Anesthesia
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Includes Credits
CE Hours: 0.75
Description: Endodontics has achieved significant progress in both diagnostic procedures and therapeutic approaches. However, the pharmacological management of acute endodontic pain still relies heavily on conventional strategies, predominantly based on systemic monotherapy. Although many of these approaches are clinically effective, their inappropriate or excessive use has contributed to relevant public health issues, particularly due to the misuse and overprescription of certain drugs. In this context, an important question arises: where should the future of acute endodontic pain management be directed? While the development of new analgesic drugs remains a long and expensive process, more accessible short-term alternatives may be considered. These include the combination of existing pharmacological agents to achieve synergistic effects, as well as the design of advanced drug delivery systems aimed at modulating peripheral mechanisms of pain transmission.Multimodal analgesia, through the use of synergistic combinations, allows for a shift in prescription habits-offering enhanced analgesic efficacy, reduced side effects, and shorter treatment durations. Furthermore, the incorporation of hydrogels, nanomaterials, and polymeric scaffolds as carriers for localized, controlled drug release presents a promising alternative that may significantly reduce the need for systemic drug exposure. This lecture explores currently available multimodal analgesic strategies in endodontics and discusses emerging peripheral alternatives that target pain control directly at its source. Such innovations may represent a paradigm shift in how dental professionals approach pharmacological pain management, promoting more precise, efficient, and safer therapeutic protocols.
Learning Objectives:
- Recognize the peripheral and central mechanisms involved in the development of endodontic dental pain.
- Identify the principles to propose effective pharmacological combinations by analyzing multimodal strategies based on analgesic synergism.
- Identify emerging drug delivery systems as a strategy for the peripheral control of endodontic pain.
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Includes Credits
CE Hours: 1.0
Description: This presentation will focus on two areas. 1) Serious adverse drug interactions that may occur in the Endodontic Patient because of drugs that he/she prescribes or administers and 2) Serious adverse drug interactions that may occur in the endodontist himself/herself because of drugs that they are taking for various medical conditions. The three serious drug interactions that may adversely affect the dental patient include; 1) the ability of the antimicrobials metronidazole and fluconazole to inhibit the metabolism of warfarin by blocking cytochrome P-450 2C9 (CYP-2C9), the major metabolic pathway of warfarin, resulting in dramatic increases in patients' international normalized ratios (INRs) and potentially fatal bleeding. 2) The ability of ibuprofen or naproxen sodium to inhibit the renal excretion of the major bipolar disorder drug lithium resulting in tremors, seizures and renal toxicity. 3) The ability of propranolol and other nonselective beta-adrenergic blocking agents to inhibit the vasodilatory effect of epinephrine in dental local anesthetic solutions, leading to severe hypertensive reactions and a concomitant reflex bradycardia. Interactions relevant to the health of dentists themselves include the ability of grapefruit juice/grapefruit to elevate blood levels of statin cholesterol lowering drugs, increasing the risk of myalgia, rhabdomyolysis and acute renal failure. It is important for clinicians to understand the theoretical basis behind these often-predictable interactions, and comprehend the evidenced-based-science that supports their existence.
Learning Objectives:
- Discuss the pharmacological mechanism behind the potentially lethal metronidazole or fluconazole/warfarin interaction.
- Discuss the rationale of why recommending ibuprofen (Advil®) and naproxen sodium (Aleve®) for pain control is a bad idea in a bipolar disorder patient taking lithium (Eskalith®).
- Identify which class of anti-hypertensive drugs where high doses but therapeutic doses of local anesthetic plus epinephrine is most likely to cause a a pressor response with a reflex bradycardia.
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Includes Credits
CE Hours: 1.25
Description: This course is an unbiased and evidence-based presentation of marijuana and its role in dentistry. I will present an introduction to the history of marijuana and trends pertaining to its use. Next, I will provide a basic science review regarding the Cannabis plant, the drug marijuana, and the Endocannabinoid System. I will review how marijuana use affects oral and general health. Finally, I will address areas of possible dental research related to cannabinoids.
Learning Objectives:
- Describe the Endocannabinoid System, what cannabinoids are, and how marijuana is connected.
- Define how marijuana affects oral and general health - specifically detailing oral pathology, dental caries, and periodontal disease
- Describe how to communicate with patients regularly using marijuana
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Includes Credits
CE Hours: 1.0
Description: Achieving anesthesia in mandibular molar teeth with irreversible pulpitis has been challenging. This study aimed to compare the efficacy of precooling articaine and increasing its dosage for inferior alveolar nerve block (IANB) in the mandibular first molars with symptomatic irreversible pulpitis.
At the conclusion of this article, the reader will be able to:
Explain the challenges in achieving successful inferior alveolar nerve block (IANB) anesthesia in mandibular first molars with symptomatic irreversible pulpitis.
Compare the effectiveness of precooling 4% articaine versus increasing its dosage on the success rate of IANB.
Apply evidence-based strategies to improve anesthesia outcomes and patient comfort in cases of symptomatic irreversible pulpitis.
Bafrin Fattahi, DDS, MSc
Negin Ghasemi, DDS, MSc
Sahar Shakouei, DDS, MSc
Mahsa Ladan Moghaddam, DDS, MSc
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Includes Credits
CE Hours: 1.5
Description: Endodontic complications of varying severity can unfortunately occur during most stages of endodontic treatment. This lecture aims to enhance understanding of common endodontic complications and recommends current management and solutions with an evidence-based approach. Preoperative, intraoperative and postoperative issues will be discussed, including possible aetiologies and prevention during root canal therapy. We will address the impact of complications on both patients and practitioners, underscoring the importance of clear communication in preserving the clinician-patient relationship. Attendees will gain current advice and knowledge on how to tackle endodontic complications effectively, fostering excellence in clinical practice and improved patient care.
Learning Objectives:
- Recognize and identify common endodontic complications.
- Implement evidence based management strategies.
- Develop strategies for preventing endodontic complications.
Bettina R. Basrani D.D.S., M.S.D., Ph.D.
Dr. Bettina Basrani is Tenured Associate Professor and Director, MSc Program in Endodontics at the Faculty of Dentistry, University of Toronto, Ontario, Canada since 2015. Dr Basrani received her DDS degree from the University of Buenos Aires and a Specialty Diploma in Endodontics and PhD from Maimonides University in Buenos Aires, Argentina. A long-time educator and researcher, she began her teaching career at the University of Buenos Aires. In 2000, she moved to Canada to serve as Chair of the Endodontic Program at Dalhousie University, Halifax, Nova Scotia. In 2004, she moved to Toronto, where she has continued her academic and clinical work. Internationally recognized as a leading authority in endodontics and as an excellent lecturer, effectively combining clinical and scientific information, Dr Basrani has received many awards throughout her career, such as the Louis Grossman Award by the French Society of Endodontics and has international courses and lectures, over 40 peer-reviewed scientific publications, three textbooks and several textbook chapters, and abstracts to her credit. Recently, in 2021 she was recognized as one of the most influential graduates from the University of Buenos Aires. She serves as reviewer for several endodontic journals. Dr Basrani is a member of many endodontics societies around the world.
Speaker Disclosure
In accordance with this policy, I declare that I have NO past or present proprietary or relevant financial relationship or receive gifts in kind (including soft intangible remuneration), consulting position or affiliation, or other personal interest of any nature or kind in any product, service, course and/or company, or in any firm beneficially associated therewith.
Ove A. Peters, D.M.D., Ph.D., M.Sc.
Dr. Ove A. Peters is a clinician-scientist at the UQ School of Dentistry; his expertise is in endodontics, including root canal treatment and vital pulp therapy, combining lab research with clinical studies and >35 years of experience as a dentist. Dr. Peters joined The University of Queensland in 2020 after faculty positions in Heidelberg, Germany and Zurich, Switzerland, as well as at the University of California, San Francisco. He now serves as the Deputy Head of School and professor of Endodontics at UQ. Earlier Dr. Peters was the founding director of the postgraduate endodontic program at the Arthur A. Dugoni School of Dentistry in San Francisco, a professor with tenure and the Chair of the Department of Endodontics at that school; he is board certified by the ABE and currently registered as specialist endodontist in Australia and New Zealand. He has published more 300 manuscripts and 3 books; his works have been cited more than 24,000 times (see here https://scholar.google.com.au/citations?user=BX9jJ_UAAAAJ). He serves as associate editor for the International Endodontic Journal. Dr. Peters has received the Louis I Grossman Award by the AAE, the Hans Genet Award by the ESE and more recently the Distinguished Scientist Award in Pulp Biology by the IADR.Disclosure(s): Dentsply Sirona: Grant/Research Support (Ongoing), Honorarium (Ongoing)
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Includes Credits
CE Hours: 1.0
Description: Pulpotomy is a proven treatment option for permanent teeth with pulp involvement, showing high success rates similar to root canal treatment. General anesthesia (GA) is used when traditional dental procedures are not feasible, especially in pediatric cases. Despite its effectiveness, limited data on endodontic treatments under GA is available, with many guidelines favoring extractions. This study aimed to evaluate the success rate of pulpotomies performed under GA on children’s first permanent molars and to identify factors influencing treatment outcomes.
At the conclusion of this article, the reader will be able to:
- Describe the success rates and clinical outcomes of pulpotomy procedures performed under general anesthesia in first permanent molars.
- Identify the factors influencing the choice of endodontic treatment plans under general anesthesia and the criteria for referring patients for GA.
- Evaluate the advantages of pulpotomy compared to root canal treatment, especially in the context of general anesthesia and its clinical challenges.
Shlomo Elbahary, DMD, PhD
Dr. Shlomo Elbahary is a Clinical Associate Professor in the Department of Endodontics at the University of Illinois Chicago College of Dentistry. He earned his D.M.D. and completed his postgraduate training in endodontics at Tel Aviv University, where he also served as a lecturer and researcher. He later obtained his Ph.D. in radicular microbiology from the University of Amsterdam.Dr. Elbahary brings extensive expertise in clinical endodontics, education, and research, with particular focus on trauma management, intentional replantation, and endodontic care for pediatric and special needs populations. He is actively involved in mentoring residents and UG students, organizing continuing education programs, and participating in international conferences. His academic and clinical work emphasizes evidence-based practice, technical proficiency, and interdisciplinary collaboration.
Disclosure(s): No financial relationships to disclose
Bradford R. Johnson, D.D.S., M.H.P.E.
Dr. Johnson completed his DDS at Virginia Commonwealth University, endodontic training at UIC, and earned an MHPE from UIC in 2005. He is a Diplomate and former President of the American Board of Endodontics and a Fellow of both the American and International Colleges of Dentists. He served as President of the Illinois Association of Endodontists, a Board Director for the American Association of Endodontists, and Commissioner for CODA. Dr. Johnson has published over 70 peer-reviewed articles and abstracts and co-authored 18 textbook chapters.
Disclosure(s): No financial relationships to disclose
Ronald Wigler
Graduate of the School of Dental Medicine, Tel Aviv University, and of the Endodontics and Dental Trauma residency program at Rambam Medical Center, Haifa. Lecturer, researcher, and postgraduate program director in the Department of Endodontics, School of Dental Medicine, Tel Aviv University. Has published numerous articles in international journals. Member of the board of the Israeli Endodontic Society and currently serves as the society’s treasurer. Owns a private practice in Tel Aviv specializing in endodontics.
Hagay Slutzky
Hagay Slutzky graduated cum laude from the Hebrew University in 1986 and earned his D.M.D. from Tel Aviv University in 1989, finishing first in his class. He specializes in esthetic dentistry and later completed a specialty in Public Health Dentistry and an M.P.H. from Hebrew University. Since 1989, he has been part of the Department of Oral Rehabilitation at Tel Aviv University. He currently serves as Chief Dental Officer for Clalit Smile, Israel’s largest DSO. Dr. Slutzky is active in several professional associations and is a member of the Israeli national dental advisory board. He has lectured widely and published on esthetic and restorative dentistry.
Sigalit Blumer
Professor Sigalit Blumer is a specialist in Pediatric Dentistry and served as the Head of the Department of Pediatric Dentistry at Tel Aviv University. She has authored numerous articles and research studies in international journals, focusing on child behavior in dental clinics, sleep apnea, and ADHD in children. Her work includes computerized anesthesia and sedation, as well as the oral microbiome and pulp therapy. Professor Blumer has been dedicated to teaching dental students and residents and is an esteemed lecturer both in Israel and internationally, sharing her expertise at various conferences and workshops. She serves on university committees and national boards that shape guidelines for pediatric dentistry in Israel.
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Includes Credits
CE Hours: 1.0
Description: Fear of dentistry, often due to past painful experiences, is a significant barrier preventing patients from visiting dentists. Achieving effective pain control, especially during root canal treatments, is crucial. However, inferior alveolar nerve blocks (IANBs) have a low success rate, influenced by factors such as anxiety, anatomical variations, and technique limitations, leading to anesthesia failure. Although numerous studies have examined the cold test and electric pulp test (EPT) in assessing the success of local anesthesia, no standardized method has been established. This study evaluated the effectiveness of EPT and cold tests in assessing the depth of anesthesia in patients with symptomatic irreversible pulpitis in the mandibular first molar teeth.
At the conclusion of this article, the reader will be able to:
- Describe the effectiveness of cold and electric pulp tests (EPT) in assessing the success of inferior alveolar nerve blocks (IANB) in patients with symptomatic irreversible pulpitis.
- Evaluate the sensitivity, specificity, and predictive values of the cold test and EPT in diagnosing pulpal anesthesia failure.
- Discuss the clinical implications of combining cold and electric pulp tests for improving diagnostic accuracy in determining pulpal anesthesia success.
Farzaneh Afkhami, DDS, MSc
Dr. Farzaneh Afkhami is a board-certified endodontist and an associate professor at the Department of Endodontics, Tehran University of Medical Sciences, Iran, and holds an academic affiliation with the School of Dentistry, The University of Queensland, Australia. She has authored over 50 research papers related to endodontics in prestigious peer-reviewed journals. Her work has garnered over 1.3 K citations and an h-index of 19 on Google Scholar. Dr. Afkhami has shared her findings at international scientific conferences and has supervised both
undergraduate and postgraduate students. Additionally, she holds a patent on a nanomaterial product as a root canal medicament, further advancing the field of endodontics.
Sholeh Ghabraei, DDS, MSc
Dr Sholeh Ghabraei is board-certified specialist in endodontics. She currently serves as associate professor in endodontics department, Dental school, Tehran university of medical sciences. Her research focuses on various aspects of endodontics including randomized controlled trials of anesthesia and pain control. She published 44 peer reviewed manuscripts.
Nasim Hashemi, DDS, MSc
Dr. Nasim Hashemi is a board-certified specialist in Endodontics. She achieved 2nd rank in the Iranian Endodontic Board Examination in 2025. Her research focuses on various aspects of endodontics including randomized controlled trials of anesthesia and pain control and broken instrument removal.
She has published nine peer-reviewed manuscripts, contributing to advancements in endodontic science.
Ove A. Peters, D.M.D., Ph.D., M.Sc.
Dr. Ove A. Peters is a clinician-scientist at the UQ School of Dentistry; his expertise is in endodontics, including root canal treatment and vital pulp therapy, combining lab research with clinical studies and >35 years of experience as a dentist. Dr. Peters joined The University of Queensland in 2020 after faculty positions in Heidelberg, Germany and Zurich, Switzerland, as well as at the University of California, San Francisco. He now serves as the Deputy Head of School and professor of Endodontics at UQ. Earlier Dr. Peters was the founding director of the postgraduate endodontic program at the Arthur A. Dugoni School of Dentistry in San Francisco, a professor with tenure and the Chair of the Department of Endodontics at that school; he is board certified by the ABE and currently registered as specialist endodontist in Australia and New Zealand. He has published more 300 manuscripts and 3 books; his works have been cited more than 24,000 times (see here https://scholar.google.com.au/citations?user=BX9jJ_UAAAAJ). He serves as associate editor for the International Endodontic Journal. Dr. Peters has received the Louis I Grossman Award by the AAE, the Hans Genet Award by the ESE and more recently the Distinguished Scientist Award in Pulp Biology by the IADR.Disclosure(s): Dentsply Sirona: Grant/Research Support (Ongoing), Honorarium (Ongoing)
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Includes Credits
CE Hours: 1.0
Description: Chronic inflammation in irreversible pulpitis leads to heightened sensitivity of nociceptive receptors, resulting in persistent hyperalgesia. This poses significant challenges in achieving effective anesthesia for patients with irreversible pulpitis. Various anesthetic techniques and pharmacological approaches have been employed to enhance the success of local anesthesia. Recently, the preemptive use of anti-inflammatory agents, specifically corticosteroids, has gained attention and shown promising results in randomized controlled trials. This systemic review and meta-analysis aimed to evaluate the impact of systemically administered corticosteroids on enhancing anesthetic success in patients undergoing endodontic treatment.
At the conclusion of this article, the reader will be able to:
- Explain the inflammatory nature of pain in irreversible pulpitis and how it can adversely affect the success of local anesthesia, especially in mandibular molars.
- Discuss the pharmacology of corticosteroids and their potent anti-inflammatory effect.
- Evaluate the body of evidence regarding the ability of corticosteroids in increasing the success of local anesthesia in irreversible pulpitis.
Norah Alajlan, BDS, MS
Dr. Norah Alajlan earned her BDS degree from King Saud University, Riyadh, Saudi Arabia. Consequently, she obtained her post-graduate training in endodontics and Masters in Oral Biology from the University of Pennsylvania. Currently, she is working as a full- time faculty at King Saud University.
Alonso Carrasco-Labra, DDS, MSc, PhD
Bekir Karabucak, D.M.D., M.S.
Dr. Karabucak is Associate Professor/Clinician Educator, Interim Chair and Director of post-graduate program in the Department of Endodontics. Dr. Karabucak serves as director of Advanced Dental Education in the School of Dental Medicine. After earning his dental degree from Istanbul University School of Dental Medicine in 1993, Dr. Karabucak completed his endodontic postgraduate training at the Department of Endodontics at Penn, where he also received his Masters in Oral Biology in 1998. He later earned his DMD degree from Penn Dental Medicine in 2002. He’s the attending endodontist at the Children’s Hospital of Philadelphia since 2005. He is a Diplomate of the American Board of Endodontics. He lectured at national and international conferences and also serves as a reviewer for the Journal of Endodontics.
Su-Min Lee, DDS, MSD, DScD
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Includes Credits
CE Hours: 1.0
Description: Previous studies on intraosseous (IO) anesthesia as a primary injection have shown high success rates. The TuttleNumbNow (TNN; Orem, UT) is a new primary IO injection technique that has not been scientifically evaluated. Therefore, the purpose of this prospective randomized, crossover study was to evaluate the anesthetic efficacy of the TNN IO technique using the Septoject Evolution needle (Septodont, Saint-Maur-des-Fosses, France) compared with buccal infiltration for pulpal anesthesia in mandibular first molars.
At the conclusion of this article, the reader will be able to:
- Discuss the success of the TuttleNumbNow intraosseous method.
- Describe how the TuttleNumbNow intraosseous method is administered.
- Define the success of the TuttleNumbNow intraosseous method versus a buccal infiltration.
Tyler Dolphin, DDS, MS
Sara Fowler, DMD, MS
Dr. Sara Fowler received her DMD from the University of Nevada Las Vegas School of Dental Medicine, a graduate of the school’s inaugural class. A native of Columbus, Ohio, Dr. Fowler returned to complete post-graduate training at The Ohio State University College of Dentistry, first with a General Practice Residency, followed by Endodontic Fellowship, and Advanced Endodontic Residency. After working in private practice, Dr. Fowler returned to teach at Ohio State and is now an Associate Professor with tenure in the Division of Endodontics. She is the director of Predoctoral Endodontics and the Emergency Dental Care Clinic, maintains private practice in the Ohio State Dental Faculty Practice, and actively participates in teaching and research with the Advanced Endodontic Residency Program.
Disclosure:
In accordance with this policy, I declare that I have NO past or present proprietary or relevant financial relationship or receive gifts in kind (including soft intangible remuneration), consulting position or affiliation, or other personal interest of any nature or kind in any product, service, course and/or company, or in any firm beneficially associated therewith.
Melissa Drum, DDS, MS
Dr. Drum received her DDS from the University of Minnesota and her endodontic certificate/master's degree from The Ohio State University. She teaches at the dental student and resident levels and is the Advanced Endodontic Program Director and past Predoctoral Endodontic/Emergency Clinic Director. Dr. Drum is active in service at the college, state and national levels and is a full tenured professor. She has published more than 80 articles, multiple book chapters, and coauthored a book. Dr. Drum became a Diplomate of the ABE in 2008 and is currently a Director and President of the ABE. She was named holder of the Al Reader Endowed Professorship in 2013. Dr. Drum received the AAE Edward M. Ostetek Award in 2014 as well as numerous local teaching and research awards over the years. Dr. Drum hates writing and reading bios and is much more fun than this paragraph describes.
John Nusstein, DDS, MS
Dr. John Nusstein is a tenured Professor and the Chair of the Division of Endodontics at The Ohio State University College of Dentistry in Columbus, Ohio.
Al Reader, DDS, MS
Dr. Al Reader is a Professor in the Division of Endodontics and is a previous program director of Advanced Endodontics at the The Ohio State University.
John Draper, MS, PhD
Dr. John Draper has a PhD and MS in statistics from Ohio State and is a senior lecturer in the Department of Management Sciences. He provided the statistical support for this research project.
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Includes Credits
CE Hours: 1.0
Description: This presentation will evaluate current best practices relative to the administration of local anesthesia for endodontic treatment and pain management. The future of local anesthesia will also be discussed and explored.
Learning Objectives:
- Describe the current best practices and protocols for achieving effective local anesthesia for endodontic treatment.
- Utilize findings from the current literature to make evidence-based clinical decisions regarding administration of local anesthesia for the management and prevention of odontogenic pain.
- Summarize new concepts and ideas regarding the future of local anesthesia and pain control.
Sara Fowler, DMD, MS
Dr. Sara Fowler received her DMD from the University of Nevada Las Vegas School of Dental Medicine, a graduate of the school’s inaugural class. A native of Columbus, Ohio, Dr. Fowler returned to complete post-graduate training at The Ohio State University College of Dentistry, first with a General Practice Residency, followed by Endodontic Fellowship, and Advanced Endodontic Residency. After working in private practice, Dr. Fowler returned to teach at Ohio State and is now an Associate Professor with tenure in the Division of Endodontics. She is the director of Predoctoral Endodontics and the Emergency Dental Care Clinic, maintains private practice in the Ohio State Dental Faculty Practice, and actively participates in teaching and research with the Advanced Endodontic Residency Program.
Disclosure:
In accordance with this policy, I declare that I have NO past or present proprietary or relevant financial relationship or receive gifts in kind (including soft intangible remuneration), consulting position or affiliation, or other personal interest of any nature or kind in any product, service, course and/or company, or in any firm beneficially associated therewith.