Debridement
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Includes Credits
CE Hours: 1.5
Description: As endodontics advances into a new era of technological innovation, practitioners have access to an increasingly broad range of adjunctive irrigation devices and disinfection techniques. Technologies such as lasers and multisonic systems offer the potential for enhanced clinical outcomes; however, their efficacy warrants careful evaluation. This presentation will provide an in-depth review of adjunctive irrigation techniques-including sonics, ultrasonics, lasers, multisonic systems, and other emerging technologies-framed within the principles of evidence-based endodontics. Participants will gain comprehensive insights into the existing research landscape, including its current limitations, challenges, and prospects for future advancement. This session aims to present a balanced perspective to support informed decision-making and effective integration of innovations in contemporary endodontic practice.
Learning Objectives:
- Revisit the fundamental goals of root canal disinfection and how modern irrigation devices may enhance or fall short of those goals.
- Discuss the challenges in generating high-quality evidence for adjunctive irrigation and the limitations of current research methodologies.
- Analyze the clinical effectiveness and limitations of advanced irrigation technologies.
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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.
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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: 0.75
Description: The demand for high-quality evidence in endodontic clinical practice is escalating, particularly with the emergence of costly technologies in adjunctive irrigation. However, the scarcity of robust laboratory and clinical studies in adjunctive irrigation over the past six decades has compromised the reliability on systematic reviews and meta-analyses. Thus, a shift towards producing better-quality studies over quantity is imperative. Constraints such as cost, ethical considerations, and narrow population designs often render Randomized Clinical Trials unfeasible, limiting their generalizability. To address this, the utilization of real-world data and AI for generating real-world evidence is gaining traction, bridging the gap between trial settings and practical clinical scenarios. This presentation will thoroughly explore the literature on adjunctive irrigation, decode enhanced root canal irrigation techniques, suggest methods to develop quality research and balancing between research and practice.
Learning Objectives:
- Discuss the optimal research methodology for root canal cleaning and disinfection.
- Explain the concept of pragmatic studies and AI incorporation and their integration for collecting real world data in adjunctive irrigation research.
- Align evidence based findings with the clinical need for lasers and multisonics in root canal irrigation for improved outcomes.
Mohamed Ibrahim, D.M.D.
Dr. Ibrahim is Professor and Director of Predoctoral Endodontics at Marquette University School of Dentistry. He earned his dental degree with honors from Mansoura University in Egypt, where he also completed his Master of Science and endodontic training. Dr. Ibrahim obtained a PhD through a joint supervision program between Mansoura University and the University of Cologne, Germany, focusing on endodontic microbiology and disinfection. He further earned a doctoral degree (Dr. Med. Dent.) from the University of Cologne, specializing in endodontic hydrodynamic disinfection.Dr. Ibrahim has published extensively in leading journals, including the Journal of Endodontics, International Endodontic Journal, and the Journal of Dental Education, among others. He is the author of two book chapters on the biocompatibility of dental biomaterials and injectable gels for dental and craniofacial applications. He has lectured nationally and internationally on various topics in endodontics.In addition to his academic contributions, Dr. Ibrahim serves as a reviewer for several peer-reviewed journals, including the Journal of Endodontics, Journal of Dental Education, Materials, and Scientific Reports. He is also an active member of the AAE Research and Scientific Affairs Committee.
Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 1.25
Description: Real-time dynamic navigation and dental lasers are often hailed as groundbreaking innovations in various fields. Real-time dynamic navigation systems, particularly in non-surgical and surgical procedures provide enhanced precision and safety by continuously adapting to changing conditions. Dental lasers offer precise, minimally invasive treatments that can enhance patient outcomes and reduce recovery times.
But are these technologies truly as transformative as they seem, or are they just advanced iterations of existing tools? This evidence based presentation will delve into the real impact of these innovations, assessing their effectiveness, adoption, and the extent to which they are changing the future non-surgical and microsurgical Endodontics. In this lecture, for the first time, the integration of real-time laser guidance with microsurgical techniques will be presented. Real-time laser guidance represents a significant leap in enhancing precision, safety, and outcomes in endodontic microsurgery.
Learning Objectives:
- Demonstrate the workflow, and application of real-time dynamic navigation in minimally invasive endodontic procedures as locating calcified canals and microsurgical procedures in close proximity to vital structures.
- Describe the different laser systems, wave lengths available in laser technologies and its different applications in non-surgical (disinfection of root canal systems) and surgical procedures (surgical incisions, osteotomies, root resection and photo-biomodulation).
- Demonstrate the integration of real-time laser-guided technology in Endodontic microsurgery.
Mohamed I. Fayad, DDS, MS, PhD
Dr. Fayad received his Doctor of Dental Surgery from the College of Dentistry, Cairo University in 1985. He received his Masters in Oral Sciences in 1994 and his PhD in 1996 from the University of Buffalo at New York. He had two years of Advanced Education in General Dentistry at Eastman Dental Center, University of Rochester at New York, and received his certificate of Specialty in Endodontics at the University of Illinois.
Currently he is the director of Endodontic research, and a clinical associate Professor in the Endodontic department at College of Dentistry at UIC, dividing his time between teaching, research, intra-and extra-mural continuing education and private practice. He currently serves on the Scientific Advisory and Manuscript Review Panels of the Journal of Endodontics, and Evidence Based Endodontics Journal. He served on the AAE Research and Scientific Affairs Committee and co-chaired AAE/AAOMR committee drafting the joint position statement on CBCT (2015). He has numerous publications and chapters in peer reviewed journals and textbooks (Pathways of the pulp) and (Contemporary surgical Endodontics). He is the co-editor of the CBCT text book (3-D Imaging in Endodontics: A new Era in diagnosis and treatment) by Springer (2016).
Speaker Disclosure
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.
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Includes Credits
CE Hours: 1.0
Description: We are undoubtedly living in a golden era for endodontics. With a plethora of advanced instruments, materials, and equipment designed to enhance clinical workflows and outcomes, the possibilities seem endless. Among these, the emergence of various disinfection devices has sparked significant interest—and controversy.
Clinicians are now faced with a critical question:
Are these high-cost devices truly game-changers in root canal disinfection, or are they overhyped luxuries?
This presentation aims to reexamine our core objectives during root canal disinfection and critically evaluate how modern instrumentation and irrigation devices can elevate the patient experience and clinical outcomes.Learning Objectives:
- Explore practical strategies to improve clinical efficiency
- Understand the role and effectiveness of various irrigation devices in improving disinfection quality
- Analyze the impact of advanced disinfection approaches on clinical patient outcomes
Adham A. Azim, D.D.S., B.D.S.
Dr. Azim is an Associate Professor, Chair of the Endodontic Department, and the Director of the Post-Graduate Program at University of the Pacific, Arthur A. Dugoni School of Dentistry. He maintains a private practice limited to Endodontics and he is also the Founder and CEO of Endolit. Dr. Azim earned his BDS from Cairo University, where he also did his Endodontic training. He later completed his Endodontic certificate at Columbia University, and since then, he has been a full-time Educator and a Part-Time Private Practitioner. Before Joining the University of the Pacific, he Served as the Division Head and the Director of the Endodontic Post-Graduate Program at University at Buffalo. Dr. Azim is the recipient of the 2023 AAE Edward M. Osetek Award for outstanding educators. He is Diplomate of the American Board of Endodontics and has lectured all over the world. He has over 40 publications in peer-reviewed journals and several text-book chapters contributions. He is a member of the Scientific Advisory Board of the Journal of Endodontics, and a reviewer for multiple other Endodontic Journals.
Speaker Disclosure
Disclosure(s): Endolit LLc: Ownership Interest (stocks, stock options, patent or other intellectual property or other ownership interest excluding diversified mutual funds) (Ongoing); FKG Dentaire, Switzerland: I am a consultant (Ongoing); Odne: Ownership Interest (stocks, stock options, patent or other intellectual property or other ownership interest excluding diversified mutual funds) (Ongoing); Woodpecker: royalties (Ongoing)
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Includes Credits
CE Hours: 0.75
Description: The goal of root canal treatment is to prevent or reverse apical periodontitis by removal of necrotic/infected or irreversibly inflamed tissues, followed by obturation of the root canal space. Mechanical instrumentation and irrigation play a key role in the removal of pulp tissue, contaminants, debris, and microorganisms from the root canal system. Different adjunctive agitation techniques have been developed to help irrigating solutions penetrate the complexities of the root canal system. Passive ultrasonic irrigation, apical negative pressure irrigation systems, sonic activation, multisonic agitation, and laser activation have been reported to be superior to conventional positive pressure needle irrigation in regards to smear layer removal, antimicrobial effect, and decreased post-operative pain. Minimally invasive canal preparation has been promoted with the activated irrigation approaches. However, what is not known is the effect of minimally invasive instrumentation, in conjunction with an activated irrigation approach on clinical outcomes (retention/longevity, healing of apical periodontitis). Can infected root canals be predictably disinfected following conservative root canal preparation? Based on a review of the current literature and personal clinical experience, appropriate preparation sizes for root canal treatment will be explored.
Learning Objectives:
- Describe how apical preparation size during root canal treatment affects the clinical outcome.
- Evaluate the current best available evidence to support minimal invasive canal preparation with different irrigation protocols.
- Choose the appropriate preparation size for root canal treatment upon irrigation protocol.
Qian Xie, D.D.S., Ph.D.
Dr. Qian Xie received her BDS and PhD degrees from Sichuan University, Chengdu, China. After a few years of practice, Dr. Xie returned to graduate school at the University of Illinois at Chicago College of Dentistry, where she received her Certificate of Specialty in Endodontics. Dr. Xie is a Diplomate of the American Board of Endodontics. Dr. Xie has been a member and an active participant in the American Association of Endodontists, the American Dental Association, the Chicago Dental Society, and the Edgar D. Coolidge Endodontic Study Club. She is a fellow of the International College of Dentists. Dr. Xie has a broad background in oral science and clinical dentistry, with specific training and expertise in oral microbiology research and clinic experience in endodontics. Her research background includes caries research, oral biofilm and endodontic irrigation.
Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 1.0
Description: Computer Guided Endodontic Solutions for Complex Cases. With the introduction of cone beam computed tomography (CBCT), intra-oral scanning, 3D planning software, 3D printers and computer aided dynamic navigation devices, It is possible to plan ahead, in a very precise, predictable, more conservative way computer aided procedures with lower clinical times for high difficulty cases, such as, severely calcified canals, endodontic microsurgery of cases with intact cortical bone close to important anatomical structures like the maxillary sinus, the mental foramen or the mandibular canal, and tooth autotransplantation of both mature or immature teeth. The necessary digital work flow for static 3D-printed guides or dynamic virtual guides and the available scientific evidence will be discussed in detail as well as the clinical protocols and required armamentarium. Several clinical cases of each type of guided treatment will be shown and described step by step with proper follow up periods displaying a positive outcome.
Learning Objectives:
- List the digital work flow necessary to perform computer aided endodontic treatments.
- Evaluate if a specific case is indicated, or not, to be treated with a computer aided or guided procedure.
- Discuss the possibility of offering these types of treatments to a patient.
Felipe Restrepo, D.D.S. M.Dent
Dr. Felipe Restrepo, was born and raised in Medellín - Colombia. Graduated from the University of Antioquia with a degree in Dentistry 2003, after one year as general practicioner he entered a two year Endodontic program and graduated from University CES in 2007. Associate Professor at the University of Antioquia teaching their postgraduate level students in endodontics and also Director of the Dental Emergencies Diploma. Dr. Restrepo has authored several scientific articles in peer-reviewed journals. Ex-president of the Antioquian Association of Endodontists. Private practice limited to Endodontics, Endodontic Microsurgery and Tooth Autotransplantation in Medellín since 2007, international speaker.
Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 1.0
Description: It appears we are in the middle of an endodontic revolution of sorts. Today's endodontists are trying to preserve as much root dentin as possible while removing as much bacterial biofilm as possible. Enhanced irrigation, whether laser or multisonic, claims to disrupt and debride the smaller shapes we are creating with our files and the hidden spaces that those files never touch. Both technologies are expensive, require ongoing maintenance, and add steps to the clinical workflow. Proponents of both laser and multisonic procedures have strong opinions as to which technology is "better", but the jury is still very much out on the answer to that question. I have chosen to incorporate both technologies into my practice, and find myself preferring one or the other depending on the case type, the tooth, and even how my schedule is running at the time. In my personal experience, there are pros and cons to both technologies, and I will discuss these in detail during my presentation.
Learning Objectives:
- Breakdown the main differences in the mechanisms of action between laser and multisonic technology in the debridement and irrigation of root canal systems.
- Describe the advantages/pitfalls, opportunities/difficulties, and joys/frustrations that are associated with incorporating each technology into the everyday treatment of endodontically compromised teeth.
- Distinguish between which cases can be treated more efficiently with a laser assisted approach vs. a procedure involving multisonic energy and activation.
S. Kirk Huffaker, DMD, MDS
Dr. Huffaker is a full-time, clinical endodontist and the owner of Mountain View Endodontics. He graduated from CWRU School of Dentistry in 2006 and completed a 3-year endodontic residency at the University of Connecticut Health Center in Farmington in 2009. He lives with his wife and 7 children in Queensbury, NY where he spends most of his "non-endodontic" time trying to keep up with all of his children's activities. He is a fellow of the International Academy of Endodontics and has lectured around the country on a variety of endodontic topics.
Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 0.75
Description: Irrigation is a key part of successful root canal treatment. Recently, many canal system irrigating technology has introduced to the Endodontics market. This created a healthy debate and discussion in the endodontic society. Emerging questions that are raised are; Which technology to implement? Are these devices affecting the outcome compared to the traditional treatment? Where is the evidence? And most importantly what kind of evidence are we looking for? What metanalysis informing us about supplemental irrigation, is the metanalysis still on top of the evidence pyramid? Are there outcome studies? What kind of outcome studies should we rely on?
This presentation will attempt to present a balanced viewpoint answering all these questions based on the most recent research findings following an evidence based approach.
Learning Objectives:
- Describe the current root canal system irrigating devices and their efficacy and limitations
- Identify the best method for evaluating cleaning and disinfection of the complex root canal system
- Identify the optimal study design and type to evaluate endodontic outcome
Mohamed Ibrahim, D.M.D.
Dr. Ibrahim is Professor and Director of Predoctoral Endodontics at Marquette University School of Dentistry. He earned his dental degree with honors from Mansoura University in Egypt, where he also completed his Master of Science and endodontic training. Dr. Ibrahim obtained a PhD through a joint supervision program between Mansoura University and the University of Cologne, Germany, focusing on endodontic microbiology and disinfection. He further earned a doctoral degree (Dr. Med. Dent.) from the University of Cologne, specializing in endodontic hydrodynamic disinfection.Dr. Ibrahim has published extensively in leading journals, including the Journal of Endodontics, International Endodontic Journal, and the Journal of Dental Education, among others. He is the author of two book chapters on the biocompatibility of dental biomaterials and injectable gels for dental and craniofacial applications. He has lectured nationally and internationally on various topics in endodontics.In addition to his academic contributions, Dr. Ibrahim serves as a reviewer for several peer-reviewed journals, including the Journal of Endodontics, Journal of Dental Education, Materials, and Scientific Reports. He is also an active member of the AAE Research and Scientific Affairs Committee.
Disclosure(s): No financial relationships to disclose