CE Hours: 2.0

Description: Use of the Piezotome for endodontic microsurgery has become quite popular, especially creating a bone "window" or "lid" to gain better access to areas like mandibular molars with thick cortical bone. It can be technique sensitive to replace those windows securely, allowing for the bone to revascularize and maintain the osteotomy space. This lecture will discuss drawing the patient's blood and centrifuging out platelet-rich fibrin plugs and membranes as well as crushing the bone "window" and mixing it with the serum created from forming the PRF membrane to make "sticky bone", which is sandwiched in between the PRF plugs and covered by the PRF membrane.
The latter part of the presentation will focus on treatment planning and case selection for Intentional Replantation, explaining the techniques in detail and showing several clinical cases with follow ups.

Learning Objectives: 

• Describe when a piezotome should be incorporated for creating a bone window (boney lid) during endo microsurgery
• Describe alternative treatment utilizing Platelet-Rich Fibrin (PRF) derived from the patient's own blood and creation of autologous sticky bone
• Describe Intentional Replantation and be comfortable performing in their private clinics

CE Hours: 1.75

Description: Guided surgery has garnered significant interest in our specialty over the past 5 to 7 years. The introduction of dynamic and static navigation has enabled endodontists to perform surgical and non-surgical procedures with greater precision and minimal invasiveness. Complex surgical cases—such as palatal root periapical surgery of maxillary molars and periapical surgery of posterior mandibular teeth—are particularly well-suited for these techniques.
However, several questions arise when planning or performing guided surgical procedures: Should the surgery be partially guided or fully guided? Is the case suitable for a guided flapless approach? Does guided surgery offer a real advantage in the given scenario?
The purpose of this clinical presentation is to examine both the benefits and limitations of guided surgery, and to discuss the critical decision-making involved in its application.

Learning Objectives: 

• Describe and discuss the clinical applications of dynamic and static navigation in anatomically compromised periapical surgical cases.
• Describe and discuss the limitations of using flapless TEMS in periapical surgery
• Evaluate whether guided surgery may become a redundant tool in periapical surgical practice

CE Hours: 1.0

Description: Endodontic surgery has seen remarkable improvements in clinical and radiographic outcomes thanks to the development of advanced microsurgical techniques and instruments. However, while these procedures effectively address apical lesions, they can sometimes lead to unintended soft tissue issues such as recession, papilla loss, and scarring. As aesthetics become increasingly important in patient care, achieving optimal hard tissue results is no longer enough; successful soft tissue management is equally critical to ensure a satisfying outcome.
In this presentation, Dr. Wohlgemuth, will guide you through pre-operative assessment and critical steps of endodontic surgery with a focus on enhancing aesthetic outcomes. The lecture will cover incision design, flap management, and the selection of suture size, type, and technique. Through a series of clinical cases, Dr. Wohlgemuth will illustrate how mastering these techniques can significantly improve the aesthetic results of your endodontic surgeries.

Learning Objectives: 

• Describe the parameters related to the aesthetic outcome
• Describe different flap designs and suture techniques to achieve optimal aesthetic outcomes
• Explain the role of pre-surgical planning on the outcome of endodontic surgery

CE Hours: 1.75

Description: In complex clinical scenarios, some dentists might just go straight to suggesting an extraction and implant. However, many patients still express a strong preference for saving their natural teeth—whether due to personal values, medical conditions, dental anxiety, or financial and philosophical reasons. When non-surgical root canal treatment is not feasible, endodontic microsurgery may offer a useful alternative. This presentation explores a comprehensive approach to case selection and treatment planning in endodontic surgery. Beyond evidence-based principles, a novel stepwise clinical sequence developed by the presenter will be introduced to guide decision-making in challenging cases. Clinical examples will include separated instruments, radicular cysts, root resorption, radicular grooves with periodontal involvement, canal transportation, perforations, and suspected vertical root fractures. Attendees will gain practical strategies for preoperative evaluation such as risk assessment, and surgical planning to achieve predictable, patient-centered outcomes.

Learning Objectives: 

• Differentiate between various types of complex cases—such as separated instruments, radicular cysts, root resorption, radicular groove, vertical root crack/fracture, perforation/transportation—and determine surgical suitability
• Apply a stepwise clinical reasoning framework to enhance predictability and success rates in root-end surgery.
• Apply insights from clinical cases and critical literature reviews to best optimize treatment outcomes.

CE Hours: 1.0

Description: Treating significant bone loss around teeth (apico-marginal defects) is a challenge for dentists, particularly endodontists who focus on the root canal and surrounding tissues. Deep pockets often indicate a connection between this bone loss and complete exposure of the tooth's root surface. This significantly impacts treatment planning and management. Studies have investigated methods to stimulate bone regrowth and improve patient well-being. A recent approach utilizing platelet concentrates demonstrated encouraging results in reducing pocket depth and promoting some bone formation. However, it fell short in effectively regenerating the bone on the side facing the cheek (facial or buccal bone). This presentation will explore a novel technique using collagen crosslinking. This method aims to improve healing and quality of life for patients with severe bone loss around their teeth. We'll compare the results of this new approach with traditional methods, analyzing both 2D and 3D healing outcomes to assess its effectiveness in bone regeneration and overall treatment success.

Learning Objectives:  

• Review the mechanisms by which root canal infections impact periodontal tissues and identifying strategies for effective healing.
• Describe guided tissue regeneration and autologous products used alongside root canal surgery. These techniques aim to prevent the apical migration of junctional epithelium.
• Assess the effectiveness of regenerative techniques in promoting healing of bone loss around teeth (apicomarginal defects) caused by root canal problems.

CE Hours: 0.75

Description: Cemental tears can be difficult to diagnose and sometimes even harder to treat. Even the best clinicians can miss diagnose them unless familiar with what to look for. The clinical signs, symptoms, and radiographic appearance of cemental tears are not always obvious even on a CBCT. However, a cemental tear can be the reason why some of those flawless non-surgical root canal therapies or apical surgeries may not heal. Unnecessary endodontic treatment can sometimes be the result of misdiagnosis. Management with a surgical approach is required to save teeth with cemental tears. We will review the etiology, diagnosis, and treatment options of cemental tears.

Learning Objectives:  

• Describe the etiology of a cemental tear.
• Diagnose a cemental tear and determine the classification based on radiographic and clinical findings.
• List the treatment options of cemental tears based on their classification.

CE Hours: 0.75

Description: Managing large cystic periapical lesions presents significant challenges for clinicians, especially when non-surgical treatment or retreatment options prove ineffective. Surgical intervention involving debridement and apical resection may be deemed contraindicated due to factors such as the proximity to vital anatomical structures, the risk of damage to adjacent teeth, and compromised healing associated with significant bony defects. Despite these challenges, decompression offers a minimally invasive treatment alternative that is frequently overlooked in modern dentistry. This presentation aims to explore the indications and advantages of decompression in treating large cystic periapical lesions. Through clinical case studies and follow-ups, we will demonstrate essential steps, including pre-operative assessment using cone-beam computed tomography (CBCT) scans, needle aspiration-irrigation techniques, and the placement of a Penrose drain. Furthermore, we will review pertinent literature to highlight the biological principles, clinical efficacy, and long-term outcomes associated with decompression.

Learning Objectives:  

• Describe the clinical indications for decompression and conduct a preoperative assessment using conebeam computed tomography (CBCT) scans.
• Perform aspiration irrigation techniques and utilize a Penrose drain for decompression.
• Evaluate the outcome of decompression in treating large cystic periapical lesions.

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: In the era of ‘white’ and ‘pink’ esthetics,  the primary objective of preserving the natural dentition is no longer acceptable, if we do not consider esthetic consequences. When we do an endodontic surgery we may solve the endodontic problem, but we may create an esthetic problem noticeable by the patient. Knowledge of essential anatomical landmarks, blood vasculature and would healing are mandatory in order to obtain an excellent soft tissue healing outcome postsurgically. This presentation will address incisions and flap designs for all tooth locations, as well as criteria for proper flap design selection. At the same time, atraumatic flap manipulation and suturing techniques under the microscope can enhance the clinician’s surgical skills and will be thoroughly discussed throughout this presentation.

Learning Objectives:  

• Describe indications of different flap designs in endodontic surgery.
• Familiarize with atraumatic manipulation, proper predictable suturing of the mucosal tissues under the microscope.
• Expand their knowledge in mucogingival surgical procedures.

CE Hours: 1.0

Description: The presentation will focus on endodontic surgery and its peculiarities. It will begin with a brief introduction and a simple step-by-step clinical case. Then various clinical cases will be shown in which the endodontic lesion will be in contact with or within the sinus. This will be followed by a brief description of how to manage clinical cases near the alveolar nerve, and finally the periodontal part and its importance in endodontic surgery will be discussed.

Learning Objectives:  

• Manage modern endodontic surgery.
• Manage endodontic survey involving maxillary sinus.
• Manage periodontal approach to modern endodontic surgery.