Regenerative Endodontics
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Includes Credits
CE Hours: 1.5
Description: Regenerative endodontics has been recognized as a unique protocol in the practitioner's armamentarium to harness the regenerative potential of periapical tissues, facilitating continued root development and regeneration of the dentin-pulp complex, particularly in immature necrotic teeth. Preclinical and clinical research have significantly enhanced our understanding of the key factors contributing to success and failure. In this presentation, we will share the most recent data and protocols for regenerative endodontics, as well as emerging tissue engineering technologies aimed at regenerating lost tissues. Dr. Botero will discuss the clinical rationale and protocols in regenerative endodontics, along with clinical evidence, outcomes, and limitations of these protocols. Dr. Bottino will then explore the current status and clinical potential of tissue engineering in endodontics, including applications in regenerative endodontics and vital pulp therapy, ongoing materials and technologies, preclinical and translational research, as well as barriers and opportunities.
Learning Objectives:
- Describe the fundamental principles and clinical protocols of regenerative endodontic procedures (REP), with emphasis on the latest evidence and outcomes and identify and analyze the clinical factors that influence the success and limitations of REP, including practical considerations for implementation and follow-up.
- Compare and contrast conventional REP with modern tissue engineering technologies in terms of clinical potential, translational hurdles, and future impact on patient care.
- Compare and contrast conventional REP with modern tissue engineering technologies in terms of clinical potential, translational hurdles, and future impact on patient care. the audience will be also able to recognize the key challenges and opportunities in advancing from current regenerative protocols toward fully functional tissue engineering solutions for endodontic regeneration.
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Includes Credits
CE Hours: 0.75
Description: Dr. Usman has cultivated a practice of 50% pediatric patients most of which are trauma referrals from emergency rooms, pediatric dental practices and self-referrals. Using evidence-based treatment protocols and innovating with new materials, Dr. Usman will move through the management of challenging traumatic injuries and show how long term follow up and assuming the role as a "dental trauma gatekeeper" produces predictable excellent outcomes for her patients. Dr. Usman will show her treatment planning philosophy rooted in understanding the interaction of patient factors such as sex and age of the child, initial diagnosis and desired outcome. Topics such as ridge preservation, auto transplantation, orthodontic extrusion and vital pulp therapy will be discussed and how building an interdisciplinary team from the start is critical to maximizing the prognosis.
Learning Objectives:
- Describe how specific patient factors influence a trauma treatment plan.
- Discuss the benefits of vital pulp therapy and regenerative treatments to preserve tooth structure.
- Direct innovative interdisciplinary treatment plans such as autotransplantation, orthodontic extrusion and ridge preservation.
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Includes Credits
CE Hours: 1.25
Description: The management of inflamed or injured dental pulp remains a core challenge in endodontics. Conventional root canal therapy controls infection but eliminates the pulp's regenerative capacity. Regenerative endodontic procedures now aim to preserve or restore vitality, with extracellular vesicles (EVs) emerging as a promising cell-free, immunomodulatory, and pro-regenerative approach. This presentation will highlight advances in EVs derived from stem cells of the apical papilla (SCAP) for pulp repair. We will review preclinical and translational evidence showing how EVs modulate inflammation, support angiogenesis and neurogenesis, and activate resident progenitors. Particular attention will be given to their cargo-specialized pro-resolving mediators, growth factors, and miRNAs-and its integration into smart biomaterials for controlled delivery.Endodontists will gain perspectives on how EV-based therapies could complement or even replace cell-based regeneration. Practical issues of sourcing, safety, and clinical translation will also be discussed. EVs represent a paradigm shift: from removing the pulp to enabling its healing.
Learning Objectives:
- Describe the biological functions and therapeutic potential of extracellular vesicles (EVs) derived from dental stem cells in the context of pulp regeneration.
- Compare EV-based strategies with current regenerative endodontic protocols in terms of feasibility, clinical integration, and future applicability.
- Evaluate the mechanisms by which EVs modulate inflammation and promote tissue repair in the pulpal microenvironment
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Includes Credits
CE Hours: 0.75
Description: Regenerative endodontic procedures (REPs) offer a biologically based treatment option with the potential to restore tooth vitality and support root maturation. Clinical success is typically measured by the resolution of symptoms, apical closure, increased canal wall thickness, root elongation, and positive vitality responses. REPs have demonstrated high predictability and long-term tooth survival, particularly critical in younger patients where the goal is to maintain function for decades. Despite logistical challenges, long-term follow-up provides essential insight into the durability of these outcomes and the factors influencing treatment success. In this presentation, we will analyze a series of REP cases with extended follow-up, highlighting clinical trends, outcomes, and complications observed over time.
Learning Objectives:
- Identify key predictive factors that influence the success of regenerative endodontic procedures.
- Apply step-by-step clinical protocols tailored to specific case scenarios.
- Discuss emerging trends and future directions in REP techniques and materials.
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Includes Credits
CE Hours: 1.25
Description: Endodontic disease is microbial in origin, and therefore, exploring microbiological principles and their relevance to clinical endodontics is essential for successful treatment. This presentation will explore the findings of contemporary microbiological studies in Endodontics and identify their role in optimizing clinical care.
Learning Objectives:
- Discuss novel microbiological concepts in Endodontics
- Explore clinical principles that rely on these microbiological findings
- Examine the efficacy and utility of contemporary technologies in optimizing endodontic disinfection protocols and improving outcomes
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Includes Credits
CE Hours: 1.25
Description: Vital pulp therapy (VPT) plays a crucial role in managing mature permanent teeth with pulp exposure or inflammation, offering a less invasive alternative to root canal treatment. The decision on when and how to perform VPT depends on the degree of pulp involvement, the tooth's vitality, and clinical symptoms. Key VPT options include direct pulp capping, partial pulpotomy, and full pulpotomy, each with specific indications based on the extent of pulpal inflammation. Recent advancements in biomaterials, mineral trioxide aggregate and other bioceramic materials, have improved treatment outcomes by promoting pulp healing and reducing the risk of failure. Hence, these treatment modalities are emerging as promising treatments for maintaining tooth vitality in children and adults. Proper case selection, strict asepsis, using biocompatible materials and good coronal seal are mandatory for success. This presentation reviews the past, present and future of VPT along with the current VPT options, emphasizing the importance of diagnosis, material selection, and individualized treatment planning to achieve optimal long-term outcomes in younger and adult patients.
Learning Objectives:
- Identify the indications and contraindications for VPT
- Evaluate the prognostic factors influencing treatment outcomes, including pulp status, restorative seal, and microbial control.
- Interpret current evidence-based guidelines and literature supporting the use of VPT
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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: 1.0
Description: Management of immature necrotic permanent teeth is complicated for many reasons. The treatment options vary depending on the etiology of pulpal and periradicular disease. In addition, the behavior of the patient may hinder the endodontist’s ability to provide ideal treatment. Finally, reimbursement rates and lack of coverage for certain services may not allow for treatment of the immature permanent tooth to become part of a financially sustainable endodontic practice. The purpose of this webinar is to highlight some of these challenges and offer practical solutions to allow for treatment of the pediatric patient to become a more viable option for your practice.
Learning Objectives:
- Explain how the etiology of pulpal and periradicular disease influences the outcomes of treatment in the young patient.
- Apply non-pharmacologic behavior guidance techniques during the treatment of pediatric patients to improve the experience for all.
- Identify strategies to improve the financially feasibility of treating pediatric patients.
Zameera Fida, D.M.D
Dr. Zameera Fida earned her DMD from the Harvard School of Dental Medicine and completed her residency in endodontics at the Tufts University School of Dental Medicine. She is a dual-trained, dual-board-certified endodontist and pediatric dentist. Prior to her endodontic training, she pursued specialty training in pediatric dentistry at Boston Children's Hospital. Dr. Fida began her academic career as Director of Predoctoral Pediatric Dentistry at the Harvard School of Dental Medicine, where she discovered a passion for teaching and mentoring students and dentists. She practiced pediatric dentistry for many years in both private practice and hospital settings before advancing her training in endodontics. After completion of her endodontic training, Dr. Fida practiced part-time in a private practice setting dedicated solely to endodontics while continuing to pursue endodontic care for pediatric patients and those with special health care needs through Boston Children's Hospital until she transitioned into her current role at the Tufts University School of Dental Medicine. Today, Dr. Fida provides endodontic care for patients of all ages and prides herself on guiding patients compassionately through the entire root canal treatment process. As Chair of the Department of Endodontics at Tufts University School of Dental Medicine, she oversees clinical, academic, and research initiatives while mentoring the next generation of endodontists.
Disclosure(s): No financial relationships to disclose
- Explain how the etiology of pulpal and periradicular disease influences the outcomes of treatment in the young patient.
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Includes Credits
CE Hours: 0.75
Description: Numerous studies indicate the clinical success of regenerative endodontic procedures (REPs), as evidenced by symptom resolution, apical closure, canal wall thickening and lengthening, and restored reaction to vitality tests. However, the true nature of the regenerated human tissue after REPs remains unclear. Animal studies, employing various experimental protocols, have reported the greatest prevalence formation of cementum-like tissue, followed by bone-like tissue, and, to a lesser extent, dentin-like tissue. The question arises: does this conclusion also hold true for patients undergoing REPs? Ethical considerations preclude the conduct of cohort studies or randomized controlled trials in humans to evaluate histological outcomes of REPs. Nonetheless, a limited subset of investigations has delved into the histological outcomes after REPs, offering insights into the regenerative processes involved.Our case-report-based systematic review, encompassing studies from PubMed, Embase, and Web of Science, yielded 17 articles reporting on 22 teeth (mature and immature) from a total of 389 studies published between 2001 and 2023. The findings indicate a predominant presence of fibrous connective tissue, along with cementum-like, and bone-like tissues, whereas true dentinal regeneration is notably rare. Histological outcomes may vary based on factors such as the preoperative condition of the tooth, disinfection protocols, and procedural techniques. Furthermore, through a series of REPs cases from the presenter, we we’re going to discuss potential predictive factors influencing outcomes, including the status of the apical papilla, residual pulp tissue, patient age, and others.
Learning Objectives:
- List the histological findings after REPs in animal study and human case reports.
- Discuss potential predictive factors influencing REPs outcomes.
- Perform REPs more confidently on selected cases.
Xiaofei Zhu, D.M.D
Dr. Xiaofei Zhu is an Assistant Professor and the Director of Research in the Endodontics Department at Boston University School of Dental Medicine. He received his DDS from Peking University, Beijing, China, in 2009. Since then, he had worked as an assistant professor and later as an associate professor (in 2015) at his alma mater. Dr. Zhu joined the Boston University Postgraduate Endodontic Program in 2019. He served on the Regenerative Endodontics committee of the AAE from 2020 to 2021. In 2021, Dr. Zhu started working at Boston University. He earned the Diplomate of the American Board of Endodontics in 2022. Dr. Zhu's primary research interest relates to dental pulp regeneration and stem cells.
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: 1.25
Description: Vital pulp therapy (VPT) plays a crucial role in managing mature permanent teeth with pulp exposure or inflammation, offering a less invasive alternative to root canal treatment. The decision on when and how to perform VPT depends on the degree of pulp involvement, the tooth's vitality, and clinical symptoms. Key VPT options include direct pulp capping, partial pulpotomy, and full pulpotomy, each with specific indications based on the extent of pulpal inflammation. Recent advancements in biomaterials, mineral trioxide aggregate and other bioceramic materials, have improved treatment outcomes by promoting pulp healing and reducing the risk of failure. Hence, these treatment modalities are emerging as promising treatments for maintaining tooth vitality. Proper case selection, strict asepsis, using biocompatible materials and good coronal seal are mandatory for success. This presentation reviews the current VPT options, emphasizing the importance of diagnosis, material selection, and individualized treatment planning to achieve optimal long-term outcomes in younger and adult patients.
Learning Objectives:
- Describe the indications for vital pulp therapy (VPT) in treating mature permanent teeth in young patients and adults.
- Assess the role of infection control and a final restoration in successful vital pulp therapy procedures.
- Examine the long-term outcomes and success rates of various vital pulp therapy procedures.
Avina K. Paranjpe, B.D.S., M.S., M.S.D., Ph.D.
Dr. Avina Paranjpe graduated with her BDS (Bachelor of Dental Surgery) degree from the Mumbai University, India in 2000. She was in private practice in Mumbai, India from 2000-2002 after which she obtained her Master's degree (MS) and a Doctor of Philosophy (PhD) in Oral Biology, Immunology from the University of California, Los Angeles in 2004 and 2007 respectively. Dr. Paranjpe earned her Master of Science in Dentistry (MSD) and Certificate in Endodontics from the University of Washington Graduate Endodontics Program in August 2009 after which she joined the faculty at the University of Washington, School of Dentistry as Assistant Professor. She was promoted to Professor with tenure in 2020 and is the current Program Director in Endodontics at the school. She is a Diplomate of the American Board of Endodontics and the immediate past ABE President. Dr. Paranjpe is involved in several ongoing research projects related to dental materials and regenerative Endodontics. She has numerous publications in the area of pulpal regeneration and revascularization, immunology, and compatibility of biomaterials. She has won multiple teaching awards including the Edward M. Osetek Educator Award 2019: Recognized for outstanding status as an educator in North America by the American Association of Endodontists. She was recently inducted as a Fellow to the International College of Dentists (FICD) and the American College of Dentists (ACD) for her contributions to the profession, community, and research.
Disclosure(s): No financial relationships to disclose