Dr Jean Philippe Mallet

Biography

Dr Jean Philippe Mallet has a dental practice limited to Endodontics in Paris (France). He graduated from the University Paris V – René Descartes (Paris, France). He is currently Teaching Associate at the University Paul Sabatier (Toulouse, France). Jean Philippe is also Past Assistant Professor at University Paris V; member of the editorial board of ENDO (Quintessence) and Past President of the French Society of Endodontics

Synopsis

Endodontic Microsurgery may be a solution to remove an apical lesion and treat the endodontic cause of the infection, especially if the lesion is a cyst or if the retreatment too destructive for a good prognosis. Introduction of CBCT analysis allow a pre-study to analyze the surgical approach of the lesion.
In the Area of “minimally invasive dentistry” the soft tissue management associated to a lower bone destruction would be the best approach for endodontic surgery. Thus, the choice of a contemporary flap design and the use of piezo and ultrasonic instrumentation should be parts of the responses. For example, on lower molars, the access must be difficult or very invasive with a thick mandibular bone (external oblique line), and on upper molars the sinus apical projection may make the access more complex.Then, the “Cortical Bone Window” approach can be the minimally invasive solution. Thus, the visibility and the access of the lesion for the root preparation and filling would be more predictable.
To be released, the quadrilateral piece of cortical bone can be cut with piezo inserts in order to be more precise, less invasive and safe with the non-body anatomical structures. Added to a PRF preparations (clots and membranes) the stable re-seating of the window will allow a better and quicker bone healing.

On endodontic surgery, the “Cortical Bone Window” technique may allow the operator an easier surgery and a quicker healing with a high regenerative healing potential, especially on molar operative site.

Key learning point

By the end of this presentation attendees will be able to:
– Analyze the indication of the “Cortical Bone Window” technique on molars
endo- surgery.
– Describe the surgical approach of the “Cortical Bone Window” technique
– Give benefits of the “Cortical Bone Window” technique added to a PRF preparation.