Endodontic Misdiagnosis? A Clinician’s Perspective on Uncertainty
CE Hours: 1.75
Description: For endodontists, it is easy to assume that any radiolucency associated with pain is of pulpal or inflammatory origin, especially if the tooth has a significant restorative history. However, numerous disease entities of variable clinical significance can be identified in the periapical region, and differentiating the typical endodontic presentation from that of a potentially more life threatening or insidious etiology is of critical importance to ensure ideal management and outcome. This review, based on clinical cases, will highlight a variety of diagnostic roadblocks including the limitations of pulp testing and radiographic interpretation of periapical images and cone beam computerized tomography. Advanced endodontic diagnosis with systematic method for the development of a differential diagnosis of periapical radiolucencies will be the main focus of this discussion.
Learning Objectives:
- Recognize the limits of available technology and issues related to pulp testing and radiographic imaging.
- Incorporate a systematic method to formulate a differential diagnosis of radiographic lesions found in the periradicular areas.
- Discuss the radiographic changes consistent with non-inflammatory etiologies and recognize when referral for biopsy is indicated.
Key:
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David Landwehr, D.D.S., M.S.
Endodontist
Capital Endodontics
Dr. David Landwehr earned his D.D.S. at the University of Minnesota. He received an M.S. degree and certificate in oral and maxillofacial pathology at The Ohio State University followed by specialty training in endodontics at the University of Michigan. Dr. Landwehr has been a private practice clinician for more than twenty years and for the last ten years has provided exemplary patient care at Capital Endodontics in Madison, WI.
Dr. Landwehr’s ongoing work as an educator and opinion leader has positioned him at the forefront of modern endodontic treatment. Dr. Landwehr authored the chapter titled Lesions That Mimic Endodontic Pathosis for the most recent edition of Cohen’s Pathways of the Pulp and was the Chief of Endodontics for the Meriter Hospital general practice residency for more than ten years. He has lectured extensively on endodontic diagnosis and oral pathology both nationally and internationally. His teaching focuses on techniques used daily in his clinical practice that are efficient, predictable and evidence based.
Disclosure(s): Dentsply Sirona Endodontic SBU: Honorarium (Ongoing); Surround Medical: Advisory Board (Ongoing)
