Retreatment
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Includes Credits
CE Hours: 1.0
Description: The decision to treat or extract a tooth in the esthetic zone is one of the more complex decisions that a practitioner must make. It is a test of the team’s knowledge and ability to reach the ultimate goal of an esthetic and functional restoration that will last for years to come. All this must be done with the patient’s emotional and financial status considered. This session will focus on the latest challenges in diagnosing endodontically treated teeth that may require surgery to assist in dental dam isolation, apical surgery and/or intentional replantation. This will be both a “why to” presentation focusing on the decision-making process and a “how to” presentation.
Learning Objectives:
- Obtain a 3D diagnostic database for successful endodontic treatment planning and case acceptance.
- Review Digital Transformation and how we collaborate through new encrypted data opportunities.
- Identify the benefits of collaborative studies
George A. Bruder, D.M.D.
Dr. Bruder was the founding Chair: Department of Endodontics and Director of the Advanced Specialty Education Program in Endodontics at Stony Brook University School of Dental Medicine from 2006 – 2015. In 2012, Dr. Bruder was awarded the prestigious Edward M. Osetek Educator Award from the American Association of Endodontists and is also a member of Omicron Kappa Upsilon, National Dental Honor Society. He is a Diplomate of the American Board of Endodontics and Fellow of the International College of Dentists. Dr. Bruder serves as CEO/President of TruEndo INC and coinvented both TruShape and TruNatomy Endodontic Instruments with Dr. Ove Peters.
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: Consultant, Dentsply Sirona; CEO/President, TruENdo INC
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Includes Credits
CE Hours: 1.0
Description: Nonsurgical root canal retreatment (NS-RCRT) becomes necessary when primary endodontic procedures fail. This study evaluates the efficacy of NS-RCRT using 2% chlorhexidine gel and foraminal enlargement techniques, aiming to assess whether these approaches enhance periapical healing outcomes and success rates compared to traditional NS-RCRT techniques reported in the literature.
At the conclusion of this article, the reader will be able to:
- Evaluate the impact of foraminal enlargement on periapical healing outcomes in nonsurgical root canal retreatment (NS-RCRT).
- Discuss the clinical implications of using 2% chlorhexidine gel as the primary irrigant in NS-RCRT.
- Identify factors influencing the success rates of NS-RCRT based on the findings from the retrospective cohort study.
Patrick Wilson Quelis Baltieri, DDS, MSc, PhD
Lucas Peixoto de Araujo, DDS, MSc, PhD
Brenda P.F.A. Gomes, DDS, MSc, PhD
Jose Flavio Affonso de Almeida, DDS, MSc, PhD
Caio Cezar Randi Ferraz, DDS, MSc, PhD
Adriana de- Jesus-Soares, DDS, MSc, PhD
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Includes Credits
CE Hours: 0.75
Description: Dealing with obliterated root canals presents a significant challenge in endodontic practice, often leading to treatment difficulties, stress and compromised outcomes. This presentation aims to equip endodontists with essential knowledge of four key principles required to effectively map dentine and localize obliterated root canals. By implementing these principles, endodontists can lower the risks associated with missed anatomy, feel confident when working in highly calcified teeth, and navigate the challenges associated with complex root canal anatomy in a predictable way.
Learning Objectives:
- List 4 simple rules to locate canals in challenging endodontic cases.
- Describe the importance of dentinal color changes when locating canals.
- Minimize the occurrence of missed anatomy during treatments/retreatments.
Fernando Marques da Cunha, D.D.S, M.S., PhD
Dr. Fernando Marques received his Doctoral of Dental Surgery (D.D.S.), Certificate of Endodontics, Master's and Ph.D. degrees in Brazil, where he developed a solid Endodontic career as a clinician, presenter, faculty and researcher.
After 20 years as a private practice owner, he moved to the US, where he joined the University of Pennsylvania and earned his second Certificate of Endodontics.
Dr. Marques is an Adjunct Assistant Professor at Texas A&M School of Dentistry.Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 1.25
Description: As bioceramic sealers are growing in popularity, there is also a rise in the number of cases obturated with bioceramic sealers that need to be retreated. One important goal during retreatment is to eliminate the etiology of persistent disease through the complete removal of the root canal content including the existing root-filling material. Compared to traditional sealers, set bioceramic sealers may be more difficult to remove or bypass with instruments due to their unique physical properties. There is also a lack of effective solvent for set sealers, therefore creating potential difficulties in retreatment. Controversies exist in the literature regarding the effectiveness of bioceramic sealer removal. This presentation will provide a comprehensive review of the available evidence on the retreatment of bioceramic sealer-obturated canals and discuss the clinical tools and techniques to facilitate bioceramic sealer removal.
Learning Objectives:
- Describe the principles of non-surgical root canal retreatment.
- Describe the available solvents and techniques for the removal of bioceramic sealers.
- Discuss the existing scientific evidence on the retreatment of bioceramic sealer-obturated canals.
Jianing He, D.M.D., Ph.D.
Dr. Jianing (Jenny) He received her dental degree from West China University of Medical Sciences in 1996, and a certificate in Endodontics, and a PhD in Oral Biology from the University of Connecticut Health Center in 2003.
Dr. He has been actively involved in endodontic education, research, and clinical practice. She is a Diplomate of the American Board of Endodontics and a fellow of the American College of Dentists. She has published over 50 manuscripts in peer-reviewed journals and served on the Research and Scientific Affairs Committee for the AAE. Dr. He is currently an Associate Editor of the Journal of Endodontics.
Dr. He is a Clinical Associate Professor at Texas A&M University College of Dentistry and maintains a full-time private practice limited to Endodontics in Flower Mound and McKinney, TX.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: Brasseler USA (Individual(s) Involved: Self): Honorarium (Terminated)
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Includes Credits
CE Hours: 0.75
Description: The frustration and difficulties related with the removal of separated instruments are well known. The presented file retrieval technique has the approach to be as minimal invasive as possible and more predictable in terms of time management, costs and outcome. A new troughing technique using sonic instead of ultrasonic reduces the time needed to expose the fractured instrument and minimizes the risk of a second fracture of the instrument as well as heat induced tissue damage. A specially developed wire with higher tensile strength and reduced elongation as well as a new ball bearing tensioning mechanism allows to remove even ingrained files using a strict push and pull movement. The device and technique will be described in detail and a step by step tutorial will be presented during this lecture. Several cases will be shown to show the possibilities of this file retrieval technique.
Learning Objectives:
- Evaluate the risks and benefits of the retrieval of broken files.
- Discuss the advantages of the presented technique.
- Evaluate the clinical use of the presented modifications in the lasso technique.
Dennis M. Köhrer, D.D.S.
Dennis Köhrer studied engineering at the renowned RWTH Aachen University and received his dental degree from the private University Witten/Herdecke. He began to specialize in endodontics and microsurgery early in his career and is actively engaged in modern technologies of endodontic treatment.
In numerous international courses and lectures he imparts his knowledge and has published several articles.
Due to his engineering expertise, he is involved in the development process of dental products and has invented the Endo-Cowboy, an endodontic instrument for the retrieval of broken files.
Together with his brother he is leading a clinic with seven doctors where he continuously strives to perfect techniques and instruments for a higher level of patient treatment.Disclosure(s): Kerr Endodontics: Speaker/Honoraria (includes speakers bureau, symposia, and expert witness) (Ongoing); Koehrer Medical Engineering GmbH: Ownership Interest (stocks, stock options, patent or other intellectual property or other ownership interest excluding diversified mutual funds) (Ongoing)
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Includes Credits
CE Hours: 1.5
Description: The regenerative endodontic protocol is a unique option for immature necrotic teeth and brings the opportunity to the endodontist to enable the mesenchymal stem cells healing potential. Although there are some clinical situations that still need stronger evidence when selecting the cases, the current research supports the key factors that influence the outcome. Nevertheless, when the pulp is still vital, the evidence emphasizes the importance of its preservation. This presentation will focus on discussing the variables and protocols to apply in your practice, and the future directions to overcome current challenges in regenerative endodontics.
Learning Objectives:
- Explain and support the basic concepts behind the regenerative endodontic procedures and adverse events
- Describe the expected outcomes in regenerative endodontics based on key predisposing factors
- Discuss the future direction of regenerative endodontic procedures to overcome the current challenges
Tatiana M. Botero, D.D.S., M.S.
Dr. Botero received her dental degree (DDS, 1987) from CES University in Medellin, Colombia, Specialty training in Endodontics at Pontificia Universidad Javeriana in Bogotá, Colombia (1995) and the advanced Specialty Certificate in Endodontics from University of Michigan in 2005. She was Clinical Assistant Professor at CES University and had her private practice in Colombia (1989-2000). Dr. Botero joined the University of Michigan in 2001 and presently she is full time Clinical Professor and teaches Endodontics to graduate and undergraduate students. She is the director of the dental postgraduate fellowship program in endodontics. She also practices Endodontics at a private Dental clinic in Michigan.
In 2012 Dr. Botero became a Diplomate of the American Board of Endodontics and she joined the Regenerative Endodontic committee from the American Association of Endodontics since 2013 and chair 2014-2020. She is Past-president of the Pulp Biology and Regeneration group of the American Association and International Association of Dental Research. Dr. Botero has authored and co-authored numerous scientific peer reviewed articles and book chapters. She serves as reviewer for several endodontic and dental journals. Her research of interest and publications are on caries-induced angiogenesis and Regenerative Endodontics.
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. -
Includes Credits
CE Hours: 1.0
Description: The oral cavity is home to hundreds of bacterial species living in complex microbial communities commonly referred to as oral biofilms. Increasing evidence suggests that interactions among members of these communities play an important role in common oral diseases such as dental caries and periodontal disease. This presentation's goal is to highlight some recent advances in oral microbiome research as it relates to endodontic research.
Learning Objectives:
- Discuss how the oral microbiome can affect systemic health
- Describe different "omics" approaches and how they can provide new insight into factors contributing to endodontic infections
- List at least one of the key take-home points from at least one recent study that has used metagenomics to assess an endodontic problem
Bruno P. Lima, DDS, PhD
Bruno Lima, DDS, PhD, is an assistant professor at the University of Minnesota, School of Dentistry in the Department of Diagnostic and Biological Sciences. Dr. Lima received his dental degree from the Federal University of Rio Grande do Norte in Brazil before moving to the US to pursue his PhD in Microbiology and Immunology at Loyola University Chicago. His research focuses on understanding how bacteria interact with their environment and the consequence of these interactions on their physiology. As a dentist, Dr. Lima is particularly interested in studying how different environmental interactions affect dental plaque development and whether these interactions can be manipulated to promote oral health. Dr. Lima has authored several peer-reviewed articles and has received funding from the National Institute of Dental and Craniofacial Research (NIDCR) since 2018. In 2020 he was selected as the recipient of the 2020 American Association of Dental Research (AADR)/Procter & Gamble Underrepresented Faculty Research Fellowship and the AADR Mentoring an Inclusive Network for a Diverse Workforce of the Future (MIND the Future). He currently serves as a member of the American Association for Dental Oral and Craniofacial Research (AADOCR) Committee on Diversity and Inclusion.
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: Root Canal Treatment is a predictable and highly successful procedure. So, why are we extracting teeth that could be saved in favor of a dental implant? During this lecture Dr. Mortman will present clinical cases of successful root canal treatment, retreatment, and surgery in teeth that may have been extracted. Long term follow-up and case discussion will be presented.
Learning Objectives:
- Evaluate teeth that have a good prognosis for endodontic treatment, endodontic retreatment, and endodontic surgery. The practitioner may currently be extracting these teeth
- Perform a self-evaluation to determine if they can save one more tooth, maybe out of their comfort level, or recommend an extraction
- Discuss with their patients the risks and benefits of root canal treatment and offer realistic expectations for treating teeth that may be extracted
Rory E. Mortman, D.D.S.
Dr. Mortman received his dental degree and endodontic certificate from NYU College of Dentistry. He completed his general practice residency at the VA Medical Center in Miami, Florida. He has been in private practice for 26 years, and is a fellow of the Pierre Fauchard Academy, the American College of Dentists, and the International College of Dentists. He has served two terms on the board of the Central Palm Beach County Dental Association. Each term consisted for 6 years starting as member at large and cumulating as president. He is past Chairman, Co-Chairman, and President of the Atlantic Coast Dental Research Clinic. The Endodontic section of the clinic trains dental assistants and general dentists in endodontics. It also offers significantly reduced fees to the underserved dental population of Palm Beach County, Florida. Dr. Mortman has lectured and published in the field of endodontics and is a participant and co-founder of the "Save A Molar Program". A partnership with the local health department to provide free Root Canal Treatment for children under 18 whose parents, guardian, or caregiver have demonstrated limited financial resources.
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Includes Credits
CE Hours: 0.75
Description: A growing number of practitioners use calcium silicate-based sealers in root canal therapy. If the primary treatment has failed, non-surgical retreatment is considered the primary treatment option. However, the retreatability of cases incorporating a calcium silicate-based sealer is debatable as a specific, clinically acceptable solvent has yet to be developed. There are also few outcome studies concerning retreating these cases. This presentation will critically review the current studies addressing retreatment and retreatability of cases incorporating a calcium silicate-based sealer, and discuss methods to retrieve calcium silicate based-sealers combined with gutta-percha cones using different solutions, solvents, primary rotary files, retreatment designed files, heat-treated or non-heat-treated files, ultrasonic or sonic irrigation, in both straight or curved canals exhibiting short, flush with the apex, or overextended obturation.
Learning Objectives:
- Compare the efficacies of different solvents/irrigants and ultrasonic/sonic irrigation for retreatment cases incorporating a calcium silicate-based sealer
- Evaluate the efficacies of different rotary files for retreatment cases incorporating a calcium-silicate sealer
- Design specific retreatment strategies for clinical scenarios involving straight or curved canals, and patent or non-patent canal cases
Ji Wook Jeong, D.M.D., M.S.D.
Dr. Ji Wook Jeong graduated from Kyunghee University School of Dentistry in Seoul, South Korea, in 2001, and earned his Doctor of Dental Medicine (DMD) degree from the same institution in 2001.He received his Associate Fellowship from the American Academy of Implant Dentistry (AAID) in 2008. Additionally, he served as an instructor and mentor for the Korea MaxiCourse® of the AAID from 2008 to 2012. In 2017, he graduated from the Advanced Program in Endodontics at the University of Texas Health Science Center (UTHSC) at Houston, School of Dentistry, where he earned a Master of Science in Dentistry (MSD) and a certificate in the specialty of Endodontics. Since graduating, he has been working as a full-time faculty member at department of Endodontics, UTHSC Houston. Currently, he serves as the course director for Endodontic Surgery and the research director for the endodontic residents. He became a diplomate of the American Board of Endodontics in 2019. He is an active member of the Scientific Advisory Board of the Journal of Endodontics, the Continuing Education Committee of the American Association of Endodontists, and the Research Committee of the Asian Pacific Endodontic Confederation.
Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 0.75
Description: Non-surgical root canal re-treatments represent very large spectrum of situations that can occur in endodontic practice. Various first treatment modalities have to be considered. Access to root canal system itself is sometimes challenging and great interest is being paid to fragment removal or perforation repair. However, not as often, safe dismantling of the actual root canal filling is being discussed.
In my 24 year practice, root canal fillings in Czech republic went from resorcinol-formaldehyde resins (Russian red) in poorly instrumented roots to various condensation techniques and sealers in over-instrumented canals. With everything in between. Due to human migration, variety of daily practice cases may be increased.
The lecture is focused at methods of removing of various root canal fillings. Unique methods are implemented in hybrid manner - combination of instruments moved by rotary or ultrasonic propellant, various solvents, several rinse activators. The procedure preserves the precious dentine structure as much as reasonable and minimises apical debris extrusion to prevent flare-ups. Long term success/survival rates will be presented.
Learning Objectives:
- Analyze existing root canal filling structure and choose appropriate method of removal
- Safely eliminate spectrum of non-guttapercha root canal filling materials including the resorcinol-formaldehyde resins
- Avoid apical extrusion of debris during root-canal re-treatment as a prevention of flare-ups