CE Hours: 0.75

Description: Root perforations represent one of the most challenging complications during endodontic procedures. These are defined as a communication between the root canal space and the periodontal tissues, and can result as a pathological phenomenon (perforating root resorptions) or a iatrogenic event. To date, factors such as time, size, location, radiolucency adjacent to the perforation, gender or the repair material have been reported as significant prognostic factors. Thus, the primary aim of this this presentation is to perform an exhaustive literature review regarding root perforations outcome. The secondary objective is to describe the clinical management of root perforations and to present the results of a recent investigation carried out in a private practice during 2014-2022 with a minimum follow-up 2 years. A sample size of 82 teeth was retrospectively assessed and the outcome (healed, healing in process, failure) was statistically related to all the possible outcome predictors.

Learning Objectives:  

• Describe a well-established protocol to manage root perforations according to the different scenarios (time, size, location of the perforation).
• Review the present literature regarding root perforations treatment outcome.
• Evaluate the success of root perforations repair in combination with the preoperative, intraoperative and postoperative prognostic factors of current investigation.

CE Hours: 1.5

Description: In modern dentistry, more natural teeth are retained in service for an increased number of years in which they are subjected to a wide array of chemical, mechanical and microbiological stimuli including the iatrogenic impact. Therefore, the presentation of different resorptive defects is not a rarity in dental offices. This clinically oriented presentation will discuss various aspects of root resorption categories from pathophysiology to diagnosis and treatment planning.  The aim is to guide the clinician through non-surgical, surgical, and monitoring management protocols supported by the best available evidence, and enhance the clinical practice to provide favorable patient-centered outcomes.

Learning Objectives:  

• Discuss pathophysiology of root resorption and clinical relevance.
• Evaluate modes of intervention in cases of root resorption applying most recent technology.
• Describe patient centered outcomes for management of root resorption.

CE Hours: 1.0

Description: Persistent worry and negative thinking impair our cognitive function, limiting problem- solving abilities and creative thinking which directly affect clinical  outcomes and personal well-being. How can we counteract these crippling effects to foster a resilient, thriving professional environment? The line between personal mindset and professional identity is increasingly intertwined. This course ventures deep into the heart of this connection, exploring how mindset shapes our professional journeys and the importance of maintaining optimism and gratitude through unexpected challenges. Participants will discover the science behind optimism and its crucial role in strategic success. We will differentiate between toxic positivity and authentic happiness and engage with Dr. Mendelson's TEAM Framework to understand the profound impact of thoughts on outcomes. With a blend of cutting-edge research and actionable insights, participants will learn to leverage their inner dialogue to craft a professional identity that resonates with success, innovation, and fulfillment. From dissecting the complexities of the mind-body connection to applying methodologies within organizational structures, learn a scientific and holistic approach to personal and professional development. This course is a beacon for those seeking to elevate their cognitive capabilities while fostering a culture of gratitude and resilience.

Learning Objectives:  

• Apply research based methods to enhance cognitive and visual functions for improved decision making and productivity
• Differentiate between toxic positivity and evidence based happiness strategies to foster authentic practice wellbeing.
• Analyze the impact of mindset on professional identity and clinical success utilizing the TEAM Framework.

CE Hours: 0.75

Description: As Endodontists our mission is to save teeth and our specialized training equips us to do so. Biologic and clinical factors that impact endodontic treatment outcomes are widely studied, discussed, and considered in treatment planning. However, other, external factors also impact our ability to maintain the natural dentition. This session will explore factors that have been shown to impact access to endodontic care and outcomes of endodontic treatment, with an emphasis on oral health policy, economic forces, and clinician decision-making. Further, this session will consider how endodontists can promote oral health equity through clinical practice and advocacy.

Learning Objectives:  

• List clinical factors shown to have significant influence on the outcomes of nonsurgical endodontic treatment.
• Discuss nonclinical factors that may impact access to endodontic care.
• Describe national (U.S.) trends in dental care use, insurance coverage, and barriers.

CE Hours: 0.75

Description: The purpose of vital pulp therapy (VPT) is to maintain the health of all or part of the pulp in normal or inflamed pulps. This group of treatments includes direct pulp capping, partial and full pulpotomy. For decades, VPT has been recommended and widely accepted as treatment for mechanical or carious pulp exposure of permanent immature teeth, with pre-operative diagnosis of normal pulp or pulpitis, to assure completion of root formation (apexogenesis). Over the past decade, advancements in our understanding of pulp biology coupled with the development of new bioactive materials have expanded the indications for VPT. Recent high-quality scientific evidence encouraged clinicians, and also endodontic associations, to suggest VPT as a predictable approach for treatment of mature permanent teeth with preoperative inflammation, in order to conserve the pulp’s protective mechanisms and great healing capacities. Notably, pulpotomy now offers a viable alternative to traditional root canal treatments for mature permanent teeth with symptomatic irreversible pulpitis. The success of VPT greatly depends on i) the absence of microorganisms, and ii) the pulpal immunocompetence/level of inflammation. Presently, these conditions cannot be reliably assessed through clinical methods alone. Consequently, it is essential to integrate meticulous pre-operative pulp diagnosis with careful intraoperative assessment of pulp tissue to ensure proper case selection. Furthermore, strict adherence to established operative protocols is crucial to improve treatment outcomes.

Learning Objectives:  

• Explain the histopathologic basis for clinical application of pulpotomy.
• Describe how intraoperative pulp tissue assessment influences the clinical decision making process.
• Discuss the factors affecting the immediate and long term outcome of pulpotomy.

CE Hours: 1.0

Description: Understanding of the relationship between Endodontics and systemic disease has evolved considerably over the past century, from the initial pseudo-science related to the focal infection theory to modern day understanding of the pathogenesis inflammatory diseases and their interrelationship. This session will discuss recent information on the association of endodontic disease pathogenesis as well as treatment outcomes with major chronic systemic diseases and their treatment.

Learning Objectives:  

• Identify the relationship between systemic diseases and the pathogenesis of endodontic diseases
• Discuss the relationship between systemic diseases and the treatment outcomes of endodontic diseases
• Present clinically relevant and evidence-based discussion points about this subject

CE Hours: 1.5

Description: Cemental tear is an important condition of relevance to Endodontics and Periodontics but is often overlooked. The diagnosis of cemental tear is often challenging, even for the experienced clinician. In practice, it is common for a cemental tear to be misdiagnosed as a vertical root fracture, an endodontic–periodontal lesion, or a failed periodontal or endodontic treatment. Dentists may treat these clinical cases as pure periodontal and periapical lesions due to misdiagnosis of cemental tears. In some cases, the presence of cemental tears was realized after the extraction of non-healing teeth. Some failed cases, for unknown reasons, are due to the presence of cemental tear. The limited attention received is most likely due to the unawareness amongst dental professionals and challenges in accurately diagnosing them, resulting in misdiagnosis and erroneous treatment. In this lecture, we will review 1) the etiology, 2) clinical, radiographic, and histological features, (3) classification, 4) recommended treatment strategies linked to the classification 5) treatment outcomes of cemental tear.

Learning Objectives:  

• Explain the different etiology of cemental tear.
• Elaborate clinical and radiographic presentation of cemental tear.
• Demonstrate different treatment strategies for cemental tears depending on the classification.

CE Hours: 1.25

Description: The pulp and periodontium have embryonic, anatomic and functional inter-relationships. The simultaneous existence of combined endodontic-periodontal lesions either with or without root damage is a clinical dilemma that can complicate diagnosis, prognosis and treatment planning. These lesions should be classified according to signs and symptoms that have direct impact on their treatment, such as presence or absence of fractures, perforations and external root resorption, presence or absence of periodontitis, and the extent of periodontal destruction around the affected teeth. Management of combined endodontic-periodontal lesions can be challenging especially when severe destruction of the surrounding periodontal tissues is noted. Exposing a CBCT scan may be an important diagnostic tool to confirm the real extent of both lesions and their possible communication and reveal root anatomic factors that may predispose to the clinical outcome. Understanding the complex pathogenesis of both lesions can determine the therapeutic approach for a successful regenerative treatment outcome.

Learning Objectives:  

• Identify and classify endodontic periodontal lesions.
• List and sequence therapeutic approaches to treat endodontic periodontal lesions.
• Define diagnostic tools to clinically assess combined endodontic periodontal lesions.

CE Hours: 1.5

Description: Apical periodontitis (AP) is a complex inflammatory disease with different clinical and radiographic presentations. The pathogenesis of AP involves an interplay of the innate and adaptive immune responses, that aim at preventing root canal microflora from causing spreading systemic infection and/or osteomyelitis. This session will discuss the major pathways involved in the progression and healing of AP. It will also address the way a myriad of systemic factors may affect this apical immune response.

Learning Objectives:  

• Discuss the major immunological pathways involved in the pathogenesis of AP
• Discuss the major immunological mechanisms of healing and bone regeneration following endodontic treatment
• Discuss the potential role of systemic factors in mediating pathogenesis or healing of AP

CE Hours: 0.0

Description: The ultimate goal in endodontics is to save the natural tooth. This can be especially challenging when the restorability is questionable and extraction has been recommended, but the patient insists on saving it. This presentation provides a framework for an Endo-Restorative practice in less-than-ideal situations, where minimal intervention procedures could maximize tooth preservation correlated with improved fracture resistance. This presentation follows the outcome of over 160 teeth from 4yrs to 18 years after endo-restorative rehabilitation. All endodontic and restorative procedures were done in a solo- private practice, between 2006 and 2020. Outcome was evaluated based on both clinical and radiographic findings at recall. Teeth were classified as healed, survived or failed. With diligent planning and patient compliance, this modality could be a promising option for medically compromised/geriatric patients and for those preferring minimal financial burden or intervention.

Learning Objectives:  

• Evaluate the optimal steps in the rehabilitation of structurally damaged teeth.
• Perform adhesive restorative techniques on the endodontically treated tooth to enhance patient experience of saving the natural tooth.
• Discuss the factors that contribute to the long term survival of structurally compromised teeth.