Canal, Pulp
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Includes Credits
CE Hours: 1.25
Description: The management of inflamed or injured dental pulp remains a core challenge in endodontics. Conventional root canal therapy controls infection but eliminates the pulp's regenerative capacity. Regenerative endodontic procedures now aim to preserve or restore vitality, with extracellular vesicles (EVs) emerging as a promising cell-free, immunomodulatory, and pro-regenerative approach. This presentation will highlight advances in EVs derived from stem cells of the apical papilla (SCAP) for pulp repair. We will review preclinical and translational evidence showing how EVs modulate inflammation, support angiogenesis and neurogenesis, and activate resident progenitors. Particular attention will be given to their cargo-specialized pro-resolving mediators, growth factors, and miRNAs-and its integration into smart biomaterials for controlled delivery.Endodontists will gain perspectives on how EV-based therapies could complement or even replace cell-based regeneration. Practical issues of sourcing, safety, and clinical translation will also be discussed. EVs represent a paradigm shift: from removing the pulp to enabling its healing.
Learning Objectives:
- Describe the biological functions and therapeutic potential of extracellular vesicles (EVs) derived from dental stem cells in the context of pulp regeneration.
- Compare EV-based strategies with current regenerative endodontic protocols in terms of feasibility, clinical integration, and future applicability.
- Evaluate the mechanisms by which EVs modulate inflammation and promote tissue repair in the pulpal microenvironment
Alexis Gaudin, Ph.D, DDS
Pr. Alexis Gaudin, PhD (2015), HDR (2020), is a full-time professor and Endodontist at Nantes University Hospital and the dental school at Nantes Université. He is recognized as a leading expert in pulp biology and the immune response in the dental pulp. Pr. Gaudin is the President of the French Society of Endodontics and a certified member of the European Society of Endodontics. An accomplished researcher, Prof. Gaudin joined the INSERM 1229 RMeS (Regenerative Medicine and Skeleton) laboratory in 2018. His work focuses on regenerative endodontics, with expertise in the immunomodulatory properties of mesenchymal stem cells and molecules involved in the resolution of inflammation. He leads pioneering projects which explore cell-free therapeutic approaches for dental pulp regeneration. Prof. Gaudin's academic journey includes a year as a visiting researcher at the University of the Pacific in San Francisco, USA, where he investigated the impact of immune responses on stem cells. His contributions have earned him numerous awards, including the CNEOC (2011), FSE (2013), and IADR-PBRG (2016) prizes.
Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 0.75
Description: Navigating calcified root canals poses a significant challenge in endodontics, increasing the risk of procedural errors, such as perforations and excessive tooth structure loss. This lecture will explore the evolution of technology from static guided endodontic techniques to the precision of dynamic navigation systems. Static guides, which are fabricated from a cone-beam computed tomography (CBCT) scan, offer high accuracy for root canal localization by providing a physical template for drilling. However, we will also discuss the limitations of static guides, such as their inability to be adjusted intraoperatively and the need for a separate physical template. This session will then introduce Dynamic Navigation Systems (DNS) as the next step in this technological progression. Unlike static guides, DNS provides real-time 3D guidance, enabling on-the-fly adjustments during the procedure and eliminating the need for a physical template. We will compare the advantages of both approaches, examining how dynamic navigation can significantly reduce substance loss compared to freehand methods and improve efficiency for less-experienced clinicians. This lecture will provide a comprehensive understanding of the strengths of each method and how its application can lead to more predictable and successful outcomes in managing complex calcified anatomies.
Learning Objectives:
- Compare and contrast the clinical applications, accuracy, and efficiency of static guided endodontics versus dynamic navigation systems for locating calcified canals.
- Evaluate the trade-offs between static and dynamic guidance, including procedural time, the ability to make real-time adjustments, and the reliance on operator skill.
- Analyze how the progressive adoption of these digital technologies, from static guides to dynamic navigation, reduces tooth substance loss and enhances precision during endodontic access preparation.
Sunee Limmeechokchai, DDS MSD
Sunee Limmeechokchai is an associate professor in the dental specialist position at Loma Linda University, School of Dentistry, California. She has been an endodontist for 20 years and an implantologist for 5 years. Her primary responsibility at dental school includes teaching students in the Endodontic Department, collaborating on complex Endodontic and implant cases, and taking care of full-arch implant oral rehabilitation cases. Sunee graduated from Chulalongkorn University, Bangkok, Thailand, with a Doctor of Dental Surgery degree. Afterward, she continued her dental specialty education by receiving a certificate in the Endodontics program from Mahidol University, Bangkok, Thailand. In addition, she received a certificate and master's degree from an advanced education program in implant dentistry at Loma Linda University, California, USA. For her other specialty certifications, she received the following Diplomats and Fellowships: Academy of Endodontics (AAE), membership 2025 Academy of Osseointegration (AO), Diplomat 2023 American academy of implant dentistry (AAID), Fellowship 2022 American Board of Oral Implantology (ABOI), Diplomat 2021 Academy of Osseointegration (AO), Certificate 2021 During her Endodontics and implant specialty training and practice, Sunee published 8 clinical research articles and case reports. She was also invited to be a key speaker and give multiple lectures and presentations at international conferences. In 2025, Sunee starts her advanced education training in the Endodontics program at Loma Linda University. In addition, Sunee received the research mentor of the year 2024 from Loma Linda University. She also dedicated her time to the Academy of Osseointegration Social Media Committee 2023-2025.
Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 1.25
Description: For generations, endodontists have been taught that the goal of obturation is to hermetically seal the root canal system-blocking microbial reinvasion and promoting periapical healing. But in today's world, where social media often glorifies radiographic aesthetics over biological function, have we drifted from our true purpose? In this presentation, Dr. Allen Ali Nasseh takes attendees on an inspiring journey through the history of obturation-from early scientific principles to modern techniques-reframing its core purpose around biology and mechanics rather than imagery. Looking ahead, emerging technologies promise greater precision and customization, while regenerative approaches may redefine the very goals of endodontics. Dr. Nasseh challenges clinicians to embrace these innovations in light of the disease model's established scientific principles, while resisting the pull of radiographic artistry.By exploring obturation's past, assessing its present, and projecting its future, this session equips attendees with evidence-based strategies to achieve functional, durable seals-ensuring clinical success in an era where truth must prevail over marketing trends.
Learning Objectives:
- Recognize how shifting philosophies have influenced clinical decision-making over time.
- Become familiar with the evolution of Endodontic obturation materials and techniques from the past to the present.
- Explore emerging technologies and regenerative approaches that may redefine endodontic goals.
Allen Ali. Nasseh, D.D.S., MMSc.
Dr. Allen Ali Nasseh received his Doctor in Dental Surgery (DDS) degree from Northwestern University Dental School (Chicago, IL) in 1994 and completed his postdoctoral endodontic training at Harvard School of Dental Medicine in 1997, where he also received a Masters in Medical Sciences (MMSc) degree in bone biology. He is a senior Clinical Instructor and lecturer in the Post-doctoral endodontic program at Harvard School of Dental Medicine since 1997 and the former Alumni editor of the Harvard Dental Bulletin. He was the president and Chief Executive Officer for Real World Endo.
Disclosure(s): Brasseler USA: Honorarium (Terminated, October 31, 2024), Royalties from multiple product developments. (Terminated, October 31, 2024)
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Includes Credits
CE Hours: 1.25
Description: This session empowers dental professionals to confidently discuss the oral-systemic link, focusing specifically on root canal safety and combating mis/disinformation. Discussions will unearth evidence-based communication techniques to address common patient anxieties and misconceptions about root canal safety, transforming uncertain moments into meaningful educational conversations. By bridging the gap between endodontic treatment and whole-body health, this dialogue will equip practitioners in explaining how saving a tooth with a root canal is a vital step in managing and reducing systemic inflammation, ultimately safeguarding a patient's overall wellness.We will re-frames root canal safety for dental professionals, moving from a defensive stance against misinformation to a proactive, evidence-based approach centered on patient education. This discourse aims to show practitioners how to confidently discuss the oral-systemic link, highlighting endodontic therapy as a critical intervention for overall health, not just a fix for a local dental problem.
Learning Objectives:
- Construct empathetic communication strategies that validate patient fears regarding root canal safety while systematically refuting common misinformation with evidence-based data.
- Explain the scientific link between endodontic infection and systemic inflammation, effectively positioning root canal therapy as a proactive component of a patient's overall health management.
- Employ and elucidate evidence based conversational techniques to effectively discuss the benefits of root canal treatment, empowering patients to make informed decisions about their care
Marcus D. Johnson, DDS, MSD
Dr. Marcus Johnson, wanted to be a dentist since age 11. A Rutgers University alum and graduate of New York University Dental School, he advanced his knowledge and training receiving his Certificate of Endodontics from Case Western Reserve University in Cleveland, Ohio while earning his Master's Degree of Science in Dentistry. Dr. Marcus Johnson is a Diplomate of the American Board of Endodontics. He is the Chief of Endodontics for One Brooklyn Hospitals in metro Brooklyn and owns and operates a private endodontic education and treatment center, City Endodontics in midtown Manhattan. He values organized dentistry and is active at the local, state and national levels. Immediate Past President for the New York State Association of Endodontists, and the host of the AAE podcast Endovoices.
Disclosure(s): Coltene: Honorarium (Ongoing)
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Includes Credits
CE Hours: 1.5
Description: This presentation explores the biological relevance of filling lateral canals, grounded in histologic evidence and clinical observations. In the initial phase, the pulp's histological response to bacterial invasion is described. As bacteria colonize the necrotic tissue near the pulp chamber, an inflammatory response develops, while surrounding tissues remain uninflamed. Over time, with or without symptoms, necrosis progresses beyond the root canal orifices, and bacterial biofilms form along canal walls and anatomical complexities. When degeneration involves lateral canals, localized inflammation occurs, typically milder toward the periodontal ligament due to its rich blood supply. Eventually, biofilms may also form in these areas and, in some cases, extend beyond the root canal system, leading to extraradicular infections. The effectiveness of current cleaning protocols and modern devices in removing vital or necrotic tissue from lateral canals is critically evaluated through extensive histological studies on human specimens. It is shown that complete debridement is unachievable, and that forcing obturation materials into lateral canals does not equate to meaningful or effective filling. The discussion is supported by clinical cases and videos, offering a biologically and histologically informed perspective on whether filling lateral canals contributes to healing and long-term success.
Learning Objectives:
- Describe the histological response of the pulp and periapical tissues to bacterial invasion, including the formation of biofilms within lateral canals.
- Evaluate the limitations of current endodontic techniques in cleaning and effectively filling lateral canals, based on histological evidence.
- Assess the clinical significance of lateral canal involvement in endodontic infections and healing outcomes, with a biologically informed perspective.
Domenico Ricucci, M.D., D.D.S.
Dr. Domenico Ricucci received his Degree in Medicine in 1982 and his Degree in Dentistry in 1985 from “La Sapienza” University of Rome, Italy. Since then, he has maintained a private practice limited to endodontics, while also directing a personal histopathology research laboratory focused on pulpal and periapical tissue responses to disease and treatment.
His main research interests include tissue reactions to caries, vital pulp therapy, biofilms in endodontic infections, causes of root canal treatment failure, pulp regeneration, and dental trauma.
Dr. Ricucci has authored 122 scientific papers and 24 book chapters, and is the author of the following textbooks/atlases: Patologia e Clinica Endodontica (2009); Endodontology: An Integrated Biological and Clinical View (2013), translated into Russian (2015), Japanese (2017), and Chinese (2019); and the recent Vital Pulp Therapy & Clinical Endodontics: A Biological Approach (2026).
His contributions to endodontic science have been recognized with the Grossman International Award from the French Society of Endodontics (2017) and the Louis I. Grossman Award from the American Association of Endodontists (2023).Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 1.0
Description: The MB2 canal, an anatomical feature present in maxillary molars, has garnered significant attention in endodontics due to its clinical significance and challenges in identification and treatment. This lecture aims to explore strategies for predictably locating and treating the MB2 canal, enhancing clinicians' ability to achieve successful endodontic outcomes. The first part of the lecture delves into the anatomy of maxillary molars, emphasizing the variability and prevalence of the MB2 canal. Understanding the internal morphology of these teeth is crucial for predicting the presence and location of additional canals, such as the elusive MB2. Next, the lecture will review diagnostic techniques and technologies that aid in MB2 canal detection. From advanced imaging modalities like CBCT to clinical indicators such as the presence of additional orifices, attendees will learn practical methods for identifying the MB2 canal during treatment planning. The main focus will then shift to treatment protocols optimized for managing the MB2 canal. Techniques like modified access openings, careful exploration using ultrasonic tips and microscopes, and negotiation with specific instruments will be discussed in detail. Case studies illustrating successful MB2 canal treatment will be presented, highlighting key learning points and common pitfalls to avoid. Emphasis will be placed on predictable and efficient workflows that can be incorporated into everyday practice. In conclusion, this lecture will empower attendees with the knowledge and skills necessary to confidently navigate the complexities of the MB2 canal, ultimately improving clinical outcomes and patient satisfaction in endodontic procedures involving maxillary molars.
Learning Objectives:
- Describe the evolution of NiTi files and the scientific basis for their classification into generations.
- Critically appraise the advantages and limitations of contemporary file systems in relation to shaping goals and dentine preservation.
- Anticipate future directions in file design, manufacturing, and regulation relevant to clinical endodontic practice.
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: 1.25
Description: Vital pulp therapy (VPT) plays a crucial role in managing mature permanent teeth with pulp exposure or inflammation, offering a less invasive alternative to root canal treatment. The decision on when and how to perform VPT depends on the degree of pulp involvement, the tooth's vitality, and clinical symptoms. Key VPT options include direct pulp capping, partial pulpotomy, and full pulpotomy, each with specific indications based on the extent of pulpal inflammation. Recent advancements in biomaterials, mineral trioxide aggregate and other bioceramic materials, have improved treatment outcomes by promoting pulp healing and reducing the risk of failure. Hence, these treatment modalities are emerging as promising treatments for maintaining tooth vitality in children and adults. Proper case selection, strict asepsis, using biocompatible materials and good coronal seal are mandatory for success. This presentation reviews the past, present and future of VPT along with the current VPT options, emphasizing the importance of diagnosis, material selection, and individualized treatment planning to achieve optimal long-term outcomes in younger and adult patients.
Learning Objectives:
- Identify the indications and contraindications for VPT
- Evaluate the prognostic factors influencing treatment outcomes, including pulp status, restorative seal, and microbial control.
- Interpret current evidence-based guidelines and literature supporting the use of VPT
Avina K. Paranjpe, B.D.S., M.S., M.S.D., Ph.D.
Dr. Avina Paranjpe graduated with her BDS (Bachelor of Dental Surgery) degree from the Mumbai University, India in 2000. She was in private practice in Mumbai, India from 2000-2002 after which she obtained her Master's degree (MS) and a Doctor of Philosophy (PhD) in Oral Biology, Immunology from the University of California, Los Angeles in 2004 and 2007 respectively. Dr. Paranjpe earned her Master of Science in Dentistry (MSD) and Certificate in Endodontics from the University of Washington Graduate Endodontics Program in August 2009 after which she joined the faculty at the University of Washington, School of Dentistry as Assistant Professor. She was promoted to Professor with tenure in 2020 and is the current Program Director in Endodontics at the school. She is a Diplomate of the American Board of Endodontics and the immediate past ABE President. Dr. Paranjpe is involved in several ongoing research projects related to dental materials and regenerative Endodontics. She has numerous publications in the area of pulpal regeneration and revascularization, immunology, and compatibility of biomaterials. She has won multiple teaching awards including the Edward M. Osetek Educator Award 2019: Recognized for outstanding status as an educator in North America by the American Association of Endodontists. She was recently inducted as a Fellow to the International College of Dentists (FICD) and the American College of Dentists (ACD) for her contributions to the profession, community, and research.
Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 1.0
Description: This study aimed to enhance the efficacy and safety of root canal irrigation in #25/.06 canals by optimizing side-vented needle designs, focusing on bevel angle adjustments and sealing configurations.
At the conclusion of this article, the reader will be able to:
Explain how bevel angle and configuration in side-vented irrigation needles influence irrigant exchange, apical pressure, and overall irrigation effectiveness.
Interpret computational fluid dynamics (CFD) and in vitro validation findings regarding optimized needle designs, including solid vs hollow bevel configurations.
Apply the study’s conclusions to clinical scenarios, evaluating how optimized needle design might improve irrigation outcomes in complex canal morphologies such as C-shaped canals.
Jiayang Gao, DDS
Yuhua Dai, DDS, MSD
Ziteng Long, DDS
Yi Min, DDS, PhD
Ya Shen, DDS, MS, PhD
Dr. Ya Shen received her dental degree and her PhD degree, both from the Faculty of Dentistry at Wuhan University, China. From 2008 to 2011, she was a Clinical Assistant Professor in the Department of Oral Biological & Medical Sciences at the University of British Columbia (UBC) in Vancouver, Canada. From 2012 to 2016, Dr. Shen served as an Assistant Professor and was later promoted to an Associate Professor of the Department of Oral Biological & Medical Sciences and is now Professor and Chair, Division of Endodontics. She is also an Associate Member of the Department of Materials Engineering at UBC. Dr. Shen has published more than 110 papers in peer-reviewed journals. She is one of the Editors of Visual Endodontics 2012 multi-media. Dr. Shen is also a reviewer for several international journals. Her main research interests are nickel–titanium instrument fracture mechanics, biofilms, and dental material in endodontics.
Yuan Gao, DDS, PhD
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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: 1.0
Description: This study aimed to assess the effect of cavity designs on instrumentation, obturation and fracture resistance for mandibular first premolars with Vertucci V canal.
At the conclusion of this article, the reader will be able to:
- Discuss which cavity design is appropriate for mandibular first premolars with Vertucci V canal.
- Compare the effectiveness of different cavity designs in instrumentation, obturation and preservation of dentin and fracture resistance.
- Describe the steps of preparing an access cavity for premolars with Vertucci V canal.
Yuxuan Liu, DDS
Yaxu Feng, DDS
Xianhua Gao, DDS
Wei Fan, DDS, PhD
Bing Fan, DDS, MSc, PhD