Charles W. Ruefenacht DDS NMD IBDM AAOT Dallas Texas April 11-13, 2013

Ozone for the treatment of root sensitivity A. Symptoms B. Anatomical base C. Etiology D. Treatment protocol with ozone

Symptoms

Sharp, immediate, transitory pain to 1. cold 2. heat 3. air 4. biting*

Anatomy and Etiology

Enamel: 98% inorganic parallel enamel rods of HA crystalline brittle not tough

DEJ: interphase layer 50:50 collagen/mineral (vol) ~ 150 microns thick binds brittle enamel w/ tough dentin shock absorber allows for toughness prevents crack propagation Physical properties of the dentin-enamel junction region. Urabe, Nakajima, Sano, Tagami. American Journal of Dentistry, Vol 13, No 3, June 2000,

SEM etched dentin

SEM Dentin Dentin: 50% mineral, 30% collagen DEJ pulpchamer 2.8 micron pulp DEJ peritubular dentin: more highly mineralized odontoblast in each tubule

Martin Brannstrom: The Hydrodynamic Theory of Dential Pain: Sensation, Preparations, Cares and the Dentinal Crack. JOE Fluid movement through tubule stimulates the odontoblastic processes triggering pain fibers. 1. cold - outward 2. heat - compression 3. air - stretch, pain ends w/ desiccation.

1. identify the correct tooth gamma 3. high speed suction about 3/4 inch away from surface 4. apply ozone for about 10 seconds and re-test. 5. repeat ozone application until sensitivity gone. 6. collect money Ozone Treatment

Treatment 1. turn off pain fibers with ozone 2. stop fluid flow with bondable resins and probably with ‘plugs’ due to remineralization.

Now you know more than most dentists.

Thanks!