Speaker: Amir Azarpazhooh, D.D.S., M.SC., F.R.C.D. (C) (DPH), CERT. ENDO., PhD, F.R.C.D. (C) (ENDO), Dip ABE|The cornerstone of evidence-based decision-making in endodontics relies on the critical analysis of relevant and methodologically rigorous studies. Understanding prognostic outcomes in contemporary endodontics is essential for making informed treatment choices. However, studies on nonsurgical endodontic initial treatment and retreatment demonstrate variability, partly due to outdated practices that do not reflect current standards of care. Modern endodontics has undergone significant evolution with advancements in tools, materials, and technologies. This contemporary armamentarium allows clinicians to manage complex anatomical and pathological challenges with greater precision and predictability, marking a clear departure from conventional methods. These innovations underscore the importance of integrating state-of-the-art equipment and techniques into everyday clinical practice. This webinar aims to provide a comprehensive and up-to-date review of contemporary nonsurgical endodontic initial treatment and retreatment by examining robust research to understand expected outcomes and identify key prognostic factors. The primary objective is to equip clinicians with the knowledge required to make informed decisions, ultimately contributing to improved long-term outcomes in endodontic care.

Speaker: Spyros Floratos, DMD|Vertical Root fracture (VRF) is a longitudinally oriented complete or incomplete fracture of the root that originates from its apical end and propagates coronally and is defined as one of the crack types. According to the literature, VRF is the third most common reason for extraction of an endodontically treated tooth. Prognosis of vertically fractured teeth is usually questionable or poor, oftentimes leading to extraction. Concerning incomplete VRFs, several surgical techniques have been described. A predictable microsurgical technique involves elimination of the fractured part of the root with simultaneous preservation of the healthy root length and regenerative technique to enhance bone reformation. This technique can ultimately save the teeth, obtain periradicular bone healing and restore functionality. The purpose of this presentation is to highlight microscopic surgical preservation for teeth with incomplete VRF in maxillary and mandibular teeth both posterior and anterior. Case selection for application of these techniques is critical, because incomplete vertical fractures are difficult to diagnose.

Authors: İpek Eraslan Akyüz, DDS; Beyza Ezgi Kıvırcık, DDS; Tuğrul Aslan, DDS, PhD; |Artificial intelligence (AI) systems are increasingly used in dental radiology to support endodontic diagnosis. However, their diagnostic reliability across different clinical categories remains unclear. This study compared 3 vision–language AI models (ChatGPT-5 Plus, Gemini 2.5 Pro, and Copilot Pro) with expert endodontists by assessing sensitivity, specificity, overall diagnostic agreement, and Youden’s Index across multiple endodontic conditions.

Authors: Domenico Ricucci, MD, DDS; Andrea F. Campello, DDS, MSc, PhD; Irina Milovidova, DDS; Isabela N. Rocas, DDS, MSc, PhD; Jose F. Siqueira, Jr. DDS, MSc, PhD ; |Occurrence of post-treatment apical periodontitis characterizes the failure of endodontic treatment. This study described the histobacteriologic and histopathologic features of biopsy specimens of teeth with post-treatment apical periodontitis.

Speaker: | Hamid Abedi, DDS, MS, MBA; Max Foroughi, PhD; Mohammad Moshirpour, PhD | This presentation highlights the development and clinical integration of an AI-driven diagnostic and teleconsultation platform designed to optimize decision-making in endodontic care. The system enables pre- and post-treatment validation through deep learning algorithms trained on annotated radiographs to assess root canal indications, extraction needs, and case difficulty. Secure, real-time telecommunication tools allow general practitioners (GPs) and endodontists to engage in case discussions and streamlined treatment planning. The platform integrates an AI-based triage and scheduling module that prioritizes appointments based on diagnostic urgency. Clinical pilot studies demonstrate improved diagnostic concordance, more accurate case difficulty grading, and enhanced workflow efficiency. By combining AI-powered analysis with expert-driven validation and scheduling automation, the system promotes higher treatment confidence, reduced unnecessary referrals, and better patient outcomes. The platform is fully validated, regulatory-ready, and positioned for commercial launch, offering a scalable solution for modern endodontic practices.

Speaker: João Filipe Brochado Martins, DDS, MsC|Selective root canal retreatment (sRCR) offers a minimally invasive alternative to full retreatment by addressing only diseased roots while preserving healthy ones. This webinar will explore the clinical efficacy, benefits, and risks of sRCR, with a focus on tooth preservation, fracture resistance, and cost-effectiveness. Participants will gain practical insights into integrating this philosophy into daily practice.

Speaker: Elliot V. Hersh, D.MD, M.S., PhD|Up until recently the only drugs available to manage acute dental l pain were acetaminophen, aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids. NSAIDs cannot be taken by a variety of patients due to poor renal function, a history of GI ulcers, drug allergy or sensitivity and for the possibility of adverse drug interactions with anticoagulants and lithium. Opioids are wrought with acute side effects including dizziness, drowsiness, nausea, vomiting and constipation. Their potential to cause substance misuse, physical dependence and addiction are also well described. On January 30, 2025 suzetrigine, a novel voltage gated sodium channel 1.8 (Nav 1.8) blocking agent was granted FDA approval for the management of moderate to severe pain. By selectively blocking the Nav 1.8 it is hoped that side effects will be less numerous and severe compared to drugs that indiscriminately block other Nav subtypes such as anticonvulsants and local anesthetics.. Unlike opioids, suzetrigine also appears to be devoid of addiction potential. In two Phase 3 post-surgical pain trials on research patients who underwent bunionectomy or abdominoplasty, suzetrigine was significantly more effective than placebo, but its analgesic effects were only equivalent to acetaminophen 325 mg plus hydrocodone 5 mg (APAP 325 mg/HYDRO 5 mg) respectively. These results are somewhat disappointing with regards to postsurgical dental pain where 440 mg naproxen sodium or APAP 500 mg plus ibuprofen 400 mg (APAP 500 mg/IBU 400 mg) have been demonstrated to provide superior analgesic effects when compared to APAP 650 mg/HYDRO 10 mg or APAP 300 mg/HYDRO 5 mg respectively. This presentation will discuss the genesis of dental postsurgical pain, the nomenclature and anatomical locations of various Nav channel subtypes and suzetrigine's possible utility and limitations in treating orofacial pain. Suzetrigine represents only the first step to optimize the selective blockade of Nav channels to treat various patient maladies.

Authors: Siwen Wu, BDS, MDS, MRD, RCSEdin; Tudor Dascalu, PhD; Rachel Fangying Seet, BDS, MDS; Pei Yuan Chan, BDS, MDS, MRD, RCSEdin, FAMS; Na Yu, BDS, MDS, PhD; Jeffry Hartanto, PhD; Bulat Ibragimov, PhD; |In early stages of cracked teeth, pulpal inflammation is considered reversible. Cracked teeth with retained pulp vitality demonstrate higher survival rates whereas root canal treatment (RCT) negatively influences survival outcomes. The clinical challenge lies in discerning when RCT is required. This study aimed to develop and validate machine learning models for predicting pulp survival in cracked teeth with reversible pulpitis and investigating associations between patient- and tooth-related variables and treatment outcomes.

Speaker: | Martin J. Rogers, D.D.S. | This lecture provides an evidence-based framework for choosing between nonsurgical retreatment and endodontic microsurgery in the management of apical disease. Content includes CBCT-driven diagnosis to distinguish missed anatomy from potential extra-radicular infection; assessment of restorability and retreatment feasibility in the presence of posts, cores, and iatrogenic complications; and the impact of prior treatment quality, lesion size, and patient factors on prognosis. We will discuss the data on survival, success, and complication profiles for retreatment vs microsurgery. Through real-case examples I will highlight stepwise decision making, microsurgical considerations relative to adjacent anatomic structures and how to identify high-risk scenarios, and follow-up intervals that meaningfully access healing. Attendees will leave with a practical way to select the least invasive, predictable pathway to resolution of periapical pathology.

Speaker: | Stephen P. Niemczyk, D.MD | 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.