THE OBTURATION

MATERIAL

NON ACTIVE TIP

Decreased risk of ledges

Safe endo file

Respect of anatomy

Cutting efficiency thanks to active

edges

DESIGN

L19 or L23 - N°30 .07

Cross section:

o triple helix with open flute

o asymetrical in the coronal part

o regular taper .07

Debris removal

FEATURES & BENEFITS

35


HyFlex REMOVER : JUST ONE FILE WITH UNIQUE FEATURES

SPECIALLY ADAPTED FOR REMOVING THE OBTURATION

MATERIAL

USES

Single

use

1 patient

3 canals

WIRE

Wire of 1mm:

Flexibility

Preserves the dentine

Protection of the peri-cervical

part

Respect of anatomy

FEATURES

APPLICATION –

SETTINGS

Continuous rotation

Speed 400-800 rpm

Recommended

torque: 2.5 N.cm

36


HyFlex REMOVER

APPLICATION

37


OVERALL PROTOCOL

Access to the

canal entrances

HyFlex Orifice

Opener

Any Orifice

Opener

Removing the

filling material

HyFlex

REMOVER

HyFlex

REMOVER

Re-ShapingHyFlex EDM

HyFlex CM

Any Shaping

method

HyFlex REMOVER

APPLICATION

38


PROTOCOL

HyFlex REMOVER

HyFlex REMOVER

APPLICATION

WL*-3mm

Area with obturation

3 canals

Single use

39

HyFlex Remover ProtocolOrif ce opener

25.12

400 rpm

Max torque 2.5 N.cm

WL - 3 mm

400-800 rpm

Max torque 2.5 N.cm

Remover

3 mm

25/~ OneFile

400 rpm

Max torque 2.5 N.cm

Irrigatio

n

Irrigatio

n

HyFlex

SHAPING

FILES

* Working Length

HyFlexi


HyFlex REMOVER

APPLICATION

WL*-3mm

Area with obturation

3 canals

Single use

40

HyFlex Remover ProtocolOrif ce opener

25.12

400 rpm

Max torque 2.5 N.cm

WL - 3 mm

400-800 rpm

Max torque 2.5 N.cm

Remover

3 mm

25/~ OneFile

400 rpm

Max torque 2.5 N.cm

Irrigatio

n

Irrigatio

nRETREATMENT PROCEDURE

HyFlex REMOVER & HyFlex EDM

* Working Length

The choice of the shaping instruments to be used after HyFlex REMOVER is

subjected to the practitioner’s own decision, depending on the clinical case

HyFlexi


SETTINGS

Continuous rotation

Speed 400-800 rpm

Recommended torque: 2.5 N.cm

Compatible with any endo motor in continuous rotation

HyFlex REMOVER

APPLICATION

41


SITUATION AND BONUS

Only for Gutta percha obturation material (+sealer)

Most of retreatments

Target: Endo-specialists & General practitioners

HyFlex REMOVER

APPLICATION

Gutta Percha

42


References Designation

60023649 B5 HyFlex Remover L19 n30 7%

60023648 B5 HyFlex Remover L23 n30 7%

HyFlex REMOVER PRICE

Recommended retail price 56.5€ blister of 5

Suitable price to enter the market

Less expensive than competition

HyFlex REMOVER

APPLICATION

43


HyFlex

REMOVERTHE ESSENTIAL PIECE

OF YOUR RETREATMENT

44

HyFlex

REMOVER

POWERPOINT_HF_REMOVER_DEALERS_EN_V1 45

HyFlex REMOVER

Year of ce-marking: 2019 - medical device class IIa according to directive 93/42/eec - notified body: LNE/G-MED

Medical device for dental care, meant for professional dental use only, not reimbursed by social security.

See product labelling and instructions for use.

Legal manufacturer:

Micro-Mega SA

12, rue du tunnel

25000 BESANCON / France

Date of creation: 04.20

REF: POWERPOINT_HF_REMOVER_DEALERS_EN_V1


REFERENCES

HyFlex REMOVER

46


REFERENCES

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REFERENCES

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REFERENCES

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REFERENCES

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