Non-surgical Root Canal Treatment
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- Includes Credits
CE Hours: 0.75
Description: Apical periodontitis (AP) is the inflammatory response to the endodontic infection advancing within the root canal, and is normally resolved with a correct instrumentation, disinfection and obturation of the endodontic system.
Nevertheless, according to recent reports, the incidence of persistent AP (PAP) in treated teeth is increasing. The most important clinical factors related to persistent AP, have to do with residual infection in uninstrumented volumes of the root canals. In recent years, it has become evident that also systemic conditions affecting the patients, on one hand, and individual genetic predisposition to sustain a stronger immune-inflammatory response, on the other hand, may influence the development and presentation of AP and its healing response to endodontic treatment.
Taking into account the patient's health may help predicting the outcome of endodontic treatment, future protocols may enhance healing by complementing treatment of AP with medications.
Learning Objectives:
- Explain the increased prevalence of AP and of persistent AP in the western world
- Describe impact of some autoimmune diseases, and of the individual immune system on the development, presentation and healing of apical periodontitis
- Evaluate the impact of immune-modulatory drugs and of of other medications on healing of apical periodontitis
Elisabetta Cotti, D.D.S., M.S.
Elisabetta Cotti, DDS, MS, received her DDS from the University of Cagliari – Italy and the specialty and MS in Endodontics from the University of Loma Linda- California. She is Full Professor of Conservative Dentistry and Endodontics, and the Chairman of the Department of Conservative Dentistry and Endodontics at the School of Dentistry, University of Cagliari- Italy. She is currently the Director of the Post Graduate programme (Master) in Clinical Endodontics at the University of Cagliari. She teaches in the Advanced Education Programs in Endodontics at the University of Bologna and she is lecturer in the Department of Endodontics at Loma Linda University, USA. She is the Treasuree for IFEA, active member of the AAE, of the Italian Association of Endodontics (SIE), Italian Academy of Endodontics (AIE), of the European Association (ESE). She is the Past President of the Italian Society of Dental Traumatology (SIDT). She practices limited to Endodontics, She is author of several articles and chapters in the field of Endodontics with has a specific interest in apical periodontit
- Includes Credits
CE Hours: 0.75
Description: To treat or not to treat? This is a common dilemma we face when managing patients with disabilities/special needs. Despite improvements in oral health care accessibility over the past decade, patients with special needs still experience difficulties accessing dental care due to limited geographic, financial, and social access, as well as some dentists’ unwillingness or self-perceived inability to treat where they feel they are not adequately trained to deal with a patient with special needs or disability and in some instances extraction of a tooth may prove to be a more manageable treatment option. In addition, often these patients are incapable of understanding, assuming responsibility for, or cooperating with preventative oral care, making them vulnerable to developing oral or oropharyngeal conditions that yield negative impacts on their oral health and quality of life. If the dental community can be shown that endodontic treatment is a viable option, then saving teeth for this population can improve their oral health-related quality of life.
Learning Objectives:
- Develop a better understanding of endodontic outcomes in patients with special needs
- Differentiate when to proceed with tooth retention versus extraction
- Conduct patient management whether clinical and/or behavioural in order to adequately treat their patient
Caithlin P. Williams-Beecher, DMD, MS
Dr. Caithlin Williams-Beecher hails from the island of Jamaica in the Caribbean. In 2010 Dr Williams-Beecher matriculated to the University of Technology, Jamaica where she was in the first cohort of students in the Doctor of Medical Dentistry programme. Upon graduation in 2015 she became one of the first dental surgeons trained on Jamaican soil; topping her graduating class with the highest honours, earning the University’s Presidential Pin for academic excellence and a host of other awards for clinical and academic excellence including the Dr Gary Glassman Endodontics Award for academic and clinical proficiency. It was with this passion for endodontics that she desired to pursue further training in Endodontics and applied to the University of Toronto, Canada (U of T) where she was accepted to do her MSc. in Endodontics. Again, this made her a pioneer as she became the first Jamaican dentist trained on local soil to complete a specialist programme in the field of dentistry. She has gained the respect and admiration of her U of T peers and faculty for her friendly personality, professionalism, and superior clinical skills. Dr Williams-Beecher is now the first and only Canadian Board-Certified Endodontist in Jamaica and the English-speaking Caribbean. Dr Williams-Beecher has a heart of service and pushes for the best in patient care and does this in the capacity of working as the Consultant Endodontist for the Ministry of Health in Jamaica as well as in private practice. She is a loving wife and a proud mother, priding herself on family, and work-life balance, all while giving back to church and community.
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: 0.75
Description: Non-surgical root canal re-treatments represent very large spectrum of situations that can occur in endodontic practice. Various first treatment modalities have to be considered. Access to root canal system itself is sometimes challenging and great interest is being paid to fragment removal or perforation repair. However, not as often, safe dismantling of the actual root canal filling is being discussed.
In my 24 year practice, root canal fillings in Czech republic went from resorcinol-formaldehyde resins (Russian red) in poorly instrumented roots to various condensation techniques and sealers in over-instrumented canals. With everything in between. Due to human migration, variety of daily practice cases may be increased.
The lecture is focused at methods of removing of various root canal fillings. Unique methods are implemented in hybrid manner - combination of instruments moved by rotary or ultrasonic propellant, various solvents, several rinse activators. The procedure preserves the precious dentine structure as much as reasonable and minimises apical debris extrusion to prevent flare-ups. Long term success/survival rates will be presented.
Learning Objectives:
- Analyze existing root canal filling structure and choose appropriate method of removal
- Safely eliminate spectrum of non-guttapercha root canal filling materials including the resorcinol-formaldehyde resins
- Avoid apical extrusion of debris during root-canal re-treatment as a prevention of flare-ups
- Includes Credits
CE Hours: 0.75
Description: Endodontic retreatment is carried out in cases where previous endodontic therapies failed. The main cause of treatment failure is bacterial persistence within the root canal or coronal leakage after treatment. Literature reports a success rate ranging from 80% to 88% for endodontic retreatment; thus, it is a procedure with a predictable prognosis when well performed. Prognosis will be affected by the type of previous treatment and anatomical alterations occurred during primary treatment. Numerous technologies such as operative microscope, CBCT, and ultrasound are available to help execute the different procedures that could demand this therapy. Overall, clinical procedures include: removal of pins or posts and other core materials; removal of guttapercha, silver cones, management of ledges, root perforations and in some cases, even separated instruments. The main objectives of this clinical lecture are to describe some of the most common clinical situations that occur during endodontic retreatment and to highlight the importance of this practice for tooth conservation.
Learning Objectives:
- Recognize the importance of diagnosis and evaluate the causes of primary treatment failure
- Perform safe and predictable protocols to approach the different difficulties that a retreatment case may present
- Describe the available technologies such as operative microscope, CBCT and ultrasound for the management of retreatment cases
- Includes Credits
CE Hours: 1.0
Description: The decision of which modality of secondary endodontic treatment to perform is multifactorial and clinician dependent. The literature surrounding the long-term survival of nonsurgical retreatment compared with surgical retreatment remains equivocal and warrants further investigation. This 7-year retrospective study seeks to compare the outcome of nonsurgical retreatments with that of root-end surgeries performed on teeth without prior nonsurgical retreatment.
- Evaluate the outcome of nonsurgical retreatments with that of root-end surgeries performed on teeth without prior nonsurgical retreatments.
- Identify the best treatment modality for a failed non-surgical root canal therapy
- Discuss the pros and cons of root-end surgery and nonsurgical retreatment.
Enida Haxhia, DDS
Mohamed Ibrahim, D.M.D.
Dr. Ibrahim is a professor and Director of Predoctoral Endodontics at Marquette University, school of Dentistry. Dr. Ibrahim earned his BDS, MS and endo training from Mansoura University, Egypt. He got a PhD via Joint supervision program between Mansoura University and Cologne University in Germany in the field of endodontic microbiology and disinfection. He also earned a Dr. Med Dent from Cologne University, Germany in endodontic hydrodynamic disinfection. Dr. Ibrahim has published several papers in Journal of Endodontics, International endodontic Journal, Journal of dental education and other international journals. He authored two book chapters about Biocompatibility of dental biomaterials and Injectable Gels for Dental and Craniofacial Applications. He also lectured and presented in endodontics nationally and internationally. Dr. Ibrahim is a reviewer at Journal of endodontics and other peer reviewed journals
Pradeep Bhagavatula, BDS, MHP, MS
- Includes Credits
CE Hours: 1.0
Description: Radiography has played a fundamental role in the advancement of nonsurgical root canal therapy (NSRCT), allowing for more accurate diagnosis and treatment. Typically, providers choose to perform NSRCT using periapical (PA) radiographs alone or, often in more difficult cases, in conjunction with cone-beam computed tomographic (CBCT) imaging. This study aimed to evaluate the outcomes of NSRCT based on imaging modality selection for the initial treatment of maxillary first molars.
- To describe the association between image modality selection, case complexity, and the associated risk of posttreatment endodontic disease.
- To list factors that may influence the outcome of non-surgical root canal treatment (NSRCT) on maxillary first molars.
- To assess the use of two imaging modalities (CBCT and PA radiographs) in the initial, non-surgical, treatment of maxillary first molars.
Devon M. Ptak, DMD, MPH,*
Matthew D. Finkelman, PhD
Robert B. Amato, DMD
- Includes Credits
CE Hours: 1.5
Description: Transformative technology has elevated the standard of clean in endodontics. Unsurpassed cleaning of complex internal spaces utilizing minimal instrumentation is accomplished through a proprietary technology that leverages optimum cleaning via broad-spectrum acoustic energy and a powerful vortex of disinfecting solutions, while providing improved patient outcomes. With the vast majority of treatments efficiently performed in one-visit, and patients universally reporting minimal-to-no discomfort post treatment, this breakthrough technology is here to stay. Factors influencing the skeptic-to-believer evolution process in the adoption of new technology into practice will be shared.
Learning Objectives:
- Discover how one practice incorporated some transformative technology to enable successful cleaning and disinfection of complex anatomies with minimal root canal preparations
- Identify factors that enable a smooth transition into advanced and transformative technology
- Assess the rationale for embracing today's advancements into everyday practice
Michael J. Ribera, D.MD, M.S.
Dr. Ribera is a 1984 graduate of Boston College and a 1989 graduate of Harvard School of Dental Medicine. In 1990 he completed a general practice residency at Harvard’s Brigham and Women’s Hospital, and in 1992 received his Certificate in Endodontics and Master of Science Degree from Northwestern University Dental School in Chicago. Dr. Ribera is a Diplomate of the American Board of Endodontics, a member of the Endodontic College of Diplomates, and a specialist member of the American Association of Endodontists. He is the 2006 recipient of the District of Columbia Dental Society’s David Mast Memorial Award for excellence in continuing education. Dr. Ribera is in full-time practice and maintains three offices in the Washington, D.C. Area.
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: 1.25
Description: Dynamic Navigation has recently gained significant interest in the field of Endodontics. As we continue to explore its potential and suitability for endodontic therapy, a need for better integration within the endodontic workflow is emerging. This presentation will provide a brief introduction of the core principles of Dynamic Navigation for Endodontics while specifically focusing on its latest advancements, the potential for achieving optimal directed dentin conservation during non-surgical endodontic access cavity preparation as well as its limitations and shortcomings. A novel approach allowing for the integration of Dynamic Navigation with the surgical operating microscope-based practice will also be discussed.
Learning Objectives:
- Describe the core principles of Dynamic Navigation in the context of non-surgical Endodontics
- Describe different techniques to achieve directed dentin conservation during access cavity preparation using Dynamic Navigation
- Describe novel approaches to achieve optimal ergonomics when integrating Dynamic Navigation with the surgical operating microscope
Bobby Nadeau, D.D.S., M.Sc
Dr. Bobby Nadeau grew up in Quebec, Canada. He received his DDS degree from Dalhousie University, Faculty of Dentistry. After one year of private practice, Dr. Nadeau attended the University of Toronto where he received his MSc. Endodontics degree. Dr. Nadeau currently is the owner of Kingston Endodontics, a private practice limited to Endodontics in Kingston, Ontario, Canada.
Speaker Disclosure
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: ClaroNav (Individual(s) Involved: Self): Consultant; Zumax Medical Co (Individual(s) Involved: Self): Consultant - Includes Credits
CE Hours: 1.5
Description: Our specialty of Endodontics has evolved, and continues to evolve, through the application of emerging technologies. Advancements in irrigation protocols have allowed for predictable cleaning of the primary canals with more conservative preparations to include no instrumentation. Subsequently, obturation materials and methods have to be modified to accommodate these smaller shapes. This case-based presentation will review the advantages and techniques used to overcome the challenges of such a paradigm shift.
Minimally prepared canal systems with enhanced irrigation have the potential to provide desirable results and conserve tooth structure. Various cases with continued care healing re-evaluations to include CBCT imaging for both pre-operative and recall examination will be presented.
Learning Objectives:
- Compare and contrast traditional tapered canal preparation versus methods and materials used for minimally prepared canals and modified obturation techniques.
- Critically evaluate the advantages of minimal preparation combined with enhanced irrigation and bioceramic sealer as an alternate option for nonsurgical RCT.
- Explain the role of minimally prepared canals and their correlation to the longevity of endodontically treated teeth based on pre-operative and post-operative CBCT comparison.
Scott K. Hetz, D.MD
Scott K. Hetz DMD, is a 1997 graduate of the University of Pittsburgh School of Dental Medicine. Dr. Hetz served in the United States Air Force for 9 years including an Advanced Education in General Dentistry program. Also while on active duty, he received his specialty Certificate in Endodontics from the University of Southern California in 2004. Dr. Hetz is a Diplomate of the American Board of Endodontics, member of the Endodontic College of Diplomates and Specialist Member of the American Association of Endodontists and District of Columbia Dental Society. He volunteers as Affiliate Faculty in the Department of Endodontics Naval Postgraduate Dental School at Walter Reed National Military Medical Center. Dr. Hetz maintains a full time practice as a partner with Advanced Endodontic Associates in Washington DC. He can be reached at scotthetz@mac.com.
Speaker Disclsoure
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: Root canal sealers are a critical component in obturation to provide a fluid-tight seal of the root canal system. Calcium silicate-based bioceramic sealers have emerged as a promising alternative to traditional resin-based or ZOE-based sealers. The increasing popularity of these materials is driving a paradigm change in obturation towards a more sealer-centric philosophy. The excellent flow characteristics, sealing ability, dimensional stability, and biocompatibility of bioceramic sealers allow them to be used in a simplified obturation technique without compromising the quality of obturation. Since the first bioceramic sealers were introduced in 2008, there has been growing evidence supporting the use of these materials. New products also continue to be developed and introduced. This presentation will provide an update on the recent development in the field of bioceramic sealers, review their relevant properties, discuss the clinical techniques of their application, and present the most current research related to the properties and clinical effectiveness of bioceramic sealers.
Learning Objectives:
- Describe the physical, chemical, and biological properties of bioceramic sealers and understand the benefits and limitations of these materials
- Describe the clinical techniques for using bioceramic sealers in root canal obturation
- Discuss current evidence from in vitro and clinical studies regarding bioceramic sealers
Jianing He, D.M.D., Ph.D.
Dr. Jianing (Jenny) He received her dental degree from West China University of Medical Sciences in 1996, and a certificate in Endodontics and a PhD in Oral Biology from the University of Connecticut Health Center in 2003.
Dr. He has been actively involved in endodontic education, research, and clinical practice. She is a Diplomate of the American Board of Endodontics, and a fellow of American College of Dentists. She has published over 50 manuscripts in peer-reviewed journals and served on the Research and Scientific Affairs committee for the AAE. Dr. He is currently an Associate Editor of the Journal of Endodontics.
Dr. He is a Clinical Associate Professor at Texas A&M University College of Dentistry, and maintains a full-time private practice limited to Endodontics in Dallas, TX.
Speaker Disclosure
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: Brasseler USA (Individual(s) Involved: Self): Honorarium (Terminated)
