Things I learned about:
Dr. Snyder had a full day of tooth try-in and delivery of partials and dentures. He uses Hydent Aerosol Denture Indicator Paste, although he also has PIP paste available. He prefers the spray because it's much easier to clean and there are no messy brushes.
He then introduced me to TAP® 3 (Thornton Adjustable Positioner)
The TAP 3 is a mandibular advancement device for the treatment of snoring and sleep apnea. It is a custom-made, two-piece appliance that snaps firmly and comfortably over the upper and lower teeth, much like a sports mouthguard or retainer. Its basic function is to hold the jaw forward so the tongue and soft tissues of the throat do not collapse into the throat causing snoring and sleep apnea. The unique design allows the patient to adjust the degree to which the lower jaw is held forward, simultaneously allowing maximum comfort and effectiveness.
Dr. Snyder told me that he used a George Gauage and the instructions can be found in the following link: TAP 3 Clinical Technique Guide
Dr. Snyder warned me that I should never make a TAP 3 for just sleep apnea but only for snoring. We are not able to diagnose and the patient has to go to their physician for the dx.
So, ask the patient if they would like something for their snoring and if they say yes, then you can Rx them a TAP 3.
After delivery of TAP 3, Dr. Snyder asked the patient to snore, and the the patient was not able to do so. Then he took the device off and told the patient to snore and the patient snored really loud. He was so happy about the device and admitted that his wife will be even happier. He also told me that he had tried the CPAP already and hated it.
Finally, Dr. Snyder emphasized the need for a Bite Tab . All patients using mandibular advancement orthotics for the management of sleep disordered breathing will feel temporary changes to their bite each morning. The bite tab was then created for the patient so that he can recover his bite.
RCT #20 - Using EndoSequence Endodontic System by Brasseler
I was so excited to observe Dr. Snyder perform a root canal on through PFM #20. He used two different burs, one to get through the porcelain and another to get through the metal for the access. He then put on a rubber dam and told me that it helps him with the orientation if he doesn't have the rubber dam on for the access. He then used SS files to get working length and from there used rotary files by Brasseler. The nice thing about the rotary files system is that if the file is getting close to bind, it will beep and rotate in the opposite direction. He then used taper-matching paper points and gutta percha to obturate. It took only 20 minutes for the whole procedure and the patient found it completely stress-free. The access was then filled with composite and the patient was told that prognosis for premolars is fair-good and the procedure went well so we just have to wait and see how the tissues repond and heal.
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