CE Hours: 0.75

Description: Vital pulp therapy (VPT) has gained more attention in the past decade due to the use of calcium silicate-based cement, understanding of the biological and molecular basis of pulp response to infection and knowing the regenerative capacity of dental pulp stem cells. Calcium hydroxide has been the pulp capping materials for half a century; however, it has not been a popular practice for carious pulp exposure or teeth with symptomatic pulpitis due to low success rates. Furthermore, it has been a clinical perception that pulp capping with Ca((OH)2 would lead to severe canal calcification. For these reasons, VPT therapy has not been a mainstream practice in the endodontic specialty. The introduction of MTA, discovery of dental pulp stem cells, and the advancement of the understanding of pulp inflammation in the past decade led to the resurrection of VPT. This presentation will discuss several key areas concerning VPT that either have been misunderstood or lack of understanding: i) Source of replacement odontoblasts and the quality of the new dentin, ii) progression of pulp inflammation responding to infection, iii) pulp stem cell response to the capping materials, iv) the mystery of pulp undergoing calcific metamorphosis after capping, and v) biological basis of clinical failure and how to improve success rates.

Learning Objectives:  

• Describe the source of replacement odontoblasts from the pulp.
• Clarify the nature of pulp calcific metamorphosis.
• Relate the knowledge of the biological and molecular basis of pulp inflammation to diagnosis and treatment outcomes including clinical failures.

CE Hours: 1.5

Description: This presentation will provide an overview of the relationship between trauma and root resorption. It will be clinically focused discussing management principles of various types of root resorption through a series of case illustrations to include inflammatory root resorption, replacement root resorption and invasive cervical resorption. Diagnosis, Classification and Etiology of root resorption will also be reviewed.

Learning Objectives:  

• Explain the clinical methods used for determining what type of resorption has been encountered.
• Differentiate key factors related to each of the various types of root resorption seen in the endodontic practice.
• Describe general principals of management for each type of root resorption.

CE Hours: 0.75

Description: Maxillary sinusitis of endodontic origin refers specifically to sinusitis secondary to periradicular disease of endodontic origin. This pathology requires an accurate diagnosis followed by appropriate endodontic treatment to remove the source of endodontic pathogens associated with the periapical disease and secondary sinus infection. The use of CBCT imaging significantly improve the ability to detect mucosal soft tissue changes, sinus membrane thickening and odontogenic sources for sinusitis, such as untreated canals. In this presentation, several cases of maxillary sinusitis of endodontic and dental origin, with different manifestations, diagnostic challenges, treatment and outcomes will be described. All of them with inflammatory sinus changes represented by mucositis, osteoperiostitis or partial obstruction; that showed sinus signs and symptoms which disappeared after dental management. In most of them, the sinus condition had an endodontic origin, however, in one case, sinusitis was caused by trauma to the face. All cases had a satisfactory response of the periradicular tissues and maxillary sinus to treatment that consisted of root canal therapy or trauma management.

Learning Objectives:  

• Describe classification of maxillary sinusitis of endodontic origin.
• Diagnose through CBCT maxillary sinusitis associated with endodontic infection.
• Evaluate different treatment alternatives for teeth causing maxillary sinusitis.

CE Hours: 0.75

Description: The primary objective of root canal obturation is to create a thorough three-dimensional seal of the canal space following chemomechanical debridement to prevent microleakage and bacterial re-contamination. Voids within the root canal fillings act as reservoirs for microorganisms, significantly impacting the effectiveness of the treatment. Tricalcium silicate sealers are known for their excellent biocompatibility, chemical stability, flowability, and  radiopacity. Recent clinical observations have shown a success rate of 90.9% when using a premixed tricalcium silicate sealer with the single-cone technique over a period of 30.1 months. Despite these advantages, in vitro studies reveal that this method may lead to the formation of voids, occupying up to 6.29% of the canal volume in round or slightly oval canals, and as much as 15.39% in more elongated canals.This presentation introduces a refined obturation technique that involves the application of a mild apical negative pressure during the insertion of the tricalcium silicate sealer. This method facilitates the sealer's movement from the canal orifice to the apex, effectively reaching full working length. The technique, when combined with the single-cone method, significantly reduces void formation in elongated root canals to just 0.42%, compared to 15.39% with the traditional method alone. This approach enhances the quality of root canal fillings by minimizing voids and avoids complications such as sealer extrusion by using smaller taper and size gutta-percha points. Unlike the vacuum obturation method proposed by Dr. Adrian Lussi, this negative pressure technique simplifies the procedure, offering a practical and efficient solution for practitioners.

Learning Objectives:  

• Describe the limitations of traditional root canal obturation, including the formation of voids.
• Utilize the principle behind the negative pressure obturation technique, to minimize void formation and improve the quality of seal in the root canal.
• Compare the performance of the negative pressure obturation technique with conventional singlecone and other obturation methods.

CE Hours: 0.75

Description: Evidence-based research consistently demonstrates the correlation between microbial contamination of the root canal system and apical periodontitis. Cleaning and disinfection of the apical third remains one of the most critical factors leading to healing and favorable endodontic outcome. Besides the microbiological challenges, from a clinical perspective, the root canal system imposes physical and anatomical complex challenges that are difficult to overcome. The development of new technologies and new evidence from the literature has only widened the already existing debate. The purpose of this presentation will be to provide a clinical perspective on how to overcome these challenges in order to obtain a predictable and efficient disinfection of the apical third.

Learning Objectives:  

• Review the clinical challenges for disinfection of the apical third.
• Describe the advantages and disadvantages of contemporary techniques.
• Discuss new clinical protocols to enhance disinfection and increase predictability.

CE Hours: 1.0

Description: Vital pulp therapy offers a promising approach to significantly prolong the lifespan of a tooth. Over the past decade, the evidence and outcomes associated with vital pulp treatment have evolved substantially. In 2021, the American Association of Endodontists (AAE) released a new position paper on this topic, providing a foundation for updated practices. This presentation will build on that foundation to highlight key aspects of vital pulp therapy, with a primary focus on managing teeth with carious exposures and symptoms of irreversible pulpitis. Through case-based analysis, it will explore treatment options grounded in evidence-based protocols. Additionally, the presentation will address common challenges to implementation, such as coding, scheduling, and material selection.

Learning Objectives:  

• Identify appropriate teeth for various treatment options and understand the expected outcomes for each approach.
• Gain a comprehensive understanding of the essential steps involved in performing vital pulp therapy.
• Evaluate the key prognostic factors that influence the success of vital pulp treatment.

CE Hours: 1.5

Description: Every practice transition is distinct, and each one is driven by the unique personalities of the individuals and businesses involved in the deal. And while the same can be said of the legal and strategic business considerations involved in practice transitions, there are many issues that are common across all of them. During this presentation, David M. Aafedt, Shareholder, Practice Group Leader and Board Member at the Minneapolis Law Firm of Winthrop & Weinstine, P.A., will explore the key business and legal considerations to keep in mind during any practice transition, whether the sale is being made to an individual, a practice group, or a DSO.

Learning Objectives:

• Describe the steps that a prospective seller or purchaser should undertake before commencing the transition process.
• Identify the due diligence that should be undertaken prior to closing on any practice transition.
• Summarize the key legal and strategic business considerations that arise in a practice transition.

CE Hours: 1.5

Description: The restoration of endodontic access cavity and subsequent build-up is a task which would historically be granted to referring general dentist or restorative dentist. Endodontists would have traditionally more surgical background with limited restorative skills. Nevertheless with the onset of adhesive protocols and techniques it is far more advantageous for the endodontist to be able to seal and rebuild the tooth core immediately after any procedure inside or near pulpal cavity - may it be RCT, NS-RCRT or vital pulp therapy. The presentation will guide through current possibilities to securely close and restore any core defect. Due to specific nature of the endodontic access cavity, great care must be paid to dentin adhesion and resin composite shrinkage issue. Outcome of such action will result in immediate seal of the root canal system and steady stress distribution within the remaining hard dental tissues.

Learning Objectives:  

• Identify clinically relevant factors of adhesive postendodontic treatment
• Indicate the need to use a fiberpost or other form of resin composite during adhesive postendodontic treatment
• Describe in detail the single session procedure steps of adhesive buildup.

CE Hours: 0.75

Description: Endodontic microsurgery (EMS) procedures demand high precision and accuracy. Among all outcome predictors, a ‘major procedural error’ during surgery in ostectomy for root apex identification and root end management seems to be the most impacting factor. Data from AAE active members indicate that access and visualization followed by root-end management are considered the most difficult stages for surgery. Most responders would positively consider additional advanced learning through new technologies. The conventional approach relies entirely on a free hand technique, which is operator dependent and subjected to difficulties and risk of complications. Among preclinical training options, 3D printed jaw models or cadaver lab are mostly utilized. However, they are destructive procedures and usually affected by high costs. Virtual reality simulations are demonstrating a huge potential and stimulating increased attention in dental medicine as a teaching tool. They provide a new and non-destructive approach whereby the operator can practice and repeat procedures with no limitations. The physical interactivity through haptic technology provides tactile force feedback to the user. To date there are no VR simulators equipped with software exercises to plan and practice EMS: osteotomy, apicectomy and ultrasonic retro preparation with real time assessment of the performance. The aim of this presentation is to illustrate the application of VR haptic simulation in endodontics and the creation of a novel virtual reality haptic training program in EMS. Furthermore, the potential integration with artificial intelligence and sensors based ergonomic software for student/operator profiling, quality assessment and risk prevention will be also discussed.

Learning Objectives:  

• Describe the applications of virtual reality and haptic simulation in endodontics.
• Evaluate the impact of virtual reality simulation into clinical practice.
• Discuss the advantages of the integration of virtual reality simulation with artificial intelligence.

CE Hours: 1.0

Description: This lecture will discuss novel rolls CBCT plays in endodontics beyond basic diagnosis.  Topics include technological advances, dynamic navigation, augmented reality, and guided procedures.

Learning Objectives:  

• Describe the advantages of CBCT use in endodontics.
• Talk about novel uses of CBCT in the endodontic practice.
• Describe where the future is headed for CBCT use in the endodontic practice.