Pulpal Diagnoses
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Includes Credits
CE Hours: 1.25
Description: Traditional definitions of endodontic care often emphasize localized treatment goals while neglecting broader impacts on systemic health and quality of life. A more comprehensive, patient-centered approach-aligned with the principles of P4 Medicine (predictive, preventive, personalized, and participatory)-may enhance the efficacy, accessibility, and relevance of endodontic therapy.Pulpal disease affects an estimated 30% of the global population, with substantial unmet treatment needs resulting in pain, tooth loss, and diminished daily function. While standardized competencies and technical quality measures guide clinical care, evolving concepts of oral health call for broader success criteria-incorporating patient-reported outcomes and long-term wellness.The integration of P4 principles into endodontic care encourages a proactive shift: predictive diagnostics can help identify individuals at elevated risk; preventive strategies, including minimally invasive care and public health initiatives, may reduce disease incidence; personalization of treatment based on genetics, behavior, and health history enhances clinical precision; and participatory care empowers patients through shared decision-making and education.Yet, significant barriers remain. The high cost of specialist training and inequities in access to care limit the global scalability of these approaches. Expanding educational opportunities, incorporating dental auxiliaries, and leveraging emerging technologies are essential for closing these gaps.This presentation will examine the relationship between endodontic disease and general health, evaluate how evolving treatment goals inform clinical decision-making, and explore practical strategies for implementing P4 concepts in diverse care settings to support lifelong oral health.<br/><br/>
Learning Objectives:
- Discuss the global burden of endodontic disease and its impact on systemic health and quality of life.
- Apply patient-centered and P4-based principles to guide endodontic treatment planning and outcome assessment.
- Identify barriers to delivering optimal care globally and explore models to enhance access, efficiency, and equity.
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Includes Credits
CE Hours: 1.5
Description: Dynamic navigation is one of the most exciting technological advances in endodontics, offering real-time guidance and improved accuracy for access preparation, canal location, and microsurgical procedures. Current studies highlight its potential to enhance outcomes and reduce operator stress. However, the cost and logistical demands may limit widespread adoption. This presentation will explore the science and applications of dynamic navigation, while also translating key principles that can be applied to everyday practice. Attendees will leave with a deeper understanding of how to integrate navigation-inspired concepts into their freehand endodontic surgery and nonsurgical techniques, improving precision and predictability without necessarily investing in a device.
Learning Objectives:
- Describe the principles of dynamic navigation technology and compare its advantages over traditional freehand endodontic access techniques.
- Demonstrate how to plan and execute guided surgical access using dynamic navigation systems in everyday clinical practice.
- Evaluate case selection, recognize limitations, and integrate dynamic navigation concepts into daily endodontic surgical practice
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Includes Credits
CE Hours: 1.5
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 the limitations of pulp testing, periapical imaging and cone beam computerized tomography. A systematic method to develop a differential diagnosis of periapical pathology 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.
- Describe how the growth pattern of the various pathologies affects clinical management and recurrence rates
- Discuss the radiographic changes consistent with non-inflammatory etiologies and recognize when referral for biopsy is indicated.
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Includes Credits
CE Hours: 1.0
Description: As endodontists, treating children is a common occurrence in our careers. While navigating canals may be straightforward, the unique challenges of pediatric patients require specialized knowledge and skills. This presentation will provide an in-depth examination of the most prevalent medical and mental comorbidities encountered in young patients undergoing root canal treatment. By exploring these complexities, we aim to equip endodontists with the essential tools and strategies needed to deliver safe, comfortable, and effective care for children in our dental offices.
Learning Objectives:
- Identify common medical comorbidities in pediatric patients that may impact endodontic treatment outcomes.
- Develop strategies for safely and comfortably treating pediatric patients with complex medical and mental health needs in a dental office setting.
- Apply knowledge of pediatric comorbidities to inform treatment planning and decision-making in endodontic care.
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Includes Credits
CE Hours: 1.0
Description: The incidence of dental trauma is highest in the first two decades of life, and hence, the young permanent anterior teeth are of particular importance in traumatic injuries. Successful retention of these teeth is paramount to the long-term esthetic, functional, and health of not just the oral cavity but also the physiological and psychological impact the loss may have on these young patients. This presentation reviews the latest guidelines by IADT, treatment options, and prognosis for Crown fractures, Root fractures, and sequelae of luxation injuries based on the biological goals, and current evidence.
Learning Objectives:
- Review the biological sequelae of select dental traumatic injuries
- Evaluate treatment aims based on current guidelines to maximize positive outcomes
- Identify possible varied treatment trends in dental trauma
Meetu R. Kohli, B.D.S, D.M.D.
Dr. Meetu Ralli Kohli is Clinical Associate Professor and the Program Director for Postgraduate Endodontic Education at the University of Pennsylvania, School of Dental Medicine, Endodontic Department. She also serves as director for Continuing Education and International Visiting Scholar Program and the Master’s in Advanced Dentistry Studies Program (MADS). She is a member of the Dean’s advisory council. Dr. Kohli earned her B.D.S. from Government Dental College, Bangalore, India. She pursued her D.M.D. degree and specialty training in Endodontics at the University of Pennsylvania, USA. During her training, she received the esteemed Louis I. Grossman Award, the Samuel R. Rossman Scholarship, and the Sherrill Ann Siegel Award & Scholarship. She is on the Scientific Advisory Board as a reviewer for the Journal of Endodontics, the International Endodontic Journal, the Journal of the American Dental Association, and other endodontic journals. Dr. Kohli has published in national and international peer-reviewed journals and has contributed to books on microsurgical retreatment. Her publications have been recognized as the best clinical research paper and as honorary mentions by JOE multiple times. She has served on the AAE’s Constitution and Bylaws Committee and the Research and Scientific Affairs Committee. She also serves as President and Director on the Board of Trustees of the American Board of Endodontics and is a diplomate. Dr. Kohli maintains multiple private practice locations in Pennsylvania, USA, limited to Endodontics.
i declare that I have NO 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.
- Review the biological sequelae of select dental traumatic injuries
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Includes Credits
CE Hours: 1.5
Description: “Cracked teeth” is one of the most widely debated, disputed and misunderstood topics in dentistry. The confusion and misunderstandings stem largely from early work on cracks and the lack of a good definition of a crack. Many dentists are confused about cracks and fractures, and they use these terms interchangeably even though they represent different problems. The confusion and misunderstanding also stem from traditional approaches to dealing with cracks in teeth which has largely been a mechanical approach. Whilst cracks are a weakness in the tooth structure, they are also a pathway for bacteria to enter the tooth and cause pulp disease. Symptoms associated with cracks in teeth come from the pulp and therefore it is essential to diagnose the pulp status and then manage the bacterial aspect of cracks rather than just dealing with them as a mechanical problem. This lecture will define cracks, explore the effects of cracks on teeth and provide guidelines for the diagnosis and management of teeth with cracks – especially teeth with reversible pulpitis, which can be managed conservatively.
Learning Objectives:
- Define cracks and fractures and differentiate between them.
- Explain that cracks are an etiology of various diseases, and not a disease or a syndrome.
- Outline the consequences of cracks in teeth.
Paul V. Abbott, B.D.Sc., M.D.S., FRACDS(Endo)
Paul Abbott is Emeritus Professor of Dentistry at The University of Western Australia. He is a Specialist Endodontist with over 46 years of clinical practice experience. Prior to taking a full-time University position in 2002, he spent 17 years in private specialist endodontic practice and he also held part-time academic positions at The University of Western Australia and the University of Melbourne. He was Dean and Head of the School of Dentistry at The University of Western Australia and Director of the Oral Health Centre of Western Australia from 2003-2009. He has presented over 1800 lectures and courses in 55 countries. He has over 440 publications with 278 articles in refereed journals, 25 textbook chapters and 51 Newsletter articles. From 2015-2022, he was the Editor-in-Chief of the international journal Dental Traumatology. Prof. Abbott's main research and clinical interests revolve around dental traumatology, tooth resorption, and the diagnosis and management of pulp, root canal and peri-radicular conditions, with particular emphasis on pain control and disinfection of the root canal system. He has won numerous awards for his teaching and service to the dental profession, including the Jens O. Andreasen Award for Lifetime Achievement in Dental Traumatology from the International Association of Dental Traumatology (2024) and the Louis I. Grossman Award (2025) from the American Association of Endodontists for cumulative publications of significant research studies that have made an extraordinary contribution to endodontology. Prof. Abbott was also appointed by the Governor-General of Australia as an Officer of the Order of Australia in 2015. In 2024, he was appointed as Chair of an IADT/DTG Committee to develop a new comprehensive classification of Tooth Resorption.
Disclosure(s): OzDent Dental Products Pty Ltd: Honorarium (Ongoing), Occasional Consultancy work (Ongoing), Other Research Support (includes receipt of drugs, supplies, equipment or other in-kind support) (Ongoing), Speaker/Honoraria (includes speakers bureau, symposia, and expert witness) (Ongoing)
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Includes Credits
CE Hours: 0.75
Description: Radiographic imaging requires recognition of typical anatomic structures and distinction from a vast array of pathologic processes. Accurate diagnostic assessment often entails recognizing normal and abnormal radiographic features coincident with synthesizing clinical and available historical information. When clinicians are confronted with interpreting various radiographic curiosities and unusual disease presentations, pulp vitality testing is crucial to determine correct pulp and periapical diagnoses, followed by appropriate treatment. Several examples of diagnostic challenges and radiographic oddities mimicking periradicular lesions of endodontic origin, culled from the records of the presenter’s 35 years of practice, will be exhibited and discussed. Several cases displaying anomalous oral findings and referred for endodontic treatment were diagnosed as malignant conditions and subsequently treated successfully, thanks to accurate and timely endodontic diagnoses.
Learning Objectives:
- Evaluate radiographic oddities with clinical skepticism.
- Perform thorough and accurate pulp vitality tests to treatment plan oral diseases appropriately.
- List and discuss nonodontogenic conditions mimicking radiographic lesions of endodontic origin.
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, a specialist member of the American Association of Endodontists, and a Fellow of the International College of Dentists. 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. Metro 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.
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Includes Credits
CE Hours: 1.0
Description: Pulpotomy is a proven treatment option for permanent teeth with pulp involvement, showing high success rates similar to root canal treatment. General anesthesia (GA) is used when traditional dental procedures are not feasible, especially in pediatric cases. Despite its effectiveness, limited data on endodontic treatments under GA is available, with many guidelines favoring extractions. This study aimed to evaluate the success rate of pulpotomies performed under GA on children’s first permanent molars and to identify factors influencing treatment outcomes.
At the conclusion of this article, the reader will be able to:
- Describe the success rates and clinical outcomes of pulpotomy procedures performed under general anesthesia in first permanent molars.
- Identify the factors influencing the choice of endodontic treatment plans under general anesthesia and the criteria for referring patients for GA.
- Evaluate the advantages of pulpotomy compared to root canal treatment, especially in the context of general anesthesia and its clinical challenges.
Shlomo Elbahary, DMD, PhD
Dr. Shlomo Elbahary is a Clinical Associate Professor in the Department of Endodontics at the University of Illinois Chicago College of Dentistry. He earned his D.M.D. and completed his postgraduate training in endodontics at Tel Aviv University, where he also served as a lecturer and researcher. He later obtained his Ph.D. in radicular microbiology from the University of Amsterdam.Dr. Elbahary brings extensive expertise in clinical endodontics, education, and research, with particular focus on trauma management, intentional replantation, and endodontic care for pediatric and special needs populations. He is actively involved in mentoring residents and UG students, organizing continuing education programs, and participating in international conferences. His academic and clinical work emphasizes evidence-based practice, technical proficiency, and interdisciplinary collaboration.
Disclosure(s): No financial relationships to disclose
Bradford R. Johnson, D.D.S., M.H.P.E.
Dr. Johnson completed his DDS at Virginia Commonwealth University, endodontic training at UIC, and earned an MHPE from UIC in 2005. He is a Diplomate and former President of the American Board of Endodontics and a Fellow of both the American and International Colleges of Dentists. He served as President of the Illinois Association of Endodontists, a Board Director for the American Association of Endodontists, and Commissioner for CODA. Dr. Johnson has published over 70 peer-reviewed articles and abstracts and co-authored 18 textbook chapters.
Disclosure(s): No financial relationships to disclose
Ronald Wigler
Graduate of the School of Dental Medicine, Tel Aviv University, and of the Endodontics and Dental Trauma residency program at Rambam Medical Center, Haifa. Lecturer, researcher, and postgraduate program director in the Department of Endodontics, School of Dental Medicine, Tel Aviv University. Has published numerous articles in international journals. Member of the board of the Israeli Endodontic Society and currently serves as the society’s treasurer. Owns a private practice in Tel Aviv specializing in endodontics.
Hagay Slutzky
Hagay Slutzky graduated cum laude from the Hebrew University in 1986 and earned his D.M.D. from Tel Aviv University in 1989, finishing first in his class. He specializes in esthetic dentistry and later completed a specialty in Public Health Dentistry and an M.P.H. from Hebrew University. Since 1989, he has been part of the Department of Oral Rehabilitation at Tel Aviv University. He currently serves as Chief Dental Officer for Clalit Smile, Israel’s largest DSO. Dr. Slutzky is active in several professional associations and is a member of the Israeli national dental advisory board. He has lectured widely and published on esthetic and restorative dentistry.
Sigalit Blumer
Professor Sigalit Blumer is a specialist in Pediatric Dentistry and served as the Head of the Department of Pediatric Dentistry at Tel Aviv University. She has authored numerous articles and research studies in international journals, focusing on child behavior in dental clinics, sleep apnea, and ADHD in children. Her work includes computerized anesthesia and sedation, as well as the oral microbiome and pulp therapy. Professor Blumer has been dedicated to teaching dental students and residents and is an esteemed lecturer both in Israel and internationally, sharing her expertise at various conferences and workshops. She serves on university committees and national boards that shape guidelines for pediatric dentistry in Israel.
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Includes Credits
CE Hours: 1.0
Description: Fear of dentistry, often due to past painful experiences, is a significant barrier preventing patients from visiting dentists. Achieving effective pain control, especially during root canal treatments, is crucial. However, inferior alveolar nerve blocks (IANBs) have a low success rate, influenced by factors such as anxiety, anatomical variations, and technique limitations, leading to anesthesia failure. Although numerous studies have examined the cold test and electric pulp test (EPT) in assessing the success of local anesthesia, no standardized method has been established. This study evaluated the effectiveness of EPT and cold tests in assessing the depth of anesthesia in patients with symptomatic irreversible pulpitis in the mandibular first molar teeth.
At the conclusion of this article, the reader will be able to:
- Describe the effectiveness of cold and electric pulp tests (EPT) in assessing the success of inferior alveolar nerve blocks (IANB) in patients with symptomatic irreversible pulpitis.
- Evaluate the sensitivity, specificity, and predictive values of the cold test and EPT in diagnosing pulpal anesthesia failure.
- Discuss the clinical implications of combining cold and electric pulp tests for improving diagnostic accuracy in determining pulpal anesthesia success.
Farzaneh Afkhami, DDS, MSc
Dr. Farzaneh Afkhami is a board-certified endodontist and an associate professor at the Department of Endodontics, Tehran University of Medical Sciences, Iran, and holds an academic affiliation with the School of Dentistry, The University of Queensland, Australia. She has authored over 50 research papers related to endodontics in prestigious peer-reviewed journals. Her work has garnered over 1.3 K citations and an h-index of 19 on Google Scholar. Dr. Afkhami has shared her findings at international scientific conferences and has supervised both
undergraduate and postgraduate students. Additionally, she holds a patent on a nanomaterial product as a root canal medicament, further advancing the field of endodontics.
Sholeh Ghabraei, DDS, MSc
Dr Sholeh Ghabraei is board-certified specialist in endodontics. She currently serves as associate professor in endodontics department, Dental school, Tehran university of medical sciences. Her research focuses on various aspects of endodontics including randomized controlled trials of anesthesia and pain control. She published 44 peer reviewed manuscripts.
Nasim Hashemi, DDS, MSc
Dr. Nasim Hashemi is a board-certified specialist in Endodontics. She achieved 2nd rank in the Iranian Endodontic Board Examination in 2025. Her research focuses on various aspects of endodontics including randomized controlled trials of anesthesia and pain control and broken instrument removal.
She has published nine peer-reviewed manuscripts, contributing to advancements in endodontic science.
Ove A. Peters, D.M.D., Ph.D., M.Sc.
Dr. Ove A. Peters is a clinician-scientist at the UQ School of Dentistry; his expertise is in endodontics, including root canal treatment and vital pulp therapy, combining lab research with clinical studies and >35 years of experience as a dentist. Dr. Peters joined The University of Queensland in 2020 after faculty positions in Heidelberg, Germany and Zurich, Switzerland, as well as at the University of California, San Francisco. He now serves as the Deputy Head of School and professor of Endodontics at UQ. Earlier Dr. Peters was the founding director of the postgraduate endodontic program at the Arthur A. Dugoni School of Dentistry in San Francisco, a professor with tenure and the Chair of the Department of Endodontics at that school; he is board certified by the ABE and currently registered as specialist endodontist in Australia and New Zealand. He has published more 300 manuscripts and 3 books; his works have been cited more than 24,000 times (see here https://scholar.google.com.au/citations?user=BX9jJ_UAAAAJ). He serves as associate editor for the International Endodontic Journal. Dr. Peters has received the Louis I Grossman Award by the AAE, the Hans Genet Award by the ESE and more recently the Distinguished Scientist Award in Pulp Biology by the IADR.Disclosure(s): Dentsply Sirona: Grant/Research Support (Ongoing), Honorarium (Ongoing)
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Includes Credits
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.
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 five years and for the last twelve 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 editions 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): DentsplySirona Endodontics: Honorarium (Ongoing)