CE Hours: 1.5

Description: Technologies continually evolve to satisfy the demands of emerging microsurgical techniques but are not limited to the classical endodontic surgical armamentarium. The most recent example is the implementation of the Piezosurgical technique for root end surgery. Heightened awareness of significant vascular elements via pre-surgical CBCT surveys mandate cautious sectioning processes. Restrictive soft tissue access hampers effective retraction for conventional surgical handpieces. Substantial cortical plate thicknesses combined with unusual anatomy can confound the most experienced surgeon. All these factors present the dichotomy of visualization/manipulation versus post-surgical regeneration. The featured clinical cases highlight the adaptability and versatility of this new technology in this challenging surgical arena.

Learning Objectives:  

• Contrast the visibility and precision of root end procedures performed using Piezo versus conventional handpiece
• Assess the adaptability, visibility and precision of this technology for "novel" surgical corrections.
• Evaluate the tissue selectivity of the Piezo and its advantages in certain clinical environments

CE Hours: 0.75

Description: The presentation will discuss the challenges in diagnosis and treatment planning of Endo-perio lesions. It will then discuss the importance of communication and collaboration between the endodontist and the periodontist in the attempt to save teeth. The role of guided bone regeneration during apical surgery - techniques and indications - will be reviewed as well as the manipulation of soft tissue in the management of resorptive lesions. This lecture will present the conversation and treatment planning of joined surgical procedures to ensure maximum patient benefit.

Learning Objectives:  

• Describe indications for guided bone regeneration during apical surgery.
• Discuss case selection for periodontal intervention before/during/after endodontic treatment
• Analyze periodontal prognosis when combined with endodontic treatment

CE Hours: 0.75

Description: Success in endodontic microsurgery often depends on the ability to adapt when faced with non-routine clinical situations. This session focuses on managing cases that fall outside textbook scenarios. Through case-based discussion, we will explore challenges such as sinus proximity and perforation, instrument and silver point retrieval, calcified canals, and surgery involving anatomically complex teeth or regions. The role of hybrid and advanced flap designs to enhance soft tissue healing and access will be explored. Special emphasis will be placed on identifying cases requiring guided bone regeneration (GBR), particularly in the presence of apicomarginal defects or cemental tears. This session aims to provide practical strategies for managing the unexpected while maintaining surgical precision and predictability.

Learning Objectives:  

• Discuss approaches to managing broken instruments, apical silver points, and calcified canals during apical microsurgery.
• Describe when and how to modify flap design to improve access and healing.
• Explain when guided bone regeneration should be integrated into surgical treatment.

CE Hours: 1.5

Description: The lecture will discuss results of the PRF study conducted at the University of Pennsylvania describing the use of Platelet Rich Fibrin (PRF) used in Endodontic Microsurgery. Also to be discussed is the use of the Piezotome to create a bone window (bony lid) and as an alternative to securing the bone window, we will show the bone crushing technique where the crushed window is used as an autogenous graft, mixed with the serum derived from pressing the PRF plug into a membrane

Learning Objectives:  

• Create Platelet Rich Fibrin (PRF) through the technique described in the presentation
• Describe and analyze the results of current PRF study
• Explain the technique and benefits to bone crushing of the bone window to use as sticky bone withing the surgical osteotomy

CE Hours: 0.75

Description: Minimally Invasive Endodontic Microsurgery. What is this? Are we really doing it? There is a consensus about what minimally invasive endodontics is. We know it refers to contracted access, small taper preparations (shaping), preservation of the peri-cervical dentin and activation of irrigants in order to properly disinfect the root canal system. But when discussing endodontic microsurgery (EMS), there is no consensus about what is being minimally invasive. Being minimally invasive could be to save a poor prognosis tooth, preserving dentin as much as possible, preserving bone as much as possible, planning a guided EMS or doing everything with a ¨Micro¨ approach (Including the soft tissue). Several clinical cases for each previously mentioned topic will be shown and described step by step with proper follow up periods displaying a positive outcome. For the ¨Micro¨ approach, a comparison between conventional and laparoscopic minimally invasive medical surgery is made in order to show how the same goal can be achieved through two very different surgical accesses, one with a big, long incision and the other with a couple of very small incisions. As endodontists we can also perform EMS trough conventional large flaps or with very small incisions achieving excellent results in less time, less risk of complications and less postoperative pain for our patients. All of these thanks to all the technology we have available at the moment like the operative microscope, micro-surgical instruments, cone beam computed tomography (CBCT), intra-oral scanning, 3D planning software, and computer aided dynamic navigation devices among others.

Learning Objectives:  

• Determine that the combination of several aspects can lead to a minimally invasive endodontic microsurgery.
• Differentiate different types of minimally invasive surgical accesses to properly perform an endodontic microsurgery.
• Conclude what a minimally invasive endodontic microsurgery really is.

CE Hours: 1.0

Description: Effective soft tissue management plays a critical role in the success of endodontic microsurgery, especially in achieving esthetic and functional outcomes. This presentation will begin by highlighting the historical evolution of flap designs-from conventional techniques such as the semilunar, intrasulcular, and submarginal flaps to the transition toward papilla-based incisions-illustrated through clinical cases that demonstrate their advantages and limitations. Established periodontal techniques such as the VIP approach, entire papilla preservation, the coronally advanced flap, and the bilaminar technique-now increasingly embraced in endodontic microsurgery-will be presented with a focus on their ability to prevent scar tissue formation and prevent or even improve gingival recession. Particular emphasis should be given on techniques for tissue elevation, manipulation, and reapproximation, as demonstrated through a wide array of clinical examples. The lecture will underscore how soft tissue and periodontal considerations, once overlooked in endodontic surgery, are now vital for achieving predictable, long-term, and esthetically pleasing outcomes.

Learning Objectives:  

• Describe the evolution of soft tissue flap designs in endodontic microsurgery and their clinical implications.
• Evaluate the benefits and limitations of the VIP approach, entire papilla preservation, coronally advanced flap, and the bilaminar technique.
• Apply principles of soft tissue elevation, manipulation, and reapproximation to minimize postoperative complications such as scar formation and gingival recession.

CE Hours: 1.0

Description: Advanced endodontic treatment techniques designed to retain severely compromised teeth otherwise destined for extraction and implant therapy will be presented. The focus will be on advanced endodontic options that preserve the compromised or failing dentition. Methods to improve endodontic success will be discussed. Advanced endodontic repair options will make you take a second look at implant therapy and be more confident deciding when to save or replace.

Learning Objectives:  

• Discuss effective repair procedures used by the endodontic professional  on new and existing perforations.
• Perform canal disinfecting procedures and also compare the effectiveness and practicality of current technologies
• Describe how endodontics can overcome and resolve common procedural complications on severely compromised teeth, and when to preserve teeth when treating radicular fractures.

CE Hours: 0.75

Description: Clinicians face complex treatment decisions every day, often guided by their personal experience and established protocols. However, in endodontics, some of the most critical and challenging choices are the proper selection of biomaterials, particularly new-generation sealers and cements. With a constant influx of products and aggressive marketing, practitioners must navigate not only how to use these materials, but also which material should be used for each clinical case and whether their use is scientifically justified. This session will present a clinically grounded decision-making framework to simplify the selection process. By applying evidence-based criteria to biomaterial choice, endodontists can improve clinical outcomes and preserve teeth that might otherwise be deemed unsalvageable.

Learning Objectives:  

• Describe the physicochemical and biological properties of endodontic biomaterials.
• Discuss how the physicochemical and biological properties of the endodontic biomaterials will influence their clinical behavior.
  • Develop a decision-making tree for the utilization of biomaterials during a clinical case.

CE Hours: 1.0

Description: Trigeminal nerve injuries secondary to dentoalveolar procedures such as dental extractions, dental implants, and endodontic therapy continue to be a significant concern for patients and practitioners. In this session, we will discuss practical approaches to recognize risk factors, risk mitigation strategies, and nerve injury management for patients requiring surgical and non-surgical endodontic therapy. 

Learning Objectives:  

• Identify risk factors for nerve damage and prognostic factors of recovery.
• Identify treatment modalities to reduce the risk of nerve injury.
• Describe the assessment and management of nerve injuries, and the timely referral to a microsurgeon when necessary.

CE Hours: 1.0

Description: Medication-related osteonecrosis of the Jaw (MRONJ) is a serious side effect of bone-modifying agents, such as bisphosphonates, denosumab, and antiangiogenic drugs. Persistent disease following root canal treatment and surgical endodontic therapy may increase the risk for MRONJ. In this session, we will discuss practical approaches to recognize risk factors, risk mitigation strategies, and MRONJ management for patients requiring surgical and non-surgical endodontic therapy.

Learning Objectives:  

• Identify risk factors for MRONJ.
• Identify methods to reduce the risk of MRONJ.
• Describe the assessment and management of MRONJ.