April 2018 Bacteria and the Root Canal System Cone Beam CT and Endodontic Treatment Prospects of Regrowing Pulps JournaCALIFORNIA DENTAL ASSOCIATION EVOLVING ASPECTS OF ENDODONTIC TREATMENTLEIF K. BAKLAND, DDS “I was convinced from my first order. The savings are very impressive!” —Dr. R in San Luis Obispo County, CA More shoppers. More savings for everyone. Join CDA members who are enjoying less overhead and more control. They’re sharing in big group purchasing benefits by shopping the TDSC Marketplace. See 20% average savings,* plus free shipping, on 25,000 dental supplies from authorized vendors. Shop, save and share today at tdsc.com. The Dentists Service *Price comparisons are made to the manufacturer’s list price. Actual savings on the TDSC Marketplace Company will vary on a product-by-product basis. April 2018 CDA JOURNAL, VOL 46, Nº4 DEPARTMENTS 209 The Editor/The TDSC Marketplace and You 213 Letter to the Editor 215 Impressions 269 RM Matters/Spring Cleaning Isn’t Limited to the Offi ce: Update Patient Records To Mitigate Risks 273 Regulatory Compliance/Managing Emergency Patients 278 Tech Trends 215 FEATURES 221 Evolving Aspects of Endodontic Treatment An introduction to the issue. Leif K. Bakland, DDS 227 Can We Eliminate Microorganisms From the Root Canal System? This article discusses the current status of irrigation effectiveness and progress. Markus Haapasalo, DDS, PhD 237 Can Use of Cone Beam Computed Tomography Have an Effect on Endodontic Treatment? This paper reviews the most updated guidelines for use of CBCT to illustrate the effects this has on clinical endodontic practice. Robert S. Roda, DDS, MS 249 Can We Regrow Pulps? This manuscript discusses techniques for managing teeth that will allow continued root development in young patients. Paul V. Abbott, BDS, MDS 260 Implant Dentistry and Endodontics: Can There Be a Mutually Beneficial Relationship? This article reports on the value of dental implants when indicated and the coexistence of endodontics and implant dentistry. Tory Silvestrin, DDS, MSD, and Charles J. Goodacre, DDS, MSD APRIL 2018 207 CDA JOURNAL, VOL 46, Nº4 Volume 46, Number 4 JournaCALIFORNIA DENTAL ASSOCIATION April 2018 CDA Classifieds. Free postings. published by the Editorial Production Manuscript California Kerry K. Carney, DDS, CDE Val B. Mina Submissions EDITOR-IN-CHIEF SENIOR GRAPHIC DESIGNER Priceless results. Dental Association www.editorialmanager. 1201 K St., 14th Floor [email protected] com/jcaldentassoc Sacramento, CA 95814 Randi Taylor SENIOR GRAPHIC DESIGNER 800.232.7645 Ruchi K. Sahota, DDS, CDE ASSOCIATE EDITOR cda.org Letters to the Editor Upcoming Topics www.editorialmanager. Brian K. Shue, DDS, CDE May/General Topics com/jcaldentassoc CDA Offi cers ASSOCIATE EDITOR Natasha A. Lee, DDS June/Millennial Dentists PRESIDENT Gayle Mathe, RDH July/Student Research Subscriptions SENIOR EDITOR [email protected] Subscriptions are available only to active members of R. Del Brunner, DDS Leif K. Bakland, DDS Advertising the Association. The PRESIDENT-ELECT GUEST EDITOR Sue Gardner subscription rate is $18 and [email protected] ADVERTISING SALES is included in membership Andrea LaMattina, CDE [email protected] dues. Nonmembers can PUBLICATIONS MANAGER Richard J. Nagy, DDS 916.554.4952 view the publication online VICE PRESIDENT at cda.org/journal. [email protected] Kristi Parker Johnson EDITORIAL SPECIALIST Permission and Manage your subscription Judee Tippett-Whyte, DDS Reprints online: go to cda.org, log in SECRETARY Blake Ellington Andrea LaMattina, CDE and update any changes to TECH TRENDS EDITOR [email protected] PUBLICATIONS MANAGER your mailing information. [email protected] Email questions or other Steven J. Kend, DDS Jack F. Conley, DDS 916.554.5950 changes to membership@ TREASURER EDITOR EMERITUS cda.org. [email protected] CDA classifiedsclassifieds workwork harder to Robert E. Horseman, DDS HUMORIST EMERITUS bbringring you resuresults.lts. SeSellinglling a practice Craig S. Yarborough, DDS, MBA or a piece ooff equipment? Now you SPEAKER OF THE HOUSE [email protected] can include photos to help buyers Stay Connected cda.org/journal Clelan G. Ehrler, DDS see the potential. IMMEDIATE PAST PRESIDENT [email protected] And if you’re hiring, candidates Management Journal of the California Dental Association (ISSN 1043–2256) is published monthly by the anywhere can apply right from California Dental Association, 1201 K St., 14th Floor, Sacramento, CA 95814, 916.554.5950. Peter A. DuBois Periodicals postage paid at Sacramento, Calif. Postmaster: Send address changes to Journal the site. Looking for a job? You can EXECUTIVE DIRECTOR of the California Dental Association, P.O. Box 13749, Sacramento, CA 95853. post that, too. And the best part— Jennifer George The California Dental Association holds the copyright for all articles and artwork published it’s free to all CDA members. CHIEF MARKETING OFFICER herein. The Journal of the California Dental Association is published under the supervision of CDA’s editorial staff . Neither the editorial staff , the editor, nor the association are responsible for Carrie E. Gordon any expression of opinion or statement of fact, all of which are published solely on the authority All of these features are designed to CHIEF STRATEGY OFFICER of the author whose name is indicated. The association reserves the right to illustrate, reduce, help you get the results you need, revise or reject any manuscript submitted. Articles are considered for publication on condition Alicia Malaby that they are contributed solely to the Journal. faster than ever. Check it out for COMMUNICATIONS DIRECTOR Copyright 2018 by the California Dental Association. All rights reserved. yourself at cda.org/classifieds. 208 APRIL 2018 Editor CDA JOURNAL, VOL 46, Nº4 The TDSC Marketplace and You Kerry K. Carney, DDS, CDE hen I was a child, we would order our shoes from the For the Marketplace to succeed and support Sears, Roebuck and our members, CDA members need to support Company catalog. I the Marketplace by using it to buy supplies. Wcan remember my mother tracing around my foot to record my footprint on a piece of paper that she would then send to the mail- order company. After some weeks, the box would arrive with my new penny loafers. It The Dentists Service Company is The staff member who does the ordering was easy and convenient. We did not have striving to recreate that experience for will have to change the way she or he has to drive into a big city to purchase shoes. our CDA members when we order dental ordered for years. This can be diffi cult. Sears and Roebuck began as a watch supplies through the TDSC Marketplace. There are issues of friendship, trust, loyalty, and jewelry mail-order company in 1893. The Marketplace was established to provide ease and familiarity. They may have had Rural areas at that time offered a limited CDA members with the same advantage the same dental supply representative for variety of items at prices that varied that large group practices enjoy in securing years. It can feel like a betrayal of a friend. according to the vendor’s inclination. favorable pricing. The price-negotiating Also, in some offi ces the dental supply rep The mail-order company expanded and power of CDA’s 27,000 members can does the inventory and restocking, thereby became successful because it offered a wide translate into reductions in overhead and saving the staff member the physical effort. selection of products at set, listed prices. In overall cost of providing patient care. But though this cooperation on the part 1906, Sears went public and was the fi rst For the Marketplace to succeed and of the rep may seem like it is free, we all major retail IPO in American fi nancial support our members, CDA members know the cost is part of the calculus that history. In the three decades between 1925 need to support the Marketplace by determines the supply prices. Sometimes and 1955, Sears expanded into brick-and- using it to buy supplies. This sounds the supply ordering may be the job of a staff mortar stores and the sales from those easy. The pricing is very good and the member who does not feel comfortable stores eventually exceeded the mail-order shipping is free. If they do not have the with the computer. This can make it revenue. In 1993, Sears discontinued its item you are looking for, they will try to hard to switch over to the online site. catalog. The company continued to expand source it for you so it will be available Therefore, it may be necessary to assign and its profi ts peaked at $1.5 billion in in the future. They are eager for your the job to another more computer-savvy 2006. However, just four years later, their feedback and will adapt to your needs and member of the offi ce team. Sometimes profi ts plummeted to virtually nothing. suggestions. It is easy to reach a human the hard job of changing gets in the way. The irony here is that in 1994, just to speak to for customer support and they In my offi ce, I was very excited about one year after Sears discontinued its strive for excellence in every customer the Marketplace. I introduced my staff catalog business, Jeff Bezos incorporated interaction. But I want to advise you of to it and said, “This is where we want to the company that would eventually one hurdle that you must overcome. place our orders.” I checked in a few days be known as Amazon. The mail-order When I talk with colleagues about later and asked, “Did you order this from business that had been abandoned by Sears the Marketplace, they “get it” right away. TDSC?” The answer was no. I explained was reinvented and became the online They understand how it can help their again that we wanted to support TDSC immediate-gratifi cation machine and the practices and they want to support an and place our orders there.