November 7-9, 2024 | Banff, AB, Canada
Insight Track: Managing Complications
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Includes Credits
CE Hours: 1.75
Description: For endodontists, it is easy to assume that any radiolucency associated with pain is of pulpal or inflammatory origin, especially if the tooth has a significant restorative history. However, numerous disease entities of variable clinical significance can be identified in the periapical region, and differentiating the typical endodontic presentation from that of a potentially more life threatening or insidious etiology is of critical importance to ensure ideal management and outcome. This review, based on clinical cases, will highlight a variety of diagnostic roadblocks including the limitations of pulp testing and radiographic interpretation of periapical images and cone beam computerized tomography. Advanced endodontic diagnosis with systematic method for the development of a differential diagnosis of periapical radiolucencies will be the main focus of this discussion.
Learning Objectives:
- Recognize the limits of available technology and issues related to pulp testing and radiographic imaging.
- Incorporate a systematic method to formulate a differential diagnosis of radiographic lesions found in the periradicular areas.
- Discuss the radiographic changes consistent with non-inflammatory etiologies and recognize when referral for biopsy is indicated.
David Landwehr, D.D.S., M.S.
Endodontist
Capital Endodontics
Dr. David Landwehr earned his D.D.S. at the University of Minnesota. He received an M.S. degree and certificate in oral and maxillofacial pathology at The Ohio State University followed by specialty training in endodontics at the University of Michigan. Dr. Landwehr has been a private practice clinician for more than twenty years and for the last ten years has provided exemplary patient care at Capital Endodontics in Madison, WI.
Dr. Landwehr’s ongoing work as an educator and opinion leader has positioned him at the forefront of modern endodontic treatment. Dr. Landwehr authored the chapter titled Lesions That Mimic Endodontic Pathosis for the most recent edition of Cohen’s Pathways of the Pulp and was the Chief of Endodontics for the Meriter Hospital general practice residency for more than ten years. He has lectured extensively on endodontic diagnosis and oral pathology both nationally and internationally. His teaching focuses on techniques used daily in his clinical practice that are efficient, predictable and evidence based.
Disclosure(s): Dentsply Sirona Endodontic SBU: Honorarium (Ongoing); Surround Medical: Advisory Board (Ongoing)
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Includes Credits
CE Hours: 2.25
Description: Patient injury as an outcome of endodontic treatment can have devastating consequences for both the patient and the endodontist. Mishaps that occur during the therapeutic stages of endodontic therapy can result in significant irreversible damage to teeth and the jaws as well as neurologic damage within the head and neck, with an unpredictable course and an uncertain prognosis. This presentation will discuss the evidence and best practices regarding clinician thinking and actions resulting in patient injury and impairment as a result of endodontic care. The presentation will review the data for prognosis and how to determine treatment and intervention strategies in local anesthetic injury; chemical harm from overfill; as well as irrigation accidents and the resulting neural trauma caused by surgical error.
Learning Objectives:
- Recognize the advantages of imaging technologies in identifying key neurovascular structures and their proximity to the root canal systems of teeth.
- Identify safe protocols for avoiding extra-radicular overfill of the root canal space when there is close proximity to neurovascular anatomy.
- Become familiar with prognosis and best practice for injuries and overfill mishaps that result in neurologic damage.
Alan Gluskin, D.D.S.
Professor of Endodontics
University of the Pacific
Alan H. Gluskin DDS: graduated from the University of the Pacific School of Dentistry, San Francisco, California in 1972. He received his Endodontic Certification from Temple University in Philadelphia in 1976. Dr. Gluskin is currently Professor, Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific in San Francisco, California. He served as Endodontic Depatrment Chair at Pacific for over thirty years. He is at present a Fellow of the International College of Dentists and the American College of Dentists.
Dr. Gluskin is a member of numerous societies including the American Association of Endodontists, the American Dental Association, and the San Francisco Dental Society. He has recently concluded his service to the Board of Directors of the American Association of Endodontists as Past President, and presently functions on the editorial boards of the Journal of Endodontics and the International Journal of Endodontics. Dr. Gluskin is the 2017 recipient of the University of the Pacific’s Eberhardt Teacher-Scholar Award and was awarded the Distinguished Faculty Award in 2023 by the dental school faculty. He is co-editor of the textbooks Decision Making in Dental Treatment Planning and Practical Lessons in Endodontic Treatment.
Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 1.75
Description: Jeff Tonner, a full-time dental malpractice defense attorney, will explore an endodontist's #1 malpractice risk (that can exceed your insurance limits); the four types of patient complaints; the profile of a typical dental malpractice patient; how to chart short fills, over fills, broken files; refunding fees; legal releases; patient termination; and, related topics.
Learning Objectives:
- Identify and understand that #1 dental malpractice risk for endodontists.
- Appreciate that endodontists will experience 2 to 5 dental-legal entanglements in a career.
- Know how to chart the three critical facts when unfortunate events (overfill, shortfill, broken file) occur.
Jeffrey Tonner, J.D.
Dental Malpractice Defense Attorney
Jeffrey J. Tonner, LLC
Jeff Tonner is a full-time dental-malpractice defense attorney in Phoenix, AZ.
Jeff has defended over 4,000 dentists before the dental board and hundreds of dental malpractice cases in superior court. He drafts and regularly reviews dental contracts, including office leases, asset purchase agreement and both employee and independent contractor agreements.
He has written two books for dentists: "Malpractice: What They Don’t Teach You In Dental School" and "Ideal Charting For General Dentists."
Jeff lectures across the US and now Canada on risk management, recordkeeping and dental ethics.
Jeff founded Lightening Dental Charts, a charting system contains custom progress-note templates, consent forms, Update & Alert bulletins and other legal aids.
Jeff graduated from Indiana University in 1977 and DePaul University Law School in 1981, where he was a member of the law review.
Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 1.5
Description: “An ounce of prevention is worth a pound of cure” (attributed to Benjamin Franklin circa 1700’S):
As average life expectancy in North America increases, so does the proportion of patients with chronic medical conditions and those taking prescription medications. Coordination of care between medical and dental providers may become easier in the future with the merger of medical and dental records into a common database but is often still a challenge today. What medical conditions and medications require medical consultation prior to treatment? This presentation will explore risk assessment to help determine which patients may require treatment modification to decrease the possibility of an adverse event during or after endodontic therapy and will focus on medical conditions that are most common and/or carry the greatest risk of an adverse event.Learning Objectives:
- Describe a risk assessment strategy for medically complex patients and know when to modify your standard treatment protocol and/or seek medical consultation prior to treatment.
- Discuss common drug:drug interactions and allergies relevant to endodontic practice.
- Explain appropriate treatment modifications for patients with cardiovascular disease, diabetes, pulmonary diseases, kidney and liver disease, immunosuppression, history of bisphosphonate therapy, and prosthetic joint replacement.
Bradford R. Johnson, D.D.S., M.H.P.E.
Dr. Johnson completed his undergraduate education at the University of Colorado, received his DDS degree from Virginia Commonwealth University, and endodontics specialty training at the University of Illinois at Chicago where is currently Professor, Department of Endodontics, Department Head and Postgraduate Program Director. He is a Diplomate of the American Board of Endodontics and received a Master of Health Professions Education (MHPE) degree from the UIC College of Medicine in 2005. In addition to full-time teaching, he maintains a part-time clinical practice limited to endodontics. Dr. Johnson has published over 50 articles and abstracts in peer reviewed dental journals and is author or co-author of eleven textbook chapters.
Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 2.0
Description: Endodontic surgery has become a predictable and highly successful way of solving recurrent endodontic infections. Even with the technologies such as operating microscope, CBCT, piezotome, ultrasonics, etc, still there are many situations that arise that require special approaches. This presentation will focus on achieving access to difficult areas, such as palatal roots, or areas covered by thick cortical bone. We will also discuss safe management of the sinuses and mental nerve, as well as a newer concept called selective curettage. When all else fails, then intentional replantation must be considered, and we will discuss techniques to perform replantation with success rates approaching 90%. The presentation is clinically oriented, showing many cases with clinical tips to successful microsurgery.
Learning Objectives:
- Demonstrate proper positioning of microscope/patient/doctor
- Troubleshoot potential complications involving the mental nerve and sinuses and palatal roots
- Become comfortable performing Intentional Replantation
Samuel Kratchman, D.MD
CLINICAL ASSOCIATE PROFESSOR OF ENDODONTICS
University of Pennsylvania School of Dental Medicine
Dr. Sam Kratchman was born and raised in New York. He received both a B.S. in Biology and a D.M.D. from Tufts University in Boston. Sam then entered The University of Pennsylvania, where he received a Certificate of Endodontics.
A prominent leader in his field, Dr. Kratchman currently teaches at U. Penn as an Associate Professor of Endodontics, and he is the Assistant Director of Graduate Endodontics, in charge of the microsurgical portion of the program. He frequently lectures on several Endodontic topics throughout the United States, Europe, South America, Canada and Asia.
Dr. Kratchman has authored several articles and chapters on Endodontics, and has co-authored the textbook of Endodontic Microsurgery with Dr. Kim in 2017. He also developed a patented instrument called the S Kondenser for the obturation of root canals. Both Main Line Today and Doctor of Dentistry magazines honored Dr. Kratchman as the cover story for their "Best of" issues.
Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 1.5
Description: Protocols and standards in root canal treatment should always allow for the ability of the operator to function in context, always practicing within a legal standard of care. The context for endodontists will change as knowledge and technology create new pathways to improve patient outcomes and become tools for communication between stakeholders, including peer professionals and patients. The utilization of needle delivery of anesthetics and medication in dentistry is universal. Unfortunately, improper utilization of needle delivery in dentistry can have serious and injurious outcomes in patient care. This presentation will discuss and consider the untoward events that can occur in the use of needle delivery of solutions and pastes in the practice and delivery of endodontic care.
Learning Objectives:
- Recognize the advantages of imaging technologies in identifying key neurovascular structures and their proximity to the root canal systems of teeth.
- Appreciate the hydraulic outcomes of common syringe methodologies and their potential for injury and mishaps
- Identify safe protocols for avoiding extra-radicular overfill of the root canal space or confined tissues spaces using needle irrigation or paste delivery
Alan Gluskin, D.D.S.
Professor of Endodontics
University of the Pacific
Alan H. Gluskin DDS: graduated from the University of the Pacific School of Dentistry, San Francisco, California in 1972. He received his Endodontic Certification from Temple University in Philadelphia in 1976. Dr. Gluskin is currently Professor, Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific in San Francisco, California. He served as Endodontic Depatrment Chair at Pacific for over thirty years. He is at present a Fellow of the International College of Dentists and the American College of Dentists.
Dr. Gluskin is a member of numerous societies including the American Association of Endodontists, the American Dental Association, and the San Francisco Dental Society. He has recently concluded his service to the Board of Directors of the American Association of Endodontists as Past President, and presently functions on the editorial boards of the Journal of Endodontics and the International Journal of Endodontics. Dr. Gluskin is the 2017 recipient of the University of the Pacific’s Eberhardt Teacher-Scholar Award and was awarded the Distinguished Faculty Award in 2023 by the dental school faculty. He is co-editor of the textbooks Decision Making in Dental Treatment Planning and Practical Lessons in Endodontic Treatment.
Disclosure(s): No financial relationships to disclose
