Irrigation
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Includes Credits
CE Hours: 1.5
Description: Endodontic complications of varying severity can unfortunately occur during most stages of endodontic treatment. This lecture aims to enhance understanding of common endodontic complications and recommends current management and solutions with an evidence-based approach. Preoperative, intraoperative and postoperative issues will be discussed, including possible aetiologies and prevention during root canal therapy. We will address the impact of complications on both patients and practitioners, underscoring the importance of clear communication in preserving the clinician-patient relationship. Attendees will gain current advice and knowledge on how to tackle endodontic complications effectively, fostering excellence in clinical practice and improved patient care.
Learning Objectives:
- Recognize and identify common endodontic complications.
- Implement evidence based management strategies.
- Develop strategies for preventing endodontic complications.
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Includes Credits
CE Hours: 0.75
Description: The demand for high-quality evidence in endodontic clinical practice is escalating, particularly with the emergence of costly technologies in adjunctive irrigation. However, the scarcity of robust laboratory and clinical studies in adjunctive irrigation over the past six decades has compromised the reliability on systematic reviews and meta-analyses. Thus, a shift towards producing better-quality studies over quantity is imperative. Constraints such as cost, ethical considerations, and narrow population designs often render Randomized Clinical Trials unfeasible, limiting their generalizability. To address this, the utilization of real-world data and AI for generating real-world evidence is gaining traction, bridging the gap between trial settings and practical clinical scenarios. This presentation will thoroughly explore the literature on adjunctive irrigation, decode enhanced root canal irrigation techniques, suggest methods to develop quality research and balancing between research and practice.
Learning Objectives:
- Discuss the optimal research methodology for root canal cleaning and disinfection.
- Explain the concept of pragmatic studies and AI incorporation and their integration for collecting real world data in adjunctive irrigation research.
- Align evidence based findings with the clinical need for lasers and multisonics in root canal irrigation for improved outcomes.
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Includes Credits
CE Hours: 1.25
Description: Real-time dynamic navigation and dental lasers are often hailed as groundbreaking innovations in various fields. Real-time dynamic navigation systems, particularly in non-surgical and surgical procedures provide enhanced precision and safety by continuously adapting to changing conditions. Dental lasers offer precise, minimally invasive treatments that can enhance patient outcomes and reduce recovery times.
But are these technologies truly as transformative as they seem, or are they just advanced iterations of existing tools? This evidence based presentation will delve into the real impact of these innovations, assessing their effectiveness, adoption, and the extent to which they are changing the future non-surgical and microsurgical Endodontics. In this lecture, for the first time, the integration of real-time laser guidance with microsurgical techniques will be presented. Real-time laser guidance represents a significant leap in enhancing precision, safety, and outcomes in endodontic microsurgery.
Learning Objectives:
- Demonstrate the workflow, and application of real-time dynamic navigation in minimally invasive endodontic procedures as locating calcified canals and microsurgical procedures in close proximity to vital structures.
- Describe the different laser systems, wave lengths available in laser technologies and its different applications in non-surgical (disinfection of root canal systems) and surgical procedures (surgical incisions, osteotomies, root resection and photo-biomodulation).
- Demonstrate the integration of real-time laser-guided technology in Endodontic microsurgery.
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Includes Credits
CE Hours: 1.0
Description: We are undoubtedly living in a golden era for endodontics. With a plethora of advanced instruments, materials, and equipment designed to enhance clinical workflows and outcomes, the possibilities seem endless. Among these, the emergence of various disinfection devices has sparked significant interest—and controversy.
Clinicians are now faced with a critical question:
Are these high-cost devices truly game-changers in root canal disinfection, or are they overhyped luxuries?
This presentation aims to reexamine our core objectives during root canal disinfection and critically evaluate how modern instrumentation and irrigation devices can elevate the patient experience and clinical outcomes.Learning Objectives:
- Explore practical strategies to improve clinical efficiency
- Understand the role and effectiveness of various irrigation devices in improving disinfection quality
- Analyze the impact of advanced disinfection approaches on clinical patient outcomes
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Includes Credits
CE Hours: 0.75
Description: Evidence-based research consistently demonstrates the correlation between microbial contamination of the root canal system and apical periodontitis. Cleaning and disinfection of the apical third remains one of the most critical factors leading to healing and favorable endodontic outcome. Besides the microbiological challenges, from a clinical perspective, the root canal system imposes physical and anatomical complex challenges that are difficult to overcome. The development of new technologies and new evidence from the literature has only widened the already existing debate. The purpose of this presentation will be to provide a clinical perspective on how to overcome these challenges in order to obtain a predictable and efficient disinfection of the apical third.
Learning Objectives:
- Review the clinical challenges for disinfection of the apical third.
- Describe the advantages and disadvantages of contemporary techniques.
- Discuss new clinical protocols to enhance disinfection and increase predictability.
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Includes Credits
CE Hours: 1.5
Description: Dr. John Olmsted and Katie Panikian, JD, CPCU, ARM will present case studies of several real endodontic malpractice cases to the audience. They will highlight endodontic procedures that became issues for dentists, and also endodontic procedures that developed problems for endodontists. A discussion will follow each case, giving the audience a chance to discuss the risk management issues involved in each case. The audience will then be asked to act as a jury, reaching a verdict on the case, and a dollar amount on a judgment. The audience will then be given the real-life verdicts and awards.
Learning Objectives:
- Describe how errors in record keeping, diagnosis, treatment planning, and endodontic treatment will affect the claims handling and legal process.
- List the cost in terms of judgments rendered against dentists/endodontists through the discussion of real life malpractice case examples.
- Outline the steps of risk management.
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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 is currently Professor, Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific in San Francisco, California. 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. Dr. Gluskin has completed his tenure on the Executive Board of Directors of the American Association of Endodontists as a Past President of the AAE. He additionally 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: 1.0
Description: The objective of this in vitro study was to evaluate the shear bond strength (SBS) of several universal adhesives to dentin treated with sodium hypochlorite (NaOCl), and NaOCl followed by ethylenediaminetetraacetic acid (EDTA).
At the conclusion of this article, the reader will be able to:
- Examine the effect of endodontic irrigants (NaOCl and NaOCl + EDTA) on the shear bond strength of mild universal adhesives in self-etch and total-etch modes.
- Identify the mechanisms by which NaOCl and EDTA influence the dentin matrix and the bonding process of adhesives.
- Evaluate strategies to optimize bond strength when using universal adhesives after root canal irrigation with NaOCl and EDTA.
Clinton D. Stevens, DDS
Steven Schiffenhaus, DMD, MS
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Includes Credits
CE Hours: 0.75
Description: The goal of root canal treatment is to prevent or reverse apical periodontitis by removal of necrotic/infected or irreversibly inflamed tissues, followed by obturation of the root canal space. Mechanical instrumentation and irrigation play a key role in the removal of pulp tissue, contaminants, debris, and microorganisms from the root canal system. Different adjunctive agitation techniques have been developed to help irrigating solutions penetrate the complexities of the root canal system. Passive ultrasonic irrigation, apical negative pressure irrigation systems, sonic activation, multisonic agitation, and laser activation have been reported to be superior to conventional positive pressure needle irrigation in regards to smear layer removal, antimicrobial effect, and decreased post-operative pain. Minimally invasive canal preparation has been promoted with the activated irrigation approaches. However, what is not known is the effect of minimally invasive instrumentation, in conjunction with an activated irrigation approach on clinical outcomes (retention/longevity, healing of apical periodontitis). Can infected root canals be predictably disinfected following conservative root canal preparation? Based on a review of the current literature and personal clinical experience, appropriate preparation sizes for root canal treatment will be explored.
Learning Objectives:
- Describe how apical preparation size during root canal treatment affects the clinical outcome.
- Evaluate the current best available evidence to support minimal invasive canal preparation with different irrigation protocols.
- Choose the appropriate preparation size for root canal treatment upon irrigation protocol.
Qian Xie, D.D.S., Ph.D.
Dr. Qian Xie received her BDS and PhD degrees from Sichuan University, Chengdu, China. After a few years of practice, Dr. Xie returned to graduate school at the University of Illinois at Chicago College of Dentistry, where she received her Certificate of Specialty in Endodontics. Dr. Xie is a Diplomate of the American Board of Endodontics. Dr. Xie has been a member and an active participant in the American Association of Endodontists, the American Dental Association, the Chicago Dental Society, and the Edgar D. Coolidge Endodontic Study Club. She is a fellow of the International College of Dentists. Dr. Xie has a broad background in oral science and clinical dentistry, with specific training and expertise in oral microbiology research and clinic experience in endodontics. Her research background includes caries research, oral biofilm and endodontic irrigation.
Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 1.0
Description: This study aimed to evaluate the removal of a biofilm-mimicking hydrogel from isthmus structures in a simulated complex root canal system consisting of 2 curved root canals by Laser-activated irrigation (LAI, AdvErl Evo, Morita) and mechanical activation techniques.
At the conclusion of this article, the reader will be able to:
- Describe various techniques for root canal irrigation and activation and their main characteristics
- Evaluate the efficiency of laser-activated irrigation, ultrasonic and sonic irrigation in complex root canal morphologies
- Discuss the influence of rod flexibility and oscillation frequency of mechanical activation devices on root canal irrigation
David Donnermeyer, PD Dr.med.dent.
Dr. Donnermeyer is board-certified specialist for Endodontology of the German Association of Endodontology and Dental Traumatology (DGET) and certified member of the European Society of Endodontology (ESE). He currently serves as assistant professor in the Department of Periodontology and Operative Dentistry, University Hospital Münster, Germany, with the perspective of relocating to the Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Switzerland. Dr. Donnermeyer graduated and obtained his PhD at University of Münster, Germany, before focussing his research on various fields of endodontology including root canal obturation and irrigation. Dr. Donnemeyer published 35 peer-reviewed manuscripts.
Patricia Claire Dust, Cand.med.dent
Patricia Dust is a student and PhD candidate in the medical faculty at the University of Münster in Germany. Her research focuses on different irrigation techniques in simulated roots canals.
Edgar Schäfer, Prof.Dr.med.dent.
Dr. Schäfer obtained his PhD at the University of Münster Germany. He is head of the Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, Germany.
Dr. Schäfer has published more than 250 peer-reviewed manuscripts, more than 50 textbook chapters and edited 5 textbooks. He is a certified specialist for Endodontology of the German Association of Endodontology and dental Traumatology (DGET), an active and certified member of the European Society of Endodontology (ESE) and an associate member of the American Association of Endodontists (AAE). From 2014 – 2016 Dr. Schäfer was President of the German Association of Operative Dentistry (DGZ) and since 2023 he is President of the German Association of Endodontology and dental Traumatology (DGET). He received more than 30 national and international academic awards.
Sebastian Bürklein, Prof.Dr.med.dent.
He graduated in 2003. From 2003–2006 he worked as a dentist in the Department of Operative Dentistry, University of Münster, Germany. In 2005, he completed his doctorate in dentistry. From 2006–2010 he made his graduation as a specialist in oral surgery in the Dental Clinic of Bochum, Germany (Head: Prof. Dr. H.-P. Jöhren). In 2009, he became a certified specialist in endodontology (German Society of Endodontology and Dental Traumatology) and in 2010, he appointed Specialist in Oral Surgery. Since 2011 he is deputy head of the Central Interdisciplinary Outpatient Clinic in the School of Dentistry (Head: Prof. Dr. E. Schäfer), University of Münster, Germany. In 2015, he became an adjunct professor. He also held various positions in different national scientific societies. From 2014-2020 he was member of the Board of the German Society of Restorative Dentistry (DGZ). Since 2021, he is member of the Board of the German Society of Endodontology and Dental Traumatology (DGET). He had over 20 years of academic and research experience and published numerous scientific papers in world-leading peer-reviewed endodontic journals. Additionally, he had book contributions in national and international reference books and lectures at national and international congresses in the field of endodontics. Since 2022, he is associate editor of the International Endodontic Journal.