powerpoint hf remover dealers en - coltene
TRANSCRIPT
POWERPOINT_HF_REMOVER_DEALERS_EN_V1
ENDODONTIC
RETREATMENTS
WHY, WHEN, HOW?
1
POWERPOINT_HF_REMOVER_DEALERS_EN_V1
AGENDA
DEFINITION
CAUSES FOR FAILURES
SUCCESS RATES
ENDODONTIC RETREATMENT
WHY & WHENAN INCREASING
POTENTIAL
COMPETITIVE LANDSCAPE
WHY A NEW COLTENE FILE?
2
POWERPOINT_HF_REMOVER_DEALERS_EN_V1
ENDODONTIC RETREATMENT
WHY & WHEN?
3
POWERPOINT_HF_REMOVER_DEALERS_EN_V1
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
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
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
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
CAUSES FOR FAILURES OF
INITIAL RCT
Improper selection of the treatment strategy
Incorrect oral examination
Misinterpretation of radiographs
Operative causes
ENDODONTIC
RETREATMENT
6
POWERPOINT_HF_REMOVER_DEALERS_EN_V1
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
POWERPOINT_HF_REMOVER_DEALERS_EN_V1
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
Operative causes : failure to obtain
biomechanics and biological
objectives
CANAL
PREPARATION
8
Source : aae.org
POWERPOINT_HF_REMOVER_DEALERS_EN_V1
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
Operative causes : failure to obtain
biomechanics and biological
objectives IRRIGATION
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
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
Operative causes : failure to obtain
biomechanics and biological
objectives
OBTURATION
10
POWERPOINT_HF_REMOVER_DEALERS_EN_V1
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
Operative causes : failure to obtain
biomechanics and biological
objectivesOTHER CAUSES
OF FAILURES
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
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
POWERPOINT_HF_REMOVER_DEALERS_EN_V1
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
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
Figures on the outcome of initial Root Canal Treatment
(RCT)
The success rate is influenced by the type of
Operator
Tooth
Obturation
Coronal restoration
Patient
SUCCESS RATE
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
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
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
Figures on the outcome of initial Root Canal Treatment
(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
POWERPOINT_HF_REMOVER_DEALERS_EN_V1
Figures on the outcome of initial Root Canal Treatment
(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
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
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
POWERPOINT_HF_REMOVER_DEALERS_EN_V1
Figures of retreatment
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
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
Figures of retreatment
Other factors that may affect the success rate of retreatments:
Quality of the overall initial RCT
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
POWERPOINT_HF_REMOVER_DEALERS_EN_V1
Figures of retreatment
Other factors that may affect the success rate of
retreatments:
Quality of the overall initial RCT
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%
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Example of a case
addressed to an endo-
specialist
POWERPOINT_HF_REMOVER_DEALERS_EN_V1
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
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
WHY A NEW COLTENE FILE
FOR RETREATMENT?
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
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 ?
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
PRODUCT PORTFOLIO
ENLARGEMENT
Propose a comprehensive retreatment solution as no file specifically
dedicated to the retreatment yet
WHY A NEW FILE ?
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
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 ?
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
THE VARIOUS TECHNIQUES OF
RETREATMENT
Rotary NiTi files and Reciprocating NiTi files from competition
WHY A NEW FILE ?
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
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
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COMPETITION ANALYSIS
POWERPOINT_HF_REMOVER_DEALERS_EN_V1
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 ?
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A file specifically designed to REMOVE the obturation material
POWERPOINT_HF_REMOVER_DEALERS_EN_V1
REMOVE
GUTTA PERCHA
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HyFlex
REMOVER
POWERPOINT_HF_REMOVER_DEALERS_EN_V1 31
HyFlex
REMOVER
POWERPOINT_HF_REMOVER_DEALERS_EN_V1
Complexity of retreatment procedures, especially removing the old filling material
Learning a new instrumental technique
Using excessive solvant, dangerous for patients
END USER CONCERNS
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
HyFlex REMOVER
TECHNICAL FEATURES &
BENEFITS
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
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
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*Working length
POWERPOINT_HF_REMOVER_DEALERS_EN_V1
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
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
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
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
HyFlex REMOVER
APPLICATION
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
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
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
PROTOCOL
HyFlex REMOVER
HyFlex REMOVER
APPLICATION
WL*-3mm
Area with obturation
3 canals
Single use
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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
POWERPOINT_HF_REMOVER_DEALERS_EN_V1
HyFlex REMOVER
APPLICATION
WL*-3mm
Area with obturation
3 canals
Single use
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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
POWERPOINT_HF_REMOVER_DEALERS_EN_V1
SETTINGS
Continuous rotation
Speed 400-800 rpm
Recommended torque: 2.5 N.cm
Compatible with any endo motor in continuous rotation
HyFlex REMOVER
APPLICATION
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
SITUATION AND BONUS
Only for Gutta percha obturation material (+sealer)
Most of retreatments
Target: Endo-specialists & General practitioners
HyFlex REMOVER
APPLICATION
Gutta Percha
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
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
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
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
POWERPOINT_HF_REMOVER_DEALERS_EN_V1
REFERENCES
HyFlex REMOVER
46
POWERPOINT_HF_REMOVER_DEALERS_EN_V1
REFERENCES
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
REFERENCES
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POWERPOINT_HF_REMOVER_DEALERS_EN_V1
REFERENCES
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REFERENCES
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