CE Hours: 1.5

Description: Regenerative endodontics has been recognized as a unique protocol in the practitioner's armamentarium to harness the regenerative potential of periapical tissues, facilitating continued root development and regeneration of the dentin-pulp complex, particularly in immature necrotic teeth. Preclinical and clinical research have significantly enhanced our understanding of the key factors contributing to success and failure. In this presentation, we will share the most recent data and protocols for regenerative endodontics, as well as emerging tissue engineering technologies aimed at regenerating lost tissues. Dr. Botero will discuss the clinical rationale and protocols in regenerative endodontics, along with clinical evidence, outcomes, and limitations of these protocols. Dr. Bottino will then explore the current status and clinical potential of tissue engineering in endodontics, including applications in regenerative endodontics and vital pulp therapy, ongoing materials and technologies, preclinical and translational research, as well as barriers and opportunities.

Learning Objectives:  

• Describe the fundamental principles and clinical protocols of regenerative endodontic procedures (REP), with emphasis on the latest evidence and outcomes and identify and analyze the clinical factors that influence the success and limitations of REP, including practical considerations for implementation and follow-up.
• Compare and contrast conventional REP with modern tissue engineering technologies in terms of clinical potential, translational hurdles, and future impact on patient care.
• Compare and contrast conventional REP with modern tissue engineering technologies in terms of clinical potential, translational hurdles, and future impact on patient care. the audience will be also able to recognize the key challenges and opportunities in advancing from current regenerative protocols toward fully functional tissue engineering solutions for endodontic regeneration.

CE Hours: 0.75

Description: The management of dental trauma remains a complex clinical challenge with significant implications for both patients and providers. Traumatic dental injuries can range from uncomplicated crown or root fractures to more severe damage involving the supporting periodontal structures, such as luxation, intrusion, and avulsion injuries. This presentation will review the most recent guidelines published by the International Association of Dental Traumatology (IADT), focusing on the prevention, diagnosis, and evidence-based management of traumatic dental injuries. A series of clinical cases-featuring multiple examples with long-term follow-ups-will be presented to illustrate practical application of these guidelines and to highlight the outcomes of various treatment approaches.

Learning Objectives:  

• Apply the IADT guidelines for the prevention, diagnosis, and management of traumatic dental injuries, and recognize when and how to modify treatment protocols based on individual case factors.
• Identify common endodontic complications associated with dental trauma and implement evidence-based strategies for their long-term management.
• Recognize the value of interdisciplinary collaboration in optimizing outcomes for patients with complex traumatic dental injuries, especially in cases involving long-term follow-up and comprehensive care.

CE Hours: 0.75

Description: Dr. Usman has cultivated a practice of 50% pediatric patients most of which are trauma referrals from emergency rooms, pediatric dental practices and self-referrals.  Using evidence-based treatment protocols and innovating with new materials, Dr. Usman will move through the management of challenging traumatic injuries and show how long term follow up and assuming the role as a "dental trauma gatekeeper" produces predictable excellent outcomes for her patients. Dr. Usman will show her treatment planning philosophy rooted in understanding the interaction of patient factors such as sex and age of the child, initial diagnosis and desired outcome. Topics such as ridge preservation, auto transplantation, orthodontic extrusion and vital pulp therapy will be discussed and how building an interdisciplinary team from the start is critical to maximizing the prognosis.

Learning Objectives:  

• Describe how specific patient factors influence a trauma treatment plan.
• Discuss the benefits of vital pulp therapy and regenerative treatments to preserve tooth structure.
• Direct innovative interdisciplinary treatment plans such as autotransplantation, orthodontic extrusion and ridge preservation.

CE Hours: 1.5

Description: This session will cover current literature on the clinical and radiographic outcome of vital pulp therapy procedures with particular focus on full pulpotomy. Among the issues that will be covered are patient's and tooth related factors, technical procedure, material selection, and their effect on the outcome. Results from clinical trials performed with standardized protocols at Jordan University of Science and Technology will be presented. In addition this session will cover the available evidence on pulpotomy as an alternative to root canal therapy.

Learning Objectives:  

• Define the limitation of available diagnostic modalities for the state of pulp inflammation and its healing potential.
• Describe biological basis for VPT procedures and draw cut off points for the selection of pulp capping and pulpotomy
• Analyze available literature on prognostic factors and outcome of VPT.

CE Hours: 1.5

Description: Teeth with mature apexes, necrotic pulps, and periapical lesions are routinely treated with conventional endodontic procedures with a high and long-term survival rate. Traumatic injuries associated with severance of the blood supply result in pulpal ischemia and often a secondary infection with bacteria. The consequence of pulpal necrosis in teeth with immature apexes, however, is the cessation of root development, making endodontic treatment with conventional techniques and materials difficult and sometimes impossible. Currently, treatment options for these teeth include MTA apexification, regenerative endodontics or a new tooth. MTA Apexification induces an artificial apical stop that allows for condensation of obturation materials. However, this procedure does not promote continuation of root development, nor does it increase fracture resistance of the root walls. An ideal treatment for a tooth with necrotic pulp and immature apex is the regeneration of pulp tissue into a root canal and promotion of a normal root development. The advantages of regenerative endodontic procedures (REPs) lie in the potential for reinforcement of dentinal walls by deposition of hard tissue and the potential for the development of an apical morphology more appropriate for conventional endodontic therapy if future treatment becomes necessary. The American Association of Endodontists has developed Clinical Considerations for REPs, which outlines detailed information regarding the steps involved in REPs. However, there are challenges, and mishaps that can occur during pre- treatment, mid treatment or following treatment. The presenter will discuss how to prevent and manage these challenges and Mishaps.

Learning Objectives:  

• Describe treatment options for teeth with open apexes.
• Describe challenges and mishaps during regenerative endodontics.
• Describe prevention and treatment of the challenges and mishaps.

CE Hours: 1.5

Description: Immerse yourself in the Data and Clinical Blitz sessions, where attendees are presented with a streamlined dive into the latest research findings or captivating and intricate Endodontic cases. It is an innovative learning experience not to be missed. The key elements for successful outcomes for VPT will be presented within the context of a "process".  Products used for VPT are important but are only part of the formula for success. The audience will have the opportunity to obtain meaningful information from brief presentations and short discussion on Pulp Biology research and the new trends for clinical protocols aiming to preserve the vitality and/or regeneration of the dental pulp to increase longevity of the tooth.

Learning Objectives:  

• Describe the importance of Vital pulp therapy as a process not as a product and the visual appearance of the exposed pulp tissues.
• Determine the perspective on pulpotomy of mature teeth with irreversible pulpitis and the factors predicting outcomes.
• Explain the ideal recall time on Regenerative Endodontics, possibility of immediate induction and the applicability of cell-based regeneration therapy.

CE Hours: 1.0

Description: The pediatric endodontic patient poses a challenge both in patient management and the status of root development. Often treatment decisions are affected by the ability to manage the behavior of the child. Knowing the various modalities available will be reviewed so that optimum treatment is sought. Dr. Usman has a philosophy of proactive treatment versus "waiting and watching" which will minimize untoward sequelae such as infection and discoloration of the tooth as well as facilitate an optimum and conservative, long-term restorative solution. Starting with a thorough understanding of diagnosis and the role of frequent recall, she will demonstrate the management of various patients who have undergone trauma or have gross caries which threaten the premature loss of the permanent tooth. A review of diagnosis and the various spectrum of pupal therapeutic techniques from apexogenesis to indirect pulp capping, modified apexification, and regenerative treatments. The clinical uses of various materials such as MTA, Endosequence bioceramics, Biodentine calcium silicate cement and collagen containing materials which have been demonstrated to have applications, will be compared. Using her own personal cases Dr. Usman will highlight her process of establishing a treatment plan taking into consideration the psychosocial factors, diagnosis and short term and long term prognoses. Some interdisciplinary time-sensitive treatments will be discussed such as decoronation and autotransplantation which involve other specialists such as orthodontics and oral-maxillofacial surgery and periodontics.

Learning Objectives:  

• List various treatment options available to manage the complex pediatric endodontic patient.
• List the materials needed to perform the intended treatment on the complex pediatric patient.
• Create a treatment plan based on the patient's psychosocial factors, diagnosis and desired treatment outcome.

CE Hours: 1.0

Description: Tooth autotransplantation, intentional replantation and surgical extrusion are different treatment options with a similar principle; the preservation of the periodontal ligament (PDL) in order for the tooth to heal and be newly articulated with the bone. Tooth autotransplantation is defined as the surgical movement of a tooth from one alveolar socket to another, either after extraction or by surgically preparing the recipient site in the same patient, it is a viable option to replace lost teeth or poor prognosis teeth. Thus, both function and preservation of the alveolar bone crest is maintained. Its success is associated with healing of the PDL and pulp tissue, absence of root resorption, soft tissue healing, and radicular formation. Intentional replantation is the atraumatic extraction of a tooth enabling the clinician to do a procedure (mostly endodontic microsurgery, or cervical resorption treatment) in less than 15 minutes (extra-alveolar time) in teeth in which, otherwise, access would not be possible. Surgical extrusion consists of atraumatic luxation and coronal repositioning of a tooth with in its same socket, this with the purpose of exposing root resorption, root fractures or decay and treat it, leaving sound tooth structure subgingival.Over the last 15 years these techniques have had a great evolution due to the introduction of cone beam computed tomography (CBCT), intraoral scanning, 3D planning software, 3D printers and computer aided dynamic navigation devices. All this technology enables a more predictable, faster and safer procedure with lower extra-alveolar times. In this lecture several clinical cases, with a proper follow up period, show the rapid progress of the technique always based in the best scientific evidence available and trying to inspire Endodontists to have this type of treatments as valid options to help their patients.

Learning Objectives:  

• Evaluate if a patient is a potential candidate for Tooth Autotransplantation, Surgical Extrusion or Intentional Replantation.
• List the digital work flow necessary to perform computer guided Tooth Autotransplantation.
• Introduce these type of treatments as possible options for clinical cases that otherwise would be hopeless.

CE Hours: 1.5

Description: Vital pulp therapy including pulpotomy is increasingly adopted in the management of various pulp exposures in children and adults, by virtue of the improved understanding of pulp histopathology and its response to the carious insult. The advent of MTA and other hydraulic calcium silicate based-materials has considerably improved the success rates over medium and long-term follow-up and therefore renewed the interest in vital pulp therapy. This presentation will review the available data on the clinical and histological diagnosis of various pulp exposures with a broad spectrum of symptomatology and will discuss the recent evidence in support of vital pulp therapy in mature permanent teeth and clinical symptoms indicative of irreversible pulpitis.  Patients’, clinicians ‘, and scientists' centered outcomes including clinical and radiographic success, survival, pain management, patient satisfaction, quality of life improvement, and cost-effectiveness will be reviewed.

Learning Objectives:  

• Describe management strategies for carious pulp exposures in children and adults based on currently available guidelines
• Define treatment consideration and case selection criteria for vital pulp therapy procedures based on possible prognostic factors
• Review the available evidence on clinicians' and patients' centred outcomes of vital pulp therapy procedures in teeth with carious pulp exposure

CE Hours: 0
*Handout only

Course Description:

This lecture will exam the current and future trend in vital pulp treatment. A case-based analysis will be used to explore treatment options that incorporate evidence-based treatment protocols into the everyday clinical practice. Pulp necrosis in immature teeth subsequent to caries or trauma has a major impact on long-term tooth retention. The aim of vital pulp therapy is to maintain pulp viability by eliminating bacteria from the dentin-pulp complex and to establish an environment in which apexogenesis can occur. The presentation will discuss various materials and treatment protocols that can achieve this goal.

At the conclusion, participants should be able to:

• Discuss the importance of tooth development and retention in long-term for long-term skeletal development.
• Describe the concepts for selecting teeth for various treatment options.
• Discuss the clinical application of various materials to pulpal tissue.

David E. Witherspoon, B.D.S., M.S., M.F.A., F.I.C.D

I declare that I have no proprietary, financial, or other personal interest of any nature or kind in any product, service, course, and/or company, or in any firm beneficially associated therewith, that will be discussed or considered during the proposed presentation.