Irrigation
Refine your search results by using the drop-down menus below, or choose “Advanced Search This List.”
-
Includes Credits
CE Hours: 0.75
Description: The primary goal of root canal treatment is to prevent or reverse apical periodontitis by removing necrotic, infected, or irreversibly inflamed tissue, followed by obturation of the root canal system. Mechanical instrumentation and irrigation play a critical role in eliminating pulp tissue, contaminants, debris, and microorganisms from the root canal space. To enhance the effectiveness of irrigation, various adjunctive agitation techniques have been developed to facilitate deeper penetration of irrigating solutions into the complex anatomy of the root canal system. Techniques such as passive ultrasonic irrigation, apical negative pressure systems, sonic activation, multisonic agitation, and laser activation have demonstrated superior outcomes compared to conventional positive-pressure needle irrigation, particularly in terms of smear layer removal, antimicrobial efficacy, and reduction in postoperative pain. However, limited research exists on how these advanced irrigation methods impact long-term clinical outcomes, such as tooth retention, treatment longevity, and healing of apical periodontitis. Additionally, there has been no direct comparison of the clinical benefits among the various advanced irrigation techniques. This presentation will share the results of a retrospective clinical study that directly compares the outcomes of three advanced irrigation systems.
Learning Objectives:
- Compare the effectiveness of advanced irrigation techniques in improving root canal treatment outcomes.
- Identify the clinical advantages of advanced irrigation methods over conventional needle irrigation in terms of smear layer removal, antimicrobial efficacy, and postoperative outcomes.
- Analyze the current evidence regarding the impact of advanced irrigation techniques on the healing of apical periodontitis and long-term treatment success.
-
Includes Credits
CE Hours: 1.0
Description: The endodontic community has seen widespread adoption of bioceramic sealers throughout the past 15 years due to their unique biocompatible properties. Although modern root canal treatments are completed with a high level of success, there is an inherent need for retreatment procedures. Unlike traditional sealers, however, bioceramic materials have presented the challenge of complete removal during root canal retreatment. Until now, the focus of retreating bioceramic obturations has been on mechanical removal with or without adjunctive solvent use. These techniques have mixed evidence-based support. This presentation will explore modern retreatment techniques including mechanical activation as well as evaluating various solvents and their impacts on root canal retreatment.
Learning Objectives:
- Review the goals of modern root canal retreatment procedures
- Discuss available solvents and techniques aimed at bioceramic retreatment
- Evaluate current scientific evidence on retreatment of bioceramic sealer-obturated canals
-
Includes Credits
CE Hours: 1.5
Description: Root canal disinfection is a critical aspect of endodontic treatment, aiming to eliminate bacteria, biofilms, and necrotic tissue from the complex anatomy of root canal system. Advanced technologies have been developed to enhance the efficacy of disinfection, including laser-assisted irrigation, ultrasonic and sonic activation, multisonics, activation and novel irrigation techniques, including nanotechnology. However, the variability in protocols and outcome measures across studies limits the ability to draw direct comparisons and establish best practices. This presentation will highlight the step-by-step approach and evidence-based protocol of using these advanced technologies in root canal debridement and discuss various factors which may impact endodontic outcome from biological, clinical, and scientific standpoints. The presentation will feature clinical cases and discuss the potential impact of the available evidence and protocols.
Learning Objectives:
- Critically analyze the role of advanced disinfection technologies in improving endodontic outcomes.
- Define the impact of biofilm on short-term and long-term endodontic treatment outcomes at the molecular level and from clinical standpoint.
- Engage in continuous education to refine knowledge, skills and keep abreast of ongoing research and developments in endodontic biofilm removal technologies.
-
Includes Credits
CE Hours: 1.0
Description: MIE access and canal preparations have been greatly advanced by the introduction of various NaOCl enhancement methods to endodontic irrigation. The most powerful, efficient, and effective of them--multi-sonic, laser, and closed-system negative pressure irrigation devices--are based on cavitation physics. On a molecular level, cavitation turns out to be one of the most powerful forces in nature and as it generates sonic energy, it is ideally suited for cleaning the smallest regions of the smallest root canal preparations, often without any instrumentation at all. This presentation will illuminate the physical forces brought to bear by cavitation and the clinical efficacies delivered when that energy is applied to NaOCl in human root canal systems. Most advantageous in the pursuit of MIE, cavitated NaOCl is seen to work as effectively or more effectively in root canal preparations that are left in their original apical morphologic state than those which have been over-instrumented, due mostly to the narrowing confines of tapered root canal preps which amplifies this sound energy when projected from coronal to apical regions of the RCS.
Learning Objectives:
- Describe how cavitation of NaOCl is ideally suited to cleaning minimally-invasive root canal preparations.
- Discriminate between methods of cavitating sodium hypochlorite, specifically their actual methods of action--beyond marketing claims by manufacturers--but also in their safety of application.
- Choose an enhanced irrigation protocol that will deliver success at the lowest device cost and with the least amount of chairside time spent.
-
Includes Credits
CE Hours: 1.5
Description: As endodontics advances into a new era of technological innovation, practitioners have access to an increasingly broad range of adjunctive irrigation devices and disinfection techniques. Technologies such as lasers and multisonic systems offer the potential for enhanced clinical outcomes; however, their efficacy warrants careful evaluation. This presentation will provide an in-depth review of adjunctive irrigation techniques-including sonics, ultrasonics, lasers, multisonic systems, and other emerging technologies-framed within the principles of evidence-based endodontics. Participants will gain comprehensive insights into the existing research landscape, including its current limitations, challenges, and prospects for future advancement. This session aims to present a balanced perspective to support informed decision-making and effective integration of innovations in contemporary endodontic practice.
Learning Objectives:
- Revisit the fundamental goals of root canal disinfection and how modern irrigation devices may enhance or fall short of those goals.
- Discuss the challenges in generating high-quality evidence for adjunctive irrigation and the limitations of current research methodologies.
- Analyze the clinical effectiveness and limitations of advanced irrigation technologies.
-
Includes Credits
CE Hours: 1.0
Description: Laser activated irrigation continues to generate excitement in endodontics, but its clinical value requires careful, unbiased evaluation. This session will present three years of independent studies investigating both the advantages and limitations of laser use in root canal treatment. Topics will include the impact of early application during crown down instrumentation, effectiveness in smear layer removal, ability to enhance irrigant penetration into complex anatomies such as isthmuses and lateral canals, its influence on obturation, the potential for irrigant extrusion, and its role in the removal of residual gutta percha during retreatment. By presenting data from a series of independent projects, this session will move beyond speculation and provide participants with a balanced understanding of what laser irrigation can and cannot deliver. Attendees will come away with practical insights to guide evidence based decision making about integrating lasers into endodontic practice, ensuring their use is grounded in science rather than marketing.
Learning Objectives:
- Identify the advantages of laser activated irrigation in enhancing canal cleaning, including smear layer removal, irrigant penetration into complex anatomies, residual gutta percha removal, and obturation quality.
- Recognize the limitations of laser activated irrigation in achieving these same outcomes and compare its performance with other activation methods.
- Evaluate the risks associated with laser irrigation, including the potential for irrigant extrusion, and integrate this knowledge into evidence based clinical decision making.
-
Includes Credits
CE Hours: 1.0
Description: This study aimed to enhance the efficacy and safety of root canal irrigation in #25/.06 canals by optimizing side-vented needle designs, focusing on bevel angle adjustments and sealing configurations.
At the conclusion of this article, the reader will be able to:
Explain how bevel angle and configuration in side-vented irrigation needles influence irrigant exchange, apical pressure, and overall irrigation effectiveness.
Interpret computational fluid dynamics (CFD) and in vitro validation findings regarding optimized needle designs, including solid vs hollow bevel configurations.
Apply the study’s conclusions to clinical scenarios, evaluating how optimized needle design might improve irrigation outcomes in complex canal morphologies such as C-shaped canals.
Jiayang Gao, DDS
Yuhua Dai, DDS, MSD
Ziteng Long, DDS
Yi Min, DDS, PhD
Ya Shen, DDS, MS, PhD
Dr. Ya Shen received her dental degree and her PhD degree, both from the Faculty of Dentistry at Wuhan University, China. From 2008 to 2011, she was a Clinical Assistant Professor in the Department of Oral Biological & Medical Sciences at the University of British Columbia (UBC) in Vancouver, Canada. From 2012 to 2016, Dr. Shen served as an Assistant Professor and was later promoted to an Associate Professor of the Department of Oral Biological & Medical Sciences and is now Professor and Chair, Division of Endodontics. She is also an Associate Member of the Department of Materials Engineering at UBC. Dr. Shen has published more than 110 papers in peer-reviewed journals. She is one of the Editors of Visual Endodontics 2012 multi-media. Dr. Shen is also a reviewer for several international journals. Her main research interests are nickel–titanium instrument fracture mechanics, biofilms, and dental material in endodontics.
Yuan Gao, DDS, PhD
-
Includes Credits
CE Hours: 1.0
Description: To address the shortage of clinical outcome studies on contemporary root canal disinfection methods, this prospective cohort study assessed healing of apical periodontitis (AP) after use of the GentleWave (GW) system or Ultrasonic Activation (UA) combined with negative pressure irrigation (NPI).
At the conclusion of this article, the reader will be able to:
- Identify key procedural differences between the GentleWave and UA + NPI protocols used in molar root canal disinfection.
- Recognize potential limitations in using conventional radiographs versus CBCT for assessing healing outcomes.
- Evaluate the appropriateness of the prospective cohort design and statistical analyses used to compare treatment outcomes.
Luis Ney Quiterio Montero, D.D.S., F.R.C.D.(C)
Dr. Luis Ney Quiterio Montero isa specialist in Endodontics with over 20 years of combined experience in clinical practice, academia, and research. He is currently a clinical instructor at the University of Toronto and a doctoral candidate in Health at the University of Bath. He previously served as Co-Director of the undergraduate Endodontics program at Dalhousie University, where he contributed to curriculum development and clinical training.
Dr. Quiterio Montero’s academic roles have also included teaching appointments at the University of the West Indies and several institutions in Latin America and the Caribbean. His research focuses on root canal disinfection and the application of artificial intelligence in Endodontics. He has published in the Journal of Endodontics and co-authored textbook chapters on biomaterials in Endodontics.
He has received several distinctions, including the Richard Komorowski Award for clinical instruction and Fellowship in the Pierre Fauchard Academy. He is also a Fellow of the Royal College of Dentists of Canada, an examiner for the RCDC and a peer reviewer for the Journal of Dental Education. Dr. Quiterio Montero is committed to advancing evidence-based practice and excellence in dental education.
Disclosure(s): No financial relationships to disclose
Bettina R. Basrani D.D.S., M.S.D., Ph.D.
Dr. Bettina Basrani is Tenured Associate Professor and Director, MSc Program in Endodontics at the Faculty of Dentistry, University of Toronto, Ontario, Canada since 2015. Dr Basrani received her DDS degree from the University of Buenos Aires and a Specialty Diploma in Endodontics and PhD from Maimonides University in Buenos Aires, Argentina. A long-time educator and researcher, she began her teaching career at the University of Buenos Aires. In 2000, she moved to Canada to serve as Chair of the Endodontic Program at Dalhousie University, Halifax, Nova Scotia. In 2004, she moved to Toronto, where she has continued her academic and clinical work. Internationally recognized as a leading authority in endodontics and as an excellent lecturer, effectively combining clinical and scientific information, Dr Basrani has received many awards throughout her career, such as the Louis Grossman Award by the French Society of Endodontics and has international courses and lectures, over 40 peer-reviewed scientific publications, three textbooks and several textbook chapters, and abstracts to her credit. Recently, in 2021 she was recognized as one of the most influential graduates from the University of Buenos Aires. She serves as reviewer for several endodontic journals. Dr Basrani is a member of many endodontics societies around the world.
Speaker Disclosure
In accordance with this policy, I declare that I have NO 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.
David A. Ellis
Professor David A. Ellis holds a personal chair in Behavioural Science at the University of Bath and is a globally recognized expert in digital technology's impact on research and daily life.
Working at the intersection of psychology and data science, his primary focus has been on the descriptive or predictive value of new and emerging forms of data for understanding the dynamics of behaviour in the digital age. He has explored the psychological value and impacts of technology as it relates to privacy, security, health, and well-being. This includes spearheading innovative research practices alongside the analysis of digital data, which continues to advance the discipline of psychology and the wider academic community.
David's research has been supported by research councils, government agencies, and industry partners. He has collaborated with civil servants, government analysts, NHS staff, patients, artists, technology entrepreneurs, and members of the public and has provided advice and research reports to large and small companies, as well as to UKRI, the UK, and Scottish governments. This often emphasises where digital transformations can deliver positive social, economic, and industrial impacts.
In accordance with this policy, I declare that I have NO 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.
Nestor Cohenca, D.D.S., F.I.A.D.T.
Professor
Dr. Cohenca completed the endodontic program at the Hebrew University in Jerusalem cum laude and received the Best Graduate Student Award. He then served 11 years on faculty at the school while maintaining a private practice limited to endodontics. In 2005, Dr. Cohenca joined the University of Washington where he completed his US endodontic certificate in 2008 and served as Tenured Professor of Endodontics and Pediatric Dentistry from 2005-2014, and Director of Endodontics and the Dental Traumatology Unit at Seattle Children’s Hospital from 2014 to 2024. Currently he maintains a private practice limited to Endodontics in Kirkland, WA. He is a Diplomate of the Israel Board of Endodontics and the American Board of Endodontics. Dr. Cohenca is a Fellow and served as President of the International Association of Dental Traumatology. He has published more than 90 peer-reviewed articles, 10 chapters and a book entitle “Disinfection of Root Canal Systems: The Treatment of Apical Periodontitis”. Dr. Cohenca provided more than 350 lectures around the world and am well known as one of the experts in dental traumatology, Endo-Pedo related topics, vital pulp therapy, CBCT and root canal disinfection.
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 - Identify key procedural differences between the GentleWave and UA + NPI protocols used in molar root canal disinfection.
-
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.
Bettina R. Basrani D.D.S., M.S.D., Ph.D.
Dr. Bettina Basrani is Tenured Associate Professor and Director, MSc Program in Endodontics at the Faculty of Dentistry, University of Toronto, Ontario, Canada since 2015. Dr Basrani received her DDS degree from the University of Buenos Aires and a Specialty Diploma in Endodontics and PhD from Maimonides University in Buenos Aires, Argentina. A long-time educator and researcher, she began her teaching career at the University of Buenos Aires. In 2000, she moved to Canada to serve as Chair of the Endodontic Program at Dalhousie University, Halifax, Nova Scotia. In 2004, she moved to Toronto, where she has continued her academic and clinical work. Internationally recognized as a leading authority in endodontics and as an excellent lecturer, effectively combining clinical and scientific information, Dr Basrani has received many awards throughout her career, such as the Louis Grossman Award by the French Society of Endodontics and has international courses and lectures, over 40 peer-reviewed scientific publications, three textbooks and several textbook chapters, and abstracts to her credit. Recently, in 2021 she was recognized as one of the most influential graduates from the University of Buenos Aires. She serves as reviewer for several endodontic journals. Dr Basrani is a member of many endodontics societies around the world.
Speaker Disclosure
In accordance with this policy, I declare that I have NO 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.
Ove A. Peters, D.M.D., Ph.D., M.Sc.
Dr. Ove A. Peters is a clinician-scientist at the UQ School of Dentistry; his expertise is in endodontics, including root canal treatment and vital pulp therapy, combining lab research with clinical studies and >35 years of experience as a dentist. Dr. Peters joined The University of Queensland in 2020 after faculty positions in Heidelberg, Germany and Zurich, Switzerland, as well as at the University of California, San Francisco. He now serves as the Deputy Head of School and professor of Endodontics at UQ. Earlier Dr. Peters was the founding director of the postgraduate endodontic program at the Arthur A. Dugoni School of Dentistry in San Francisco, a professor with tenure and the Chair of the Department of Endodontics at that school; he is board certified by the ABE and currently registered as specialist endodontist in Australia and New Zealand. He has published more 300 manuscripts and 3 books; his works have been cited more than 24,000 times (see here https://scholar.google.com.au/citations?user=BX9jJ_UAAAAJ). He serves as associate editor for the International Endodontic Journal. Dr. Peters has received the Louis I Grossman Award by the AAE, the Hans Genet Award by the ESE and more recently the Distinguished Scientist Award in Pulp Biology by the IADR.Disclosure(s): Dentsply Sirona: Grant/Research Support (Ongoing), Honorarium (Ongoing)
-
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.
Mohamed Ibrahim, D.M.D.
Dr. Ibrahim is Professor and Director of Predoctoral Endodontics at Marquette University School of Dentistry. He earned his dental degree with honors from Mansoura University in Egypt, where he also completed his Master of Science and endodontic training. Dr. Ibrahim obtained a PhD through a joint supervision program between Mansoura University and the University of Cologne, Germany, focusing on endodontic microbiology and disinfection. He further earned a doctoral degree (Dr. Med. Dent.) from the University of Cologne, specializing in endodontic hydrodynamic disinfection.Dr. Ibrahim has published extensively in leading journals, including the Journal of Endodontics, International Endodontic Journal, and the Journal of Dental Education, among others. He is the author of two book chapters on the biocompatibility of dental biomaterials and injectable gels for dental and craniofacial applications. He has lectured nationally and internationally on various topics in endodontics.In addition to his academic contributions, Dr. Ibrahim serves as a reviewer for several peer-reviewed journals, including the Journal of Endodontics, Journal of Dental Education, Materials, and Scientific Reports. He is also an active member of the AAE Research and Scientific Affairs Committee.
Disclosure(s): No financial relationships to disclose