CE Hours: 0.75

Description: Root perforations represent one of the most challenging complications during endodontic procedures. These are defined as a communication between the root canal space and the periodontal tissues, and can result as a pathological phenomenon (perforating root resorptions) or a iatrogenic event. To date, factors such as time, size, location, radiolucency adjacent to the perforation, gender or the repair material have been reported as significant prognostic factors. Thus, the primary aim of this this presentation is to perform an exhaustive literature review regarding root perforations outcome. The secondary objective is to describe the clinical management of root perforations and to present the results of a recent investigation carried out in a private practice during 2014-2022 with a minimum follow-up 2 years. A sample size of 82 teeth was retrospectively assessed and the outcome (healed, healing in process, failure) was statistically related to all the possible outcome predictors.

Learning Objectives:  

• Describe a well-established protocol to manage root perforations according to the different scenarios (time, size, location of the perforation).
• Review the present literature regarding root perforations treatment outcome.
• Evaluate the success of root perforations repair in combination with the preoperative, intraoperative and postoperative prognostic factors of current investigation.

CE Hours: 1.5

Description: In modern dentistry, more natural teeth are retained in service for an increased number of years in which they are subjected to a wide array of chemical, mechanical and microbiological stimuli including the iatrogenic impact. Therefore, the presentation of different resorptive defects is not a rarity in dental offices. This clinically oriented presentation will discuss various aspects of root resorption categories from pathophysiology to diagnosis and treatment planning.  The aim is to guide the clinician through non-surgical, surgical, and monitoring management protocols supported by the best available evidence, and enhance the clinical practice to provide favorable patient-centered outcomes.

Learning Objectives:  

• Discuss pathophysiology of root resorption and clinical relevance.
• Evaluate modes of intervention in cases of root resorption applying most recent technology.
• Describe patient centered outcomes for management of root resorption.

CE Hours: 1.0

Description: Managing root resorption can be challenging as it involves the management of pulpal, periapical, and periodontal tissues. The clinician must consider long-term vs. short-term outcomes, function, and esthetics. Maintaining a balance between conservative and aggressive approaches renders the decision-making process complicated. In this presentation, biological and clinical aspects of different types of resorption will be explored, with a focus on External Invasive Resorption. Various approaches to the treatment of root resorption will also be discussed.

Learning Objectives:  

• Identify common types of root resorption.
• List clinical and pathobiological features for each type of resorption.
• Describe various treatment modalities for External Invasive Resorption.

CE Hours: 1.25

Description: The pulp and periodontium have embryonic, anatomic and functional inter-relationships. The simultaneous existence of combined endodontic-periodontal lesions either with or without root damage is a clinical dilemma that can complicate diagnosis, prognosis and treatment planning. These lesions should be classified according to signs and symptoms that have direct impact on their treatment, such as presence or absence of fractures, perforations and external root resorption, presence or absence of periodontitis, and the extent of periodontal destruction around the affected teeth. Management of combined endodontic-periodontal lesions can be challenging especially when severe destruction of the surrounding periodontal tissues is noted. Exposing a CBCT scan may be an important diagnostic tool to confirm the real extent of both lesions and their possible communication and reveal root anatomic factors that may predispose to the clinical outcome. Understanding the complex pathogenesis of both lesions can determine the therapeutic approach for a successful regenerative treatment outcome.

Learning Objectives:  

• Identify and classify endodontic periodontal lesions.
• List and sequence therapeutic approaches to treat endodontic periodontal lesions.
• Define diagnostic tools to clinically assess combined endodontic periodontal lesions.

CE Hours: 0.75

Description: Many teeth that Endodontists encounter have challenging “Endo-restorative-perio” issues.   These include teeth with deep sub-gingival caries, cracks, resorptions, and coronal micro-leakage. Many clinical "tips and tricks" will be discussed in this presentation in order to successfully and predictably save these teeth long-term. Deep margin elevation for subgingival carious teeth, crack dissection, non-surgical resorption repair and many other techniques will be discussed.

Learning Objectives:  

• Describe  “deep margin elevation" technique and its role in reducing the need for surgical crown lengthening.
• Discuss techniques to treat resorption defects successfully.
• Perform preendo and postendo buildup with adhesive techniques that reduce the need for post placement.

CE Hours: 1.0

Description: Severe traumatic dental injuries in growing patients often lead to a range of complications, including pulp necrosis, ankylosis, infra-occlusion, complex restorability issues, tooth loss and subsequent bone loss. These issues can severely impact the patient’s quality of life, since the most affected teeth are the maxillary central incisors in the aesthetic area. Given that young patients have limited options for tooth replacement, preserving both the architecture and amount of bone in the affected area is crucial. Effective bone preservation ensures that when the time comes for future prosthetic solutions, such as implants, they can be implemented with minimal additional procedures. By employing effective bone preservation techniques, both immediate and long-term results can be improved, making future tooth replacement easier and less costly. This presentation will cover a series of clinical cases  that demonstrate how these strategies can significantly impact aesthetic and functional outcomes for young patients.

Learning Objectives:  

• Identify the range of complications that can arise from severe traumatic dental injuries in young patients.
• Explain bone preservation techniques and how they can potentially maintain both the architecture and quantity of bone in these patients assisting in future replacement procedures.
• Describe practical skills in applying effective bone preservation strategies in clinical practice to ensure optimal outcomes for future prosthetic interventions.

CE Hours: 1.25

Description: Managing cervical root resorption is anything but straightforward. It encompasses a wide spectrum of approaches, from minimal intervention to extensive surgical repair or even tooth extraction. The decision-making process is highly multifactorial, requiring careful consideration of, the stage of resorption, the location and extent of the defect, Tooth position and accessibility, as well as the patient’s age, overall oral health, and preferences. This presentation aims to provide a comprehensive review of the biological processes underlying root resorption, diagnostic strategies for accurate staging, and clinical approaches to improve prognosis and outcomes.

Learning Objectives:  

• Discuss the biological mechanisms controlling the progression and healing of cervical root resorption.
• Identify the key elements necessary for predictable and successful surgical interventions.
• Review the latest evidence-based insights into prognostic factors and clinical outcomes for informed treatment planning.

CE Hours: 1.5

Description: This presentation will provide an overview of the relationship between trauma and root resorption. It will be clinically focused discussing management principles of various types of root resorption through a series of case illustrations to include inflammatory root resorption, replacement root resorption and invasive cervical resorption. Diagnosis, Classification and Etiology of root resorption will also be reviewed.

Learning Objectives:  

• Explain the clinical methods used for determining what type of resorption has been encountered.
• Differentiate key factors related to each of the various types of root resorption seen in the endodontic practice.
• Describe general principals of management for each type of root resorption.

CE Hours: 1.5

Description: Until recently there was a paucity of information on the concise relationship between endodontics and orthodontics during treatment planning decisions especially following tooth trauma and its sequelae. This relationship ranges from effects on the pulp from orthodontic treatment and the potential for resorption during tooth movement, to the clinical management of teeth requiring integrated endodontic and orthodontic treatment. This presentation will provide both a literature basis for this relationship along with treatment directives to meet challenges in clinical practice.

Learning Objectives:  

• Identify the impact of orthodontic tooth movement (OTM) on the pulp and the supporting periodontium.
• Identify and discuss treatment planning for teeth that have undergone trauma and are planned for OTM.
• Identify issues of tooth resorption as it relates to the dental pulp, trauma and OTM using the literature as a guide for diagnostic and treatment choices.

CE Hours: 1.5

Description: The objective of ECR treatment is to remove the lesion, firmly seal the cavity, while maintaining a strong functional tooth. Up to date, treatment of ECR was based solely on the extent of resorption (class). However, new research has indicated that ECR is far more complex as multiple factors can affect its progression. Thus, our treatment approach should be updated. In this presentation we propose a step-wise treatment approach strategy on how to treat ECR cases. The criteria for choosing the most appropriate treatment were based not only on the ECR class but on additional factors such as: the existence of bone-ingrowth, patient symptoms, size, number and position of the portal(s) of entry, oral hygiene level, occlusion, existence of parafunctional habits and the probing feasibility. Based on these criteria, different treatment options were selected such as: 1) monitoring 2) extraction or 3) treatment by internal, external or a combination approach. To asses this proposed approach we evaluated the 10 year outcome of the overall and individual treatment options.

Learning Objectives:  

• Describe the complexity of ECR and how it affects the treatment decision.
• Design ECR treatment strategy.
• Define how each treatment affects the outcome.