Replantation
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Includes Credits
CE Hours: 0.75
Description: This session aims to provide a comprehensive overview of intentional replantation and surgical repositioning in endodontics, blending historical perspectives, evidence-based guidelines, and clinical expertise to empower attendees in making informed decisions. Beginning with an exploration of their origins and early usage as a last-resort option to a recognized treatment alternative. By synthesizing current literature and guidelines, the session will delve into the latest recommendations and evidence-based data pertaining to intentional replantation and surgical repositioning. Participants will develop a nuanced understanding of the efficacy, indications, and limitations of these techniques within modern endodontic practice. The presentation will feature a selection of clinical cases showcasing intentional replantation and surgical repositioning in practical scenarios. Through detailed case analyses and interactive discussions, attendees will have the opportunity to examine the decision-making process, treatment outcomes, and complexities encountered in these intricate procedures.
Learning Objectives:
- Evaluate the historical evolution of intentional replantation and surgical repositioning techniques in endodontics, tracing their development from early practices to contemporary standards.
- Critically examine clinical cases, illustrating the decision making process, treatment outcomes, and challenges associated with intentional replantation and surgical repositioning, understanding of their practical application.
- Be familiar with current literature, guidelines, and evidence based data to assess the efficacy, indications, and limitations of intentional replantation and surgical repositioning in modern endodontic practice.
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Includes Credits
CE Hours: 2.0
Description: Endodontic surgery has become a predictable and highly successful way of solving recurrent endodontic infections. Even with the technologies such as operating microscope, CBCT, piezotome, ultrasonics, etc, still there are many situations that arise that require special approaches. This presentation will focus on achieving access to difficult areas, such as palatal roots, or areas covered by thick cortical bone. We will also discuss safe management of the sinuses and mental nerve, as well as a newer concept called selective curettage. When all else fails, then intentional replantation must be considered, and we will discuss techniques to perform replantation with success rates approaching 90%. The presentation is clinically oriented, showing many cases with clinical tips to successful microsurgery.
Learning Objectives:
- Demonstrate proper positioning of microscope/patient/doctor
- Troubleshoot potential complications involving the mental nerve and sinuses and palatal roots
- Become comfortable performing Intentional Replantation
Samuel Kratchman, D.MD
CLINICAL ASSOCIATE PROFESSOR OF ENDODONTICS
University of Pennsylvania School of Dental Medicine
Dr. Sam Kratchman was born and raised in New York. He received both a B.S. in Biology and a D.M.D. from Tufts University in Boston. Sam then entered The University of Pennsylvania, where he received a Certificate of Endodontics.
A prominent leader in his field, Dr. Kratchman currently teaches at U. Penn as an Associate Professor of Endodontics, and he is the Assistant Director of Graduate Endodontics, in charge of the microsurgical portion of the program. He frequently lectures on several Endodontic topics throughout the United States, Europe, South America, Canada and Asia.
Dr. Kratchman has authored several articles and chapters on Endodontics, and has co-authored the textbook of Endodontic Microsurgery with Dr. Kim in 2017. He also developed a patented instrument called the S Kondenser for the obturation of root canals. Both Main Line Today and Doctor of Dentistry magazines honored Dr. Kratchman as the cover story for their "Best of" issues.
Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 0.75
Description: Prevention and/or elimination of pulpal pathology and apical periodontitis is the ultimate goal of endodontic treatment. The success rate of primary non-surgical root canal treatment is >90%.Root canal retreatment might also fail or may not be feasible, on those cases root end surgery is the procedure of choice in those cases. The success rate of the micro-surgery was reported to be (94%) as shown in the systematic review and meta-analysis by Setzer et al. Despite its very high success, micro-surgery may be difficult to perform in certain cases. The combination of artificial intelligence (AI) and digital workflow has the potential to revolutionize endodontics. AI can be used to improve diagnosis, treatment planning, and patient care, while digital workflow can improve efficiency and accuracyIn this lecture, the advancement of AI and digital workflow in the field of Endodontic microsurgery, intentional replantation , and autotransplantation will be discussed, including the use of guided and navigation systems technology to perform the highest standard procedure with a predictable outcome.
Learning Objectives:
- Learn how to use artificial intelligence (AI) to improve the diagnosis and treatment planning.
- Perform precise and accurate guided Root-end surgeries.
- Discuss the use of digital workflows in Endodontics to maximize the outcome of Auto transplantation for different clinical presentations.
Mohammed A. Alharbi, B.D.s, D.Sc.D
Dr. Mohammed Alharbi is an assistant Professor at the Endodontic department at King Abdulaziz University, Jeddah, Saudi Arabia. And Adjunct Assistant professor at the University of Pennsylvania school of Dental Medicine. Dr. Alharbi received his BDS Degree from King Abdulaziz University in 2009 with an Honor Degree. Dr. Alharbi completed his Endodontic postgraduate training at the University of Pennsylvania in 2014 , Doctor of Science in Dentistry (DScD) from the University of Pennsylvania in 2017, and Executive MBA from Prince Mohammed Bin Salman College for business administration and entrepreneurship.
He is a Diplomate of the American Board of Endodontics. He received Hatton research award from the IADR in 2017, The Young Investigator award from the AADR mineralized tissue group 2017, and the KAU Dean’s researcher award for the faculty with the highest impact factor in 2019 and 2020. He is currently in the editorial board of the Journal of dental research (JDR) and published many articles in peer reviewed journals. Dr. Alharbi lectures nationally and internationally as a member of Penn Endo Global Symposium team.Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 1.0
Description: Tooth autotransplantation, intentional replantation and surgical extrusion are different treatment options with a similar principle; the preservation of the periodontal ligament (PDL) in order for the tooth to heal and be newly articulated with the bone. Tooth autotransplantation is defined as the surgical movement of a tooth from one alveolar socket to another, either after extraction or by surgically preparing the recipient site in the same patient, it is a viable option to replace lost teeth or poor prognosis teeth. Thus, both function and preservation of the alveolar bone crest is maintained. Its success is associated with healing of the PDL and pulp tissue, absence of root resorption, soft tissue healing, and radicular formation. Intentional replantation is the atraumatic extraction of a tooth enabling the clinician to do a procedure (mostly endodontic microsurgery, or cervical resorption treatment) in less than 15 minutes (extra-alveolar time) in teeth in which, otherwise, access would not be possible. Surgical extrusion consists of atraumatic luxation and coronal repositioning of a tooth with in its same socket, this with the purpose of exposing root resorption, root fractures or decay and treat it, leaving sound tooth structure subgingival.Over the last 15 years these techniques have had a great evolution due to the introduction of cone beam computed tomography (CBCT), intraoral scanning, 3D planning software, 3D printers and computer aided dynamic navigation devices. All this technology enables a more predictable, faster and safer procedure with lower extra-alveolar times. In this lecture several clinical cases, with a proper follow up period, show the rapid progress of the technique always based in the best scientific evidence available and trying to inspire Endodontists to have this type of treatments as valid options to help their patients.
Learning Objectives:
- Evaluate if a patient is a potential candidate for Tooth Autotransplantation, Surgical Extrusion or Intentional Replantation.
- List the digital work flow necessary to perform computer guided Tooth Autotransplantation.
- Introduce these type of treatments as possible options for clinical cases that otherwise would be hopeless.
Felipe Restrepo, D.D.S. M.Dent
Dr. Felipe Restrepo, was born and raised in Medellín - Colombia. Graduated from the University of Antioquia with a degree in Dentistry 2003, after one year as general practicioner he entered a two year Endodontic program and graduated from University CES in 2007. Associate Professor at the University of Antioquia teaching their postgraduate level students in endodontics and also Director of the Dental Emergencies Diploma. Dr. Restrepo has authored several scientific articles in peer-reviewed journals. Ex-president of the Antioquian Association of Endodontists. Private practice limited to Endodontics, Endodontic Microsurgery and Tooth Autotransplantation in Medellín since 2007, international speaker.
Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 1.5
Description: When orthograde retreatment and apical microsurgery are considered unfeasible, when they fail to resolve persistent endodontic infection, or when the remaining tooth structure is deemed non-restorable, the tooth is usually extracted and replaced with an implant or another prosthetic device. Alternatively, when clinical conditions permit, the tooth can be extracted, manipulated extra-orally and replanted (Intentional Replantation, Surgical Extrusion), or a non-strategic tooth can be transplanted into the socket of the extracted tooth (Autogenous Transplantation). These seemingly radical but rather simple procedures offer predictably good outcomes when the biologic principles of tooth replantation are respected.
This lecture will discuss the procedures of Intentional Replantation/Transplantation in a contemporary context, as predictable means for retaining otherwise “untreatable” teeth to greatly benefit patients. Strict guidelines for case selection, a step-by-step protocol and a variety of clinical applications will be outlined and illustrated with typical cases. Reported outcomes will also be highlighted for various clinical applications of both procedures.
Learning Objectives:
- Describe the procedural guidelines and steps for Intentional Replantation, Surgical Extrusion and Autogenous Transplantation aimed to prevent external root resorption and persistent infection
- Outline the indications for Intentional Replantation and Autogenous Transplantation
- Summarize the long-term outcomes of Intentional Replantation, Surgical Extrusion and Autogenous Transplantation
Shimon Friedman, D.M.D.
Dr. Shimon Friedman is Professor Emeritus, former Head of Endodontics and Founding Director of the M.Sc. Endodontics Program at the Faculty of Dentistry, University of Toronto, Canada. He received the D.M.D. degree (1975) and endodontics certificate (1983) from the Hebrew University in Jerusalem, Israel. He is board-certified in endodontics in Israel and had served as Chairman of the Israel Endodontic Society from 1985 to 1988. With over 250 peer-reviewed articles, textbook chapters and research abstracts, and over 330 international lectures, Dr. Friedman has acquired extensive experience in endodontic practice, research and education. He is the recipient of several awards, culminating in the AAE’s 2008 Louis I. Grossman Award, as well as the AAE's 2018 I.B. Bender Lifetime Educator Award, for outstanding contributions to endodontic science and education. Though now retired, Dr. Friedman continues following the research and lecturing extensively on endodontic treatment outcomes, management of post-treatment endodontic infection, and impacts of contracted endodontic cavity designs on nonsurgical treatment efficacy and biomechanical responses of teeth.
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: Sonendo Inc.: Ownership Interest (stocks, stock options, patent or other intellectual property or other ownership interest excluding diversified mutual funds) (Ongoing), Scientific Advisory Board member (Ongoing)
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Includes Credits
CE Hours: 0.75
Description: The management of traumatic dental injuries (TDI) often poses a clinical challenge that affects dentist, patients and their families. Treatment of TDI sequalae can be complex, time consuming, expensive and often requires multidisciplinary collaboration. Through a series of clinical case presentations, this session will show the role of the endodontist in the diagnosis and management of complications of TDI through incorporation of the dental trauma guidelines, contemporary literature and clinical experience.
Learning Objectives:
- Articulate how to utilize the dental trauma guidelines and how to make modifications on a case by case basis
- Outline endodontic complications following dental trauma and their management
- Explain the importance of interdisciplinary collaboration in the treatment of complications following TDI
Isabel Mello, D.D.S., M.Sc., Ph.D.
Dr. Mello received her DDS degree from the Federal University of Alfenas, Brazil. She completed her residency and Master of Sciences in Endodontics at the University of Sao Paulo and later defended her PhD in Dental Sciences through a joint program between the University of Sao Paulo and the University of British Columbia.
She is the Division Head of Endodontics at Dalhousie University in Nova Scotia, Canada, and has received several teaching awards throughout her academic career. Dr. Mello has lectured nationally and internationally, is an active researcher, and has published several papers in peer-reviewed journals. She is a board-certified Endodontist and a fellow of the Royal College of Dentists of Canada. She is also a reviewer for the Journal of Endodontics and other journals.
Dr. Mello serves as consulting staff in the Dentistry Department at the IWK Children’s Hospital in Nova Scotia and maintains a part-time practice in the region.
Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 1.0
Description: There is increasing evidence that teeth with failed endodontic treatment, unsuitable for retreatment due to restorative or anatomic factors, may be candidates for a replantation procedure. The best available evidence indicates that clinicians should integrate the replantation procedure into their treatment planning in select cases. It has been demonstrated that replantation offers the potential for success when proper case selection and procedures are followed. There is a significant cost differential between replantation and that of an implant and crown or fixed prosthesis. Patients who cannot afford an implant, crown, or fixed prosthesis may have their needs addressed by replantation. The procedure offers a viable alternative for some patients who might otherwise lose a tooth resulting in reduced function and diminished esthetics. This presentation will review pertinent literature, consider indications and contraindications for the procedure, and demonstrate completed cases with follow-up. The presentation will utilize a video demonstrating the procedure to serve as a procedural guide. An ongoing multicenter replantation outcomes study will also be reviewed.
Learning Objectives:
- Recognize indications and contraindications for intentional replantation
- Describe critical steps in the intentional replantation procedure
- Organize the armamentarium necessary for a replantation procedure
Paul Rosenberg, DDS
Dr. Paul Rosenberg served as Professor and Chair of the Department of Endodontics, Director of the Advanced Education Program and Director of the International Program, at New York University College of Dentistry from 1990-2012. He was Associate Dean for Graduate Programs from 2000-2005.
He is a past Director of the American Board of Endodontics 2002-2008 and was a member of the Scientific Advisory Board of the Journal of Endodontics. He has published extensively in journals and textbooks and has lectured nationally and internationally on Endodontic pain. His textbook titled, Endodontic Pain: Diagnosis, Causes, Prevention and Treatment, was published in 2014 by Springer.
In 2000 Dr. Rosenberg won the Distinguished Teaching Award, which is the highest award for teaching at NYU. In December 2007, NYU College of Dentistry unveiled a new facility, the Paul and Maxine Rosenberg Educational Wing in his honor, dedicated to providing post-graduate students with a facility devoted to their specific needs.
In 2017 Dr. Rosenberg received the I.B. Bender Lifetime Educator Award from the American Association of Endodontics. The award acknowledges contributions in the field of education.
Dr. Rosenberg continues to serve as a Professor in the Department of Endodontics.
Disclosure
In accordance with this policy, 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.
Fabricio B. Teixeira, D.D.S., M.S., Ph.D.
Dr. Fabricio Teixeira is Professor and Chair of the Department of Endodontics at the University of Iowa. He is also the current holder of the Richard E. Walton Professorship. Before coming to Iowa, he served as Director of the Advanced Education Program in Endodontics at the University of Texas Health at San Antonio. He obtained his certificate in endodontics from the UT San Antonio and was the first recipient of the Endowment Carlos E. del Rio Distinguished Professorship in Endodontics. Before moving to Texas, he served as Associate Professor in the Department of Endodontics at the University of North Carolina at Chapel Hill, where he still maintains an appointment as adjunct faculty. Dr. Teixeira is Diplomate of the American Board of Endodontics and currently serves as Director of the ABE. He holds a position as endodontic consultant of the American Dental Association for the Commission on Dental Accreditation. He is member of the OKU National Dental Honor Society and Fellow of the International College of Dentists. He is former Associate Editor of Endodontic Topics, current editor Evidence-Based Endodontics and Visual Endodontics. He holds a position on the Scientific Advisory Board of the Journal of Endodontics and serves as peer reviewer on many other international journals. He is actively involved in clinical research and has lectured nationally and internationally on several topics. He has published extensively in peer-reviewed journals, abstracts and textbook chapters. He also maintains a private practice limited to endodontics in Iowa City.
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CE Hours: 0
Description: The preservation of natural teeth has regained interest over replacement with dental implants. However, not all situations can be solved by classical initial and secondary endodontic treatment, or surgical retreatment. Endodontists should not only have the expertise in standard endodontic microsurgery, but also include root resection, hemisection or autotransplantation in their repertoire. This lecture will review indications, techniques, and prognosis for these alternative surgical choices the compromised teeth
Learning Objectives:
- Discuss how to include a patient’s lifecycle in the decision making process how to save a tooth
- Be knowledgable about the outcome of resective and transplantation techniques
- Make the distinction between crown and root resection
Frank C. Setzer, D.M.D., Ph.D., M.S.
Dr. Setzer graduated from the Dental School of the Friedrich- Alexander-University Erlangen-Nuremberg, Germany, in 1995, where he also received his doctoral degree in 1998. He pursued his endodontic specialty training at the University of Pennsylvania after working for nine years in a multi-specialist private practice as associate and partner. Dr. Setzer graduated from the endodontic program of the University of Pennsylvania in 2006, receiving the Louis I Grossman Postdoctoral Student Award in Endodontics. He earned a Master of Science in Oral Biology and a DMD degree in 2008 and 2010, respectively. Dr. Setzer serves as the Clinic Director and Pre-Doctoral Program Director at the Department of Endodontics of the University of Pennsylvania. Dr. Setzer lectures on several topics of endodontics throughout the United States, Europe, South America, and Asia. He has authored articles on endodontics in peer-review journals and serves as Associate Editor for Endodontics for Quintessence International and, amongst other journals, on the scientific advisory board of Journal of Endodontics, International Endodontic Journal and Journal of the American Dental Association.
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: 0.75
Description: Although different techniques have been suggested for clinical crown lengthening, all of them have some limitations in terms of aesthetics. In aesthetic zones, crown lengthening maneuvers require a complex diagnostic process, special attention should be taken, or the surgical technique could often result in gingival line asymmetry. The basic goal of the surgical extrusion treatment is to coronally reposition the remnant tooth structure, which will guarantee a reliable sound and healthy supragingival tooth support, to offer a good restorative outcome. This technique can be used successfully to treat severely damaged teeth, especially in the anterior aesthetic zone. During the lecture, a simplified protocol for surgical extrusion will be presented, as well as long-term follow-up clinical cases (more than 9 years follow-up period). The advantages and disadvantages of this procedure will be analyzed.
Learning Objectives
- Based on clinical evidence to discuss risks and benefits of surgical extrusion techniques
- Describe and perform the simplified surgical extrusion technique presented during the lecture
- List inclusion and exclusion clinical criteria for choosing cases to apply the surgical extrusion technique
Jenner O. Argueta, D.D.S., M.Sc.
Dr. Jenner Argueta earned his dentistry and endodontics master’s degree at San Carlos de Guatemala University. He obtained the International Endodontics Program Certificate at Buffalo, The State University of New York. Jenner Is the former president of the Guatemalan Endodontics Academy, period 2016 – 2020, certified researcher at the Guatemalan National Council for Science and Technology and Endodontics professor in post-graduate endodontics programs from different countries in Latin America. His clinical practice is focused on microendodontics and micro-restorative dentistry.
Dr. Argueta has multiple academic awards, international scientific publications and, experience as an international lecturer in four continents, he has been lecturing in the most important endodontics congresses in the world (AAE, IFEA, SELA, FOLA, FOCAP, ROOTS, Harvard University, among others). Dr. Argueta is in charge of the social dental program provided by a non-profit organization in Guatemala called ADIZ. ADIZ provide dental attention to students with scholarships sponsored by international organizations.
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: 2.0 CE hour
Description:
Intentional Replantation or Re-implantation has traditionally been thought of as the “treatment of last resort” because of the difficulties in extracting, handling and successfully replanting the tooth. The replanted tooth was often lost to resorption shortly after the procedure, usually from the desiccation of the periodontal ligament. This technique has been modified by the presenter to significantly reduce this root surface event. The resection, preparation and filling of the root end are achieved while the remainder of the tooth is immersed in a tissue culture solution. This satisfies the nutritional requirements of the cells populating the root surface, and considerably extends the extra-oral period. This multi-media presentation outlines in detail the modified technique via case presentation and examines the success rate with recall periods of 3-20 years.
- Appraise via 2 and 3-D imaging the triage and feasibility of the selected tooth for successful harvest and replantation.
- Describe the sequences and techniques for the extraction, handling and replantation of the tooth, and the proper care of the alveolus.
- Identify potential sources of complications and discuss their remedies.
Stephen P. Niemczyk, DMD
Dr. Niemczyk graduated from the University of Pennsylvania School of Dental Medicine, receiving his D.M.D. in 1982 and his postgraduate Endodontic certificate in 1984. Since 1995, Dr. Niemczyk has been the Director of Endodontic Microsurgery at the IB Bender Postdoctoral Endodontic Program at Albert Einstein Medical Center in Philadelphia, and was recently named the Assistant Program Director in 2018. He is the 2020 recipient of the AAE Calvin D. Torneck Part-Time Educator Award, and also serves as a surgical consultant to the Naval Postgraduate Endodontic Program at the Walter Reed National Medical Center in Bethesda, MD, and the U. S. Army Endodontic Residency Program in Fort Gordon, GA.
Dr. Niemczyk has lectured extensively in the U.S., Central America, Europe, the Middle East and Asia on topics ranging from Microsurgery and Intentional Replantation to advances in Non-Surgical Endodontics and Cone-Beam CT. He has authored numerous papers, chapters on Microsurgery in Dental Clinics of North America, Ingle’s Endodontics 7th Edition and CBCT in Non-Surgical Retreatment. He is a member of the Scientific Advisory Board for the Journal of Endodontics and the Journal of Oral and Maxillofacial Surgery, Medicine and Pathology. He is the founder of Endodontic Microsurgical Innovations, dedicated to the development of new treatment techniques and instrumentation. He is a Diplomate of the American Board of Endodontics, and maintains a full-time practice limited to Endodontics in Drexel Hill, PA.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: DENTSPLY Tulsa Dental Specialties (Individual(s) Involved: Self): Honorarium
Stephen P. Niemczyk, D.M.D.
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: Honorarium/gift (Dentsply Sirona).