Fracture

Fracture

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  • Includes Credits

    CE Hours: 1.0

    Description: This will be an update on diagnosis, treatment, prognosis and restoration for cracked teeth.

    Learning Objectives: 

    • Diagnose cracked teeth with available technology
    • Treat cracked teeth with the latest techniques
    • Explain outcomes to patients based on the Iowa Staging Index

    If you have any questions for Dr. Krell, you can email him at keithvk@aol.com with the subject line "AAE Webinar"

    Keith V. Krell, D.D.S., M.S., M.A.

    Dr. Krell received his D.D.S. and M.S. degrees from the University of Iowa in 1981 and 1983, respectively. He earned his M.A. degree in sociology-anthropology in 1975, from the United States International University in San Diego, Calif. 

    Dr. Krell has been an endodontist for over 43 years. He was a full-time educator for 8 years at the University of Iowa and was in private practice in West Des Moines, Iowa for 29 years until he retired December 31, 2017. He is still an adjunct clinical Professor in the Department of Endodontics at the University of Iowa College of Dentistry. He has lectured nationally and internationally about his research on cracked teeth based on his data base of over 3,000 private practice cases.  His complete data base is over 50,000 cases.

    Dr. Krell is a Diplomate of the American Board of Endodontics, as well as a past president and past director of the ABE.  He is a past president of AAEF (now the Foundation for Endodontics) and finally is past president of the American Association of Endodontists.

    Dr. Krell has been married for over 52 years to Diane and they have five grandchildren. He still has research interests in cracked teeth and vertical root fractures.

    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.

  • Includes Credits

    CE Hours: 1.5

    Description: Vertical root fractures in endodontically treated teeth were considered a vexing –frustrating issue both for the operator and the patient alike. In recent years, this complication of root canal treatment had showed both advances in VRF diagnosis and in saving from extraction in some of these teeth.

    VRF diagnosis has to be done accurately and n timely due to the destructive results in the supporting bone if not achieved in time. The use of CBCT as an additional diagnostic tool, enhances the possibility to achieve accurate VRF diagnosis, although some drawbacks in this imaging modality still exists. Treatment options vary from root amputation in multirooted teeth to a more complex surgical management.

    Learning Objectives:  

    • Describe the importance of achieving accurate and timely manner VRF diagnosis
    • List the recent advances in VRF diagnosis imaging modalities
    • Discuss the various considerations to save a vertically fractured tooth

    Aviad Tamse, D.M.D.

    Dr Aviad Tamse received his DMD degree in 1969, and from 1971 to 1973, he attended Harvard Dental school in Boston, Massachusetts, where he received his endodontic training. Dr. Tamse was President of the Israel Endodontic Society, ,and chair of the Accreditation Committee of Graduate Dental Programs in Israel. Dr Tamse served as chair of the department of Endodontology Tel-Aviv University School of Dental Medicine from 2000-2008 , and in 1982 was a co-founder of the European Society of Endodontology. Dr. Tamse has authored and co-authored over 90 scientific articles in peer-reviewed journals and 5 chapters in books.Recently he served as the senior editor of a book on vertical root fractures in dentistry. He served on the Editorial Board of the International Endodontic Journal . His primary research interest has been vertical root fractures in endodontically treated teeth and is the editor of a new book on root fractures. Currently Dr. Tamse is Professor Emeritus at the Department of Endodontology, School of Dental Medicine, Tel-Aviv University.

  • Includes Credits

    CE Hours: 1.25

    The relationship of the pulp and the periodontium is dynamic. Multiple anatomical and iatrogenic pathways can communicate these tissues in both health and disease. These pathways include furcation canals, dentinal cracks, and vertical root fractures. In other cases, a cemental root fracture (cemental tear) can mimic periapical pathosis. It is generally agreed that the pulp and its necrotic content affect the periodontal tissues. A controversy exists over the ability of periodontal disease to affect the dental pulp. During this presentation, we will review diagnostic techniques, the prognosis, and treatment alternatives for endo/perio lesions.

    Learning Objectives: 

    • Evaluate the characteristics and clinical presentation of endo-perio lesions.
    • Discuss clinical presentation of cracked teeth, vertical root fractures and cemental tears.
    • Discuss the endodontic prognosis in cases with complex endo-perio involvement.

    Ronald Ordinola-Zapata, DDS, MS, PhD

    Dr. Ronald Ordinola Zapata is an Associate Professor at the Endodontic Division University of Minnesota School of Dentistry. Dr. Zapata completed his Endodontic residency program at the IB Bender Endodontic Division, Albert Einstein Medical Center in Philadelphia, (2018), and a Certificate in Clinical Research at the School of Public Health, University of Minnesota. In 2021 Dr. Zapata achieved the Diplomate status of the American Board of Endodontics. Dr. Zapata enjoys teaching, writing scientific papers, and documenting challenging cases. In his academic career, Dr. Zapata has published more than 100 scientific papers in peer-reviewed journals and lectured internationally in more than 10 countries. Dr. Zapata also serves as Associate Editor of the International Endodontic Journal (UK) and is a member of the Scientific Advisory Board of the Journal of Endodontics (USA).

    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.

  • Includes Credits

    CE Hours: 2.0

    Description: This 90-minute session will update the latest information regarding cracks and fractures of teeth. Dr. Krell will speak on the evolution and prevention of cracks. Dr. Nixdorf will speak on diagnosis using imaging techniques. Dr. Davis will speak on the clinical treatment options and outcomes.

      Be able to correctly use current definitions for cracks and fractures.
    • Explain the advantages and limitations of emerging technologies for crack/fracture detection.
    • Discuss the options are for prognosis and treatment of teeth/patients with cracks and fractures.

    Donald R. Nixdorf, DDS, MS

    After graduating from the University of Alberta Faculty of Dentistry, Dr. Nixdorf completed hospital dentistry residency at The Ohio State University, Anesthesia fellowship at Johns Hopkins University, Orofacial Pain fellowship at the University of Alberta, and a Master of Science in Clinical Research at the University of Minnesota. As a Diplomate of the National Dental Board of Anesthesiology (NDBA) and the American Board of Orofacial Pain (ABOP), he maintains a specialty Orofacial Pain practice on the diagnoses and management of chronic TMD pain, headaches, and neuropathic pain within multi-disciplinary settings. Dr. Nixdorf’s research has focused on the topics of non-odontogenic “tooth” pain from a classification, diagnosis, epidemiology, and treatment perspectives, as well as TMD and, most recently, dental MRI, with over 85 published articles. Dr. Nixdorf is Professor, Division Director, and past Graduate Program Director at the University of Minnesota in the Division of TMD & Orofacial Pain.

    Keith V. Krell, D.D.S., M.S., M.A.

    Dr. Krell received his D.D.S. and M.S. degrees from the University of Iowa in 1981 and 1983, respectively. He earned his M.A. degree in sociology-anthropology in 1975, from the United States International University in San Diego, Calif. 

    Dr. Krell has been an endodontist for over 43 years. He was a full-time educator for 8 years at the University of Iowa and was in private practice in West Des Moines, Iowa for 29 years until he retired December 31, 2017. He is still an adjunct clinical Professor in the Department of Endodontics at the University of Iowa College of Dentistry. He has lectured nationally and internationally about his research on cracked teeth based on his data base of over 3,000 private practice cases.  His complete data base is over 50,000 cases.

    Dr. Krell is a Diplomate of the American Board of Endodontics, as well as a past president and past director of the ABE.  He is a past president of AAEF (now the Foundation for Endodontics) and finally is past president of the American Association of Endodontists.

    Dr. Krell has been married for over 52 years to Diane and they have five grandchildren. He still has research interests in cracked teeth and vertical root fractures.

    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.

    Matthew C. Davis, D.D.S.

    Dr. Matthew Davis is a board-certified endodontist in private practice in Glenview and Winnetka, Illinois. He attended the University of Iowa College of Dentistry where he received his Doctor of Dental Surgery in 1999 and his specialty certificate in endodontics in 2001. He has been a full-time practicing endodontist for twenty years. He became a diplomate of the American Board of Endodontics in 2010. As an author, he has had several publications and has been a member of the Scientific Advisory Board for the Journal of Endodontics from 2013 to the present.

    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.

    Matthew C. Davis, D.D.S.
    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.

    Don Nixdorf, D.D.S., M.S.
    In accordance with this policy, I declare I have a 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, as indicated: MinnScan LLC () : Patent holder, Stockholder/Ownership Interest (excluding diversified mutual funds)

    Keith V. Krell, D.D.S., M.S., M.A.
    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.

  • Includes Credits

    CE: 0.75

    Course Description: 

    Horizontal root fractures are complex injuries as many tissues are involved - pulp, dentine, cementum, bone and periodontal ligament. These fractures can occur at different levels of the root. Fractures in the apical third and mid-third of the root should be managed conservatively and predictable healing can usually be achieved without needing root canal treatment. Management of coronal third fractures is based on whether the fracture occurs sub-crestally (within bone) or supra-crestally (outside bone). Sub-crestal fractures should be managed conservatively while supra-crestal fractures require more invasive treatment. This presentation will outline the types of horizontal root fractures, the healing responses following such fractures, options for managing these fractures to obtain the best outcome and how to manage adverse outcomes.

    At the conclusion, participants should be able to:

    • Describe the various types of horizontal root fractures.
    • Evaluate the prognosis for the different types of root fractures.
    • Manage the various types of root fractures to provide a good prognosis for the tooth.

    Paul V. Abbott, B.D.Sc., M.D.S., FRACDS(Endo)

    Paul Abbott is an Emeritus Professor of Dentistry at The University of Western Australia. He is a Specialist Endodontist. Prior to taking a full-time University position in 2002, he spent 17 years in private specialist endodontic practice and he also held part-time academic positions at The University of Western Australia and the University of Melbourne. He was Dean and Head of the School of Dentistry at The University of Western Australia and Director of the Oral Health Centre of Western Australia from 2003- 2009. He has presented over 1000 lectures and courses in 49 countries. He has published 230 articles in refereed journals, 25 textbook chapters and 47 Newsletter articles. From 2015-2022, he was the Editor-in-Chief of the international journal Dental Traumatology. Prof. Abbott’s main research and clinical interests revolve around dental
    traumatology, tooth resorption, the diagnosis and management of pulp, root canal and peri-radicular conditions, with particular emphasis on pain control and disinfection of the root canal system. Prof. Abbott has received numerous awards for excellence in teaching and service to the dental profession, particularly in education and research. In 2015, the Governor-General of Australia appointed Prof. Abbott as an Officer of the Order of Australia (AO) - one of the highest honours in Australia – “For distinguished service to clinical dentistry, and to higher education, as an academic, researcher and author, to endodontics as a practitioner, and to professional organisations.”

    Paul Vincent. Abbott, B,D.Sc., MDS, FRACDS(Endo)

    I declare I have a 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, as indicated: OzDent Pty Ltd () : Consultant, Honorarium

  • Includes Credits

    CE Credits: 1.5

    Course Description:   In 2008, the AAE had stated that the combination of a sinus tract, isolated probing defect with or without a dowel, is pathognomonic for vertical root fracture (VRF) in endodontically treated teeth. When the diagnosis is done, extraction of the tooth or root is needed. Unfortunately, this combination does not occur often because VRF can mimic other clinical entities with a variety of radiographic manifestations. As a result, accurate and timely diagnosis of a vertical root fracture is still confusing and perplexing at times for the clinician. A recent systematic review analysis showed the lack of evidence-based data to support the usefulness of the clinical and radiographic evaluation methods. The rapid improvements in CBCT imaging techniques may soon be one of the useful means to achieving more accurate and timely diagnosis of VRFs in endodontically treated teeth.  

    At the conclusion, participants should be able to:

    • Discuss the importance of achieving timely and correct diagnosis of vertical root fractures and the difficulties in doing so.
    • Recognize the lack of evidence-based data supporting the common clinical evaluation methods for vertical root fracture diagnosis.
    • Discuss the best available data that was the basis for the AAE's 2008 statement regarding the combination of signs and symptoms to be pathognomonic for vertical root fractures in endodontically treated teeth.

    Aviad Tamse, D.M.D.

    Dr Aviad Tamse received his DMD degree in 1969, and from 1971 to 1973, he attended Harvard Dental school in Boston, Massachusetts, where he received his endodontic training. Dr. Tamse was President of the Israel Endodontic Society, ,and chair of the Accreditation Committee of Graduate Dental Programs in Israel. Dr Tamse served as chair of the department of Endodontology Tel-Aviv University School of Dental Medicine from 2000-2008 , and in 1982 was a co-founder of the European Society of Endodontology. Dr. Tamse has authored and co-authored over 90 scientific articles in peer-reviewed journals and 5 chapters in books.Recently he served as the senior editor of a book on vertical root fractures in dentistry. He served on the Editorial Board of the International Endodontic Journal . His primary research interest has been vertical root fractures in endodontically treated teeth and is the editor of a new book on root fractures. Currently Dr. Tamse is Professor Emeritus at the Department of Endodontology, School of Dental Medicine, Tel-Aviv University.

    Aviad Tamse, D.M.D.  

    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.

  • Includes Credits

    CE Hours: 0

    Description:  A tooth is considered to be a split tooth if it contains a fracture line extending from the occlusal surface through both marginal ridges. Currently, the only treatment option for a split tooth is extraction. The present case report describes a novel therapeutic strategy for the preservation of a split tooth (first maxillary premolar) with a fracture in the mesiodistal direction. A systematic nonsurgical procedure involving visualization and slight widening of the fracture line is described. This procedure facilitates sealing of the fracture gap with a biocompatible calcium silicate cement (mineral trioxide aggregate) as well as internal composite resin stabilization and cuspal coverage restoration of the tooth. A 3-year follow-up showed a promising clinical and radiographic outcome. The concept presented here is an alternative treatment option for a split tooth, which allows preservation of the tooth rather than its extraction.

    At the conclusion, participants should be able to:

    • Describe important diagnostic criteria for a split tooth.
    • Describe a step by step procedure for the sufficient restoration of a split first upper premolar.
    • Discuss factors which influence the long-term success after repair of a split tooth.

    Alexander Schurz, DMD

    Holger Gehrig, DMD, MSc

    Dorothee L. Schuessler, DDS, PhD

    Johannes Mente, Prof,DMD