Obturation Technique
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- Includes Credits
CE Hours: 1.5
Description: Root canal obturation is a critical step in non-surgical root canal treatment. In recent years, more emphasis is being placed on preserving more natural tooth structure during endodontic treatment in order to improve the long-term survival of the natural dentition. With the introduction of calcium silicate-based root canal sealers, root canal obturation techniques have evolved to adapt to this more conservative philosophy. This lecture will present an overview of the changing philosophy in root canal obturation, discuss the properties of new obturation materials, review the most current and clinically relevant evidence on various obturation materials and techniques, and describe the clinical procedure of the contemporary sealer-based obturation using calcium silicate-based sealers. The lecture will provide evidence-based clinical guidance for endodontists to meet today’s challenges in root canal obturation and achieve a more predictable treatment outcome.
Learning Objectives:
- Explain the objectives and principles of root canal obturation
- Explain the properties of calcium silicate-based root canal sealers
- Explain the rationale and the clinical techniques of sealer-based root canal obturation
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)
- 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)
- Includes Credits
CE Hours: 0
Description: The presentation will look at canal system irrigation with the intent of understanding how various modalities work and how effective they are. The recently introduced multisonic, fluid dynamic irrigation technology works in a fundamentally different way than traditional needle irrigation. Its method of action will be looked at in-depth so participants can understand exactly how it works. Once explained, this action will be visualized with macro video in anatomically accurate clear plastic tooth models. During this, a direct comparison will be made with traditional irrigation protocols. Issues of effectiveness, safety and cost will be examined. The presentation will be summarized with a discussion of the ramification of this technology on our broader shaping and obturation concepts.
At the conclusion, participants should be able to:
- Describe the various irrigation protocols used today in endodonitcs
- Describe the advantages and disadvantaages of each irrigation protocol
- Describe the method of action of the new multisonic fluid dynamic driven irrigation devise and how this technology impacts traditional endodontic treatment protocols
Eric J. Herbranson, DDS, MSC
Dr. Herbranson graduated with a BS in Physics in 1964, a DDS degree from Loma Linda University in 1970 and a MS in Endodontics from Loma Linda University in 1973. He has practiced endodontics in the San Francisco East Bay since that time. He has served on most of the Alameda County Dental Society board positions, including President and Trustee. He was inducted as a Fellow of the International College of Dentists in 2003. He has been actively involved in education for years, has lectured nationally and internationally and authored text book chapters and articles. He was declared Alumni of the Year from Loma Linda University School of Dentistry in 2006 Following his interest in photography he developed the X-Mount camera mount system and is a recognized expert in surgical microscope photography. His non-dental photographs have been published in a number of national magazines. He is a founder of eHuman.com who is the developer of the Tooth Atlas, a computerized atlas of the anatomy of human teeth. It has been recognized as a significant tool in learning the complex microanatomy of teeth and has been adapted by many of the dental schools in the United States.
Eric J. Herbranson, D.D.S., M.S., FICD
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: eHuman (StockHolder/Ownership Interest), Global Surgical Corporation (Financial) support), Sonendo Inc. (Grant, Consultant, Honorarium), SSwhite Bur, Inc (Consultant, Honorarium)
- Includes Credits
CE: 1.0
Course Description:Endodontic success is dependent on many things we do as practitioners. It is important that we effectively debride and disinfect the root canal system, however once this is completed, the system must be sealed both coronally and apically to ensure a greater chance for success. With advances in technology that allow us to debride minimally prepared canals, our techniques to obturate these small spaces have changed. This presentation will revisit the goals of obturation and discuss multiple techniques from single cone to carrier-based systems with a focus on the future of obturation.
At the conclusion, participants should be able to:
- Discuss current research related to endodontic obturation.
- Describe the limitations associated with obturating small canal preparations.
- Evaluate techniques that allow for efficient obturation of small spaces that achieve the goals of obturation.
Michael J. Tulkki, D.D.S., M.S.
Dr.Tulkki is originally from Cold Spring, MN. He received his Doctor of Dental Surgery in 2001 from the University of Minnesota Dental School. He received his Masters of Science and Certificate in Endodontics in 2006 from the University of Minnesota. While completing his residency his research focus was antibacterial properties of irrigating solution on bacterial biofilms. In 2010, Dr. Tulkki received board certification from the American Board of Endodontists. He is a past president of the Minnesota Endodontic Association. In addition to clinical practice, he has been involved with the University of Minnesota Dental School while teaching and lecturing. He is an active member of the American Dental Association, American Association of Endodontists, Minnesota Association of Endodontists and the American Board of Endodontics.
Michael J. Tulkki, D.D.S., M.S.
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: DENTSPLY Sirona Dental Specialties (Self) : Consultant (Status: Ongoing), Honorarium (Status: Ongoing); Sonendo, Inc. (Self) : Consultant (Status: Ongoing), Honorarium (Status: Ongoing)
CE: 0
Course Description:A short introduction to "level of evidence in endodontic research" will be given. The lecture will continue with a description of the building blocks for success in endodontic treatment, and how these have changed (or not!) during the decades. We will then look at the “endodontic triad” as a disease/treatment model and how the three arms are related. An identification of how legacy protocols came out of the then available technology will be discussed with an emphasis on the continued evolution of debridement technology and how it has impacted the other arms of the triad and challenges our ideas around obturation. The use of new sealers that effectively seal in large film thicknesses, the concept of gutta percha points used as a condenser rather than an obturation material, and a review of the need for vertical condensation will also be evaluated along with whether obturation will really be necessary in the future.
At the conclusion, participants should be able to:
- Describe the inter-relation of the classic endodontic triad arms and how changing one will influences the others.
- Discuss what near-term treatment protocol changes are possible and how they may simplify endodontic treatment.
- Evaluate whether or not the protocol changes that are possible today are more effective.
Markus Haapasalo DDDS, Phd, FRCDC(Endod.)
Dr. Markus Haapasalo is the professor and chair of the Division of Endodontics at University of British Columbia, Vancouver, Canada. He is the former head of the Department of Oral Biological and Medical Sciences. He is a member of Royal College of Dentists of Canada (Endodontics) and an associate member of AAE. Dr. Haapasalo is a member of the editorial board of the International Endodontic Journal and the Scientific Advisory Board of Journal of Endodontics. In endodontics, his areas of special interest include instrumentation, biofilms, irrigation, persistent infections and resorptions. In addition, Dr. Haapasalo has received several teaching and research awards and is an eminent speaker at numerous international conferences.
Markus Haapasalo, D.D.S., PhD
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 () : Grant/Research Support; Dentsply Maillefer () : Honorarium; Dentsply Tulsa () : Grant/Research Support, Honorarium, Royalties; FKG Dentaire, Switzerland () : Honorarium; Henry Schein, Sybron Endo () : Honorarium; Sonendo Inc. () : Consultant, Material support, Other Financial or Material Support, Stockholder/Ownership Interest (excluding diversified mutual funds); sybronendo () : Grant/Research Support; Vista dental () : Grant/Research Support
- Includes Credits
CE Hours: 1.0 CE hour
Description: A root canal obturated with a calcium silicate–based sealer (bioceramic sealer [BCS]) and a modified gutta-percha cone (bioceramic cone [BCC]) might improve the fracture resistance of the root. The objective of this study was to evaluate root reinforcement of a bioceramic cone/sealer (TotalFill; FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) by investigating the fracture resistance, push-out bond strength, sealer penetration, and modulus of elasticity (MOE) in comparison with gutta-percha/AH Plus (Dentsply Maillefer, Tulsa, OK) (GP/AH).
At the conclusion, participants should be able to:
Determine the fracture resistance, push-out bond strength, and sealer penetration of roots obturated with BCC/BCS;
Compare BCC/BCS obturated root canals with root canals obturated with GP/AH;
Describe the modulus of elasticity (MOE) of BCC, GP, BCS, and AH was evaluated.Sittichoke Osiri, D.D.S.
Danuchit Banomyong, D.D.S., Ph.D.
Vanthana Sattabanasuk, DDS, PhD
Kallaya Yanpiset, D.D.S., M.S.
