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Review of Ruddle on Retreatment Review of Ruddle on Retreatment Amy Beth Dukoff, D.M.D. Management of Blocks, Ledges, Transportation, and Perforations A Review of Ruddle on Retreatment Amy Dukoff r. Cliff Ruddle is the founder and director of Ruddle videotapes Advanced Endodontics. He gives lectures, presents hands-on workshops, and has a micro endodontic training center. This tape will show these techniques and provide more information. This videotape reviews previously taught endodontic techniques with alternative methods of treatment. In this tape, the techniques are demontrated with plastic models, extracted teeth, operating on patients and 3-D animation. Amy Dukoff Each segment is organized, explanatory, and well thought- out. Dr. Ruddle outlines his approach to a case’s treatment plan and his rationale for it. For example, crown-down is explained visually, and and Dr. Ruddle explains why it is important to open the coronal third before the apical third. He explains how opening the coronal one-third facilitates the apical instrumentation. MTA is described with its use and application. Furthermore, Dr. Ruddle incorporates CollaCote in his treatment plans. He says that he makes a “breakdown into a breakthrough.” Of course, tooth selection along with great access is a must. The video is worth watching. He reveiws techniques and basic concepts well. I highly recommend this tape. Dr. Ruddle has a very positive attitude in support of his process. His encouraging style of teaching the material enhances the tape. 11/02/1999 ENDO TIP You can reach Dr. Ruddle at: Advanced Endodontics 227 Las Alturas Road Santa Barbara, CA 93103 Phone: (800) 753-3636 Fax: (805) 965-8253 www.endoinfo.com [ﺩﻡﺡﻡ file:///D|/HEALTH/DENTISTRY/L%20E%20C%20T%20U%20R%20E%20S/E%20N%20D%20O/endomail/articles/ad01ruddle.html[2/21/2011 10:24:50 Review of Ruddle on Retreatment FEEDBACK? We welcome your responses and questions. Please feel free to visit the Endo Forum and add your comments about any of the articles in Endo-Mail. © Copyright 2000 by Musikant, Deutsch, Kase, Dukoff, Bui, & Hoffman. All rights reserved. [ﺩﻡﺡﻡ file:///D|/HEALTH/DENTISTRY/L%20E%20C%20T%20U%20R%20E%20S/E%20N%20D%20O/endomail/articles/ad01ruddle.html[2/21/2011 10:24:50 Vicoprofen Product Review Amy Beth Dukoff, D.M.D. Vicoprofen: Effective Pain Relief? A Product Review Amy Dukoff icoprofen combines two widely used analgesics. It produces a wonderful combination for the management of dental pain. The additive effect provides the doctor with an alternative for the patient seeking pain relief. The Vicoprofen tablet is 7.5 mg of Hydrocodone Bitrate with 200 mg of Ibuprofen. Hydrocodone Bitrate is a semi- synthetic, central acting opoid. Ibuprofren is a non-steroidal anti-inflammatory, peripheral acting drug. It is supplied in a fixed combination orally for short term usage (usually less Amy Dukoff than 10 days). Any contraindications and warnings for Ibuprofren are the same for Hydrocodone and Ibuprofen respectively. Knoll Pharmaceutical Company provides research describing the analgesic. They claim that there is a rapid onset of 11.0 to 16.2 minutes with its maximum effect in one hour. They also claim that most adverse reactions were mild and moderate with gastrointestinal reactions common. The manufacturer recommends 1 tablet every four to six hours with a maximum dosage of 5 tablets for a 24-hour period. Their study found that one Vicoprofen (7.5 mg) was equal in relieving pain to two tablets of acetaminophen with codeine (300 mg/30 mg x 2). The suggested prescription is Vicoprofen #40 Tabs. I usually dispense #12—#16, with instructions to take one tablet every 4-6 hours as needed for pain. I give this product a Four Star rating. I like hydrocodone for some of my patients because they tolerate it better than codeine. Some patients don’t like the side effects of codeine but aren’t allergic to it and would like pain relief similar to codeine’s narcotic effects. Ibuprofen has also been shown to be effective in treating inflammation. In the past, I have had the patients alternate between Tylenol with codeine and Advil. Vicoprofen in this combination seems to be effective and worth trying. 11/02/1999 FEEDBACK? We welcome your responses and questions. Please feel free to visit the Endo Forum and add your comments about any of the articles in Endo-Mail. [ﺩﻡﺡﻡ file:///D|/HEALTH/DENTISTRY/L%20E%20C%20T%20U%20R%20E%20S/E%20N%20D%20O/endomail/articles/ad02vicoprofen.html[2/21/2011 10:24:50 Vicoprofen Product Review © Copyright 2000 by Musikant, Deutsch, Kase, Dukoff, Bui, & Hoffman. All rights reserved. [ﺩﻡﺡﻡ file:///D|/HEALTH/DENTISTRY/L%20E%20C%20T%20U%20R%20E%20S/E%20N%20D%20O/endomail/articles/ad02vicoprofen.html[2/21/2011 10:24:50 Review of Pro Root Instructional Video Amy Beth Dukoff, D.M.D. Pro Root Instructional Video A Product Review Amy Dukoff RO ROOT is an instructional video by Densply and Tulsa Dental. Its subject is MTA (Mineral Trioxide Aggregate), which is a new material with a variety of uses. MTA can be used as a repair material for the root structure. One application is for procedural errors. MTA adheres well to the root wall. Also, it seals in cases of internal resorbtion and furcal communications. In addition, the video shows cases of success during apexification, pulp-capping pulpotomies, and as a root end Amy Dukoff seal. The video discusses MTA’s properties. The video states that MTA allows for normal healing, new cementum growth, adequate setting time, and the “least” leakage. They give supporting research. The video is informative and direct. I recommend viewing the video, and I also recommend the clinical use of MTA. MTA has been an adjuct in my practice. I have found that MTA does seal and repair well, but my method of dispensing the material for each use differs from the method shown in the video. I am more frugal, using only a small amount of the powder with a correspondingly small amount of distilled water. I use the packet for more than one procedure, and it works well. On the whole, the video is a good educational tool. November-December 2000 FEEDBACK? We welcome your responses and questions. Please feel free to visit the Endo Forum and add your comments about any of the articles in Endo-Mail. © Copyright 2000 by Musikant, Deutsch, Kase, Dukoff, Bui, & Hoffman. All rights reserved. [ﺩﻡﺡﻡ file:///D|/HEALTH/DENTISTRY/L%20E%20C%20T%20U%20R%20E%20S/E%20N%20D%20O/endomail/articles/ad03proroot.html[2/21/2011 10:24:50 Review of Celebrex and COX-2 Amy Beth Dukoff, D.M.D. Celebrex and COX-2 A Product Review Amy Dukoff ELEBREX IS A COX-2, nonsteroidal, anti- inflammatory drug. Celebrex is made by Searle/Pfizer and is the brand name for celecoxib. The recommended dose is 200 mg daily or 100 mg twice a day. COX-2 is an isoform of cyclooxygenase (COX). Cyclooxygenases are used in the cyclooxygenase pathway of the inflammatory process. Cyclooxygenases occur in two Celebrex isoforms: COX-1 and COX-2. They are used in the metabolism of arachidonic acid to produce prostaglandins. Amy Dukoff COX-1 affects upper gastrointestinal tract mucosal protection and platelet aggregation. COX -1 is seen in many tissues, yet COX-2 presence may go unnoticed. They both are important in mediating inflammation and pain. Celebrex inhibits COX-2 and not COX-1. Therefore, the upper gastrointestinal mucosal protection remains, and studies have shown that COX-2 non-inflammatory drugs have a lower incidence of gastrointestinal ulceration than conventional non-steroidal anti-inflammatories. Celebrex does have some limitations. It cannot be taken with Bactrim or Septra. Also, if your patient is on Librium, you should be cautious with its use, Furthermore, for some patients the expense can be a factor, since Celebrex costs $2.50 per pill. As with all non-steroidal anti-inflammatories, one must take heed of the contra-indications for this family of drugs. March-April 2001 FEEDBACK? We welcome your responses and questions. Please feel free to visit the Endo Forum and add your comments about any of the articles in Endo-Mail. © Copyright 2000 by Musikant, Deutsch, Kase, Dukoff, Bui, & Hoffman. All rights reserved. [ﺩﻡﺡﻡ file:///D|/HEALTH/DENTISTRY/L%20E%20C%20T%20U%20R%20E%20S/E%20N%20D%20O/endomail/articles/ad04celebrex.html[2/21/2011 10:24:51 The Importance of Diagnosis Amy Beth Dukoff, D.M.D. The Importance of Diagnosis Amy Dukoff IAGNOSIS IS ESSENTIAL before initiating root A good mutual canal therapy. A separate appointment is often needed understanding to diagnosis accurately. If the patient’s need is odontogenic, the patent will be grateful that the right tooth is treated so that of the his symptoms are dissipated. If it is not odontogenic, the treatment and proper referral or treatment is needed. proper The patient’s symptoms and the patient’s description of what he or she thinks has happened to the tooth are diagnosis is important, of course. However, after a patient explains why important in Amy Dukoff he feels it is a specific tooth, the patient may pinpoint another attaining a tooth. A complete diagnosis is needed for an understanding successful of the patient’s chief complaint; that diagnosis includes objective findings of clinical and radiographic examination outcome. and clinical tests. Clinical findings are not limited to pulp vitality tests, intra-oral or extra-oral exam. One must also evaluate for TMD ( tempromandibular disorder). Furthermore, evaluating for bruxism, clenching, and abnormal habits can lead to additional clues to conditions that might affect the patient’s symptoms. Finally, radiographic examination and evaluation are required.
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