CE Hours: 1.25

Description: ULTRASOUNDS REAL TIME IMAGING  (USI) is and advanced complement in  endodontic diagnostic techniques. Ultrasound  real-time imaging, (echography ), widely used in most  fields of medicine since its introduction  in 1942, is based on the generation and reflection of ultrasound waves  and on the different mechanical and acoustic  properties of body tissues.  USI does not use ionizing radiations, and thus it represents a safe exam. The most important features of USI  are its safety and  its ability to describe the content of the lesions within the maxillary bones, in terms of presence of solid tissue, different fluids and vascularity. The use of USI has been successfully  applied to the endodontic field for the  DETECTION and DESCRIPTION of apical periodontitis, for the  DIFFERENTIAL DIAGNOSIS between CYSTIC  and SOLID lesions of endodontic origin, and between endodontic lesions and non-endodontic lesions;  and also for evaluating the  short  and  long term outcome of  orthograde and  surgical endodontic treatment. An integrated system of CBCT and USI would provide the clinician with the tools for the complete assessment of apical periodontis.

Learning Objectives:  

• Describe the imaging technique called Ultrasound real-time examination, its main features and its biological safety.
• Describe  the most important advantages of using  Ultrasound real-time examination when applied to the visualization and description of lesions of apical periodontitis in the mandible and in the maxillary bone, their content and vascularization.
• Describe the advantages of using Ultrasound real-time examination, as a complement to 3D radiographic examination, to differentially diagnose bone  lesions with fluids or solid content, high, low, or no vascularity, to trace sinus tracts.

CE Hours: 0.75

Description: Our knowledge on the need for root canal disinfection has improved tremendously over the past decades and yet, much about how endodontic microbiota are organized into sessile communities i.e. biofilms, remains largely unexplored. While we know that these biofilms and their by-products are the principal causes of apical periodontitis, knowledge is still nascent on their cellular and extracellular composition, epigenetic influences that drive compositional changes and most importantly, their functional profiles. We provided the first reports on the role of biological cues relevant to root canal environment and microbial genetics on biofilm matrix development. Driven by this evidence and our findings on inhibiting bacterial communication, the aim of this presentation is to provide an overview and in-depth analysis of the lifestyle, composition and functional characteristics of the root canal microbiome. This presentation will be instrumental in guiding the development of novel approaches against endodontic biofilms and prevention of their recovery.

Learning Objectives:  

• Characterize the key properties of biofilms that contribute to their tolerance to antimicrobial agents and disinfection strategies.
• Discuss the current state of knowledge on microbial and functional profiles of the root canal microbiome.
• Describe innovative approaches to suppress and/or eliminate endodontic biofilms.

CE Hours: 1.0

Description: Hypertension is a common major systemic disease and 1 of the most significant causes of mortality worldwide. Persistent hypertension is 1 of the risk factors for stroke, heart attack, heart failure, and arterial aneurysm and is a leading cause of chronic kidney failure. Common medications used to treat hypertension include beta blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, and calcium channel blockers. The purpose of this study was to assess the prevalence of periapical abscesses in patients with different types of hypertension conditions and to evaluate the effect of commonly used antihypertensive medications on the prevalence of periapical abscesses.

• Assess the risk factors for patients with hypertention.
• Identify the common medications used to treat patients with hypertension.
• Recognize the possible prevalence of periapical abscesses in patients treated with different antitensive medications.

CE Hours: 1.0

Description: The pathological extension of periapical infection into the maxillary sinuses is often overlooked in clinical medical and dental practice, with its sequelae often misdiagnosed as rhinogenic sinusitis. This lecture explains and illustrates the similarities, distinguishing differences, and frequent inter-relationship between endodontic disease and paranasal sinus infections. The associated clinical and radiographic findings of maxillary sinusitis of endodontic origin (MSEO) are explained using many real-world clinical case examples with an update on the current literature. Emphasis is placed on the importance of CBCT imaging, magnification, proper terminology, and clinical expertise for rendering both non-surgical and surgical endodontic treatment when indicated. The goal is to help practitioners distinguish rhinosinusitis from odontogenic sinusitis, and specifically MSEO, in an effort to improve the health of patients through accurate diagnosis, appropriate treatment, and improved communication between endodontists and ENT specialists.

Learning Objectives: 

• Describe the clinical symptoms and radiograph similarities and differences between rhinogenic sinusitis and the various forms of odontogenic sinusitis.
• Describe the progression and pathogenic effects of apical periodontitis on the sinus tissues and the associated clinical and radiographic findings of maxillary sinusitis of endodontic origin (MSEO) using current terminology.
• Describe the importance of proper endodontic management for successful treatment of MSEO, recognizing the complexity of maxillary posterior canal morphology and the unique non-surgical and surgical challenges present with maxillary posterior teeth proximate to the maxillary sinus.