SP-25 Management of Challenges and Mishaps Associated with Regenerative Endodontics: From Diagnosis to Prognosis
CE Hours: 1.5
Description: Teeth with mature apexes, necrotic pulps, and periapical lesions are routinely treated with conventional endodontic procedures with a high and long-term survival rate. Traumatic injuries associated with severance of the blood supply result in pulpal ischemia and often a secondary infection with bacteria. The consequence of pulpal necrosis in teeth with immature apexes, however, is the cessation of root development, making endodontic treatment with conventional techniques and materials difficult and sometimes impossible. Currently, treatment options for these teeth include MTA apexification, regenerative endodontics or a new tooth. MTA Apexification induces an artificial apical stop that allows for condensation of obturation materials. However, this procedure does not promote continuation of root development, nor does it increase fracture resistance of the root walls. An ideal treatment for a tooth with necrotic pulp and immature apex is the regeneration of pulp tissue into a root canal and promotion of a normal root development. The advantages of regenerative endodontic procedures (REPs) lie in the potential for reinforcement of dentinal walls by deposition of hard tissue and the potential for the development of an apical morphology more appropriate for conventional endodontic therapy if future treatment becomes necessary. The American Association of Endodontists has developed Clinical Considerations for REPs, which outlines detailed information regarding the steps involved in REPs. However, there are challenges, and mishaps that can occur during pre- treatment, mid treatment or following treatment. The presenter will discuss how to prevent and manage these challenges and Mishaps.
Learning Objectives:
- Describe treatment options for teeth with open apexes.
- Describe challenges and mishaps during regenerative endodontics.
- Describe prevention and treatment of the challenges and mishaps.
Key:
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Mahmoud Torabinejad, D.M.D., M.S.D., Ph.D.
Dr. Torabinejad is president and director of the Endodontic Institute of Surgical Education and Research Foundation. He is a professor of endodontics and former Director of the advanced specialty education program in endodontics at Loma Linda University (LLU) School of Dentistry. Currently, he is professor of endodontics at LLU, research professor at the University of Minnesota, Dean's professor of endodontics at the University of Maryland, affiliate professor of endodontics at the University of Washington in Seattle and adjunct professor of endodontics at the University of Pacific in San Francisco and University of California in San Francisco. He is a diplomate of the American Board of Endodontics. He has authored eight textbooks and more than 350 publications. He is the #1 author of citations in classic articles in the field of endodontics and # 1 author of citation for pulp regeneration. He has presented over 250 lectures nationally and internationally in over 40 countries. He has over 20 patents and no financial interest in any of them at this time. He received several awards from LLU during his 42-year tenure at LLU. They include: the LLU Centennial Van Guard Award for Healing, the Distinguished Research Award from the Dental School, and the LLU distinguished investigator award. He is the recipient of the Louis I. Grossman Award of the French Association of Endodontists. He has received the Ralph F. Sommer Award of the American Association of Endodontists (AAE) twice, Louis I. Grossman Award of the AAE, Philanthropic award of the Foundation for Endodontics, the Edgar D. Coolidge Award of the AAE. Recently , in recognition of his contribution to the field of endodontics, University of Washington in Seattle, Washington established and Endowed Chair under his name. He is a past president of the California Association of endodontics and past president of the AAE and its Foundation.
Disclosure(s): No financial relationships to disclose
Joe A. Petrino, DDS, MS
Dr. Petrino grew up in Montana. He graduated from the University of Minnesota School of Dentistry in 2006. He then completed a General Practice Residency at the Veteran's Affairs Medical Center in Minneapolis. Following completion of the endodontic residency at University of Minnesota in 2009, he entered private practice in St. Cloud, MN. In 2011, he moved to Missoula, MT where he has owned and operated Missoula Endodontics, PC. He became a Diplomate of the American Board of Endodontics in 2012.
Disclosure(s): No financial relationships to disclose
