The 22-year-old male patient had a history of trauma to his maxillary incisors and arrived at my practice with symptoms related to tooth #21. The tooth, opened in an emergency by the patient’s mother, was tender when prodded, with a moderate level of sensitivity on the respective buccal gingiva. Sensitivity tests were negative for the other central incisor (tooth #12 was positive), and a periapical radiograph showed radiolucency in the periapical areas of both of the central incisors. The apices of these teeth were quite wide and the length of teeth appeared to exceed 25 mm.

My treatment plan was as follows: root canal therapy with two apical plugs with a calcium silicate-based bioactive cement. The patient provided his consent for the treatment of the affected tooth and asked to have the other treated in a subsequent visit.

After isolating with a rubber dam, I removed the temporary filling, and then the entire pulp chamber roof with a low-speed round drill. The working length was immediately evaluated using an electronic apex locator and a 31 mm K-type file. The working length was determined to be 28 mm.

As can be seen in the photographs, the canal was actually quite wide, so I decided to only use an irrigating solution and not a shaping instrument. Root canals are usually shaped so that there will be enough space for proper irrigation and a proper shape for obturation. This usually means giving these canals a tapered shape to ensure good control when obturating. With open apices, a conical shape is not needed, and often there is enough space for placing the irrigating solution deep and close to the apex.

I decided to use only some syringes containing 5 per cent sodium hypochlorite and EDDY, a sonic tip produced by VDW, for delivery of the cleaning solution and to promote turbulence in the endodontic space and shear stress on the canal walls in order to remove the necrotic tissue faster and more effectively. After a rinse with sodium hypochlorite, the sonic tip was moved to and from the working length of the canal for 30 seconds. This procedure was repeated until the sodium hypochlorite seemed to become ineffective, was clear and had no bubbles. I did not use EDTA, as no debris or smear layer was produced.

I suctioned the sodium hypochlorite, checked the working length with a paper point and then obturated the canal with a of 3 mm in thickness plug of bioactive cement. I then took a radiograph before obturating the rest of the canal with warm gutta-percha. I used a compomer as a temporary filling material.

The symptoms resolved, so I conducted the second treatment only after some months, when the tooth #11 became tender. Tooth #21 had healed. I performed the same procedure and obtained the same outcome (the four-month follow-up radiograph showed healing).

Editorial note: A complete list of references are available from the publisher. This article was published in roots - international magazine of endodontology No. 04/2017.

Bergman joined Henry Schein in 1980 as the company’s first chief financial officer. After the death of then CEO Jay Schein in 1989, Bergman assumed leadership and guided the company through its transformation into a publicly traded enterprise, culminating in a 1995 initial public offering.

In a company press release, Bergman stated that recent strategic and managerial advances have made the end of this year “the right time for me to retire”. He said: “I look forward to working with the board to identify my successor and effect a smooth transition. Henry Schein has been my professional home for 45 years, and I will conclude this chapter of my life with enormous gratitude for the opportunity to serve as CEO and with great confidence in the company’s future.”

Philip A. Laskawy, lead director at the company, added: “Under Stan’s leadership, Henry Schein has become the global leader in providing dental and medical products and solutions for healthcare providers in alternate care settings, and we recognise the significant impact he has had on the company and the entire healthcare industry. We owe a tremendous debt of gratitude to Stan for his steadfast devotion to Henry Schein and for bringing his unique blend of strategic vision, attention to detail and entrepreneurship to the company.”

The company’s announcement followed a personal letter sent by Bergman to Henry Schein employees on the morning of 15 July. In the letter, he listed some of his greatest successes, including transforming the company from a US-based dental mail order company into a global dental distributor and advancing public–private partnerships to foster greater access to oral care. Company revenue during Bergman’s tenure increased from US$225.0 million in 1989 to nearly US$13.0 billion (€12.5 billion^*) in 2024, representing a compound annual growth rate of approximately 17.5%.

Henry Schein stoked succession rumours earlier this year when it agreed to a deal of purchase and collaboration with KKR. The private equity firm acquired US$250 million worth of the company’s common stock and was able to appoint its representatives William Daniel and Max Lin to the Henry Schein board of directors. Lin was named vice chair of the company’s nominating and governance committee, which is tasked with overseeing CEO succession.

Bergman commented in the press release: “As part of succession planning, the company has focused on developing the next generation of leaders and earlier this year simplified the business by separating into three operating divisions, each with outstanding leadership. I fully expect that Andrea Albertini, CEO of the Global Distribution Group—who also has responsibility for the Global Technology Group—and Tom Popeck, CEO of the Healthcare Specialties Group, together with the rest of the company’s executive management committee, will elevate Henry Schein to new heights.”

Tags: