Retreatment
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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.
- 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.
- 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 earned a dental degree (DMD) at Kyunghee University in Seoul, South Korea, in 2001. He had practiced as general dentist for 13 years in Seoul. During his general practice, he earned a credential associate fellowship from American Academy of Implant Dentistry (AAID) in 2008. He also served as an instructor and mentor of the Korea MaxiCourse® of AAID from 2008 to 2012. In addition, he graduated from the advanced program of Endodontics in the University of Texas Health Science Center (UTHSC) at Houston, School of Dentistry in 2017 where he earned a postgraduate degree (MSD) and the certificate of the specialty of Endodontics. He has been working as a full-time faculty at UTHSC at Houston since he graduated from the program. He is interested in secondary endodontic treatment as micro-endodontic surgery and retreatment. He had multiple international lectures on micro-endodontic surgery, including “Live surgery”. Also, he authored multiple peer-reviewed articles. He is an active member of the Scientific Advisory Board of Journal of Endodontics, American Academy of Endodontists, and a board-certified endodontist of the American Board of Endodontics.
- 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
- Includes Credits
CE Hours: 0.75
Description: Endodontic retreatment is carried out in cases where previous endodontic therapies failed. The main cause of treatment failure is bacterial persistence within the root canal or coronal leakage after treatment. Literature reports a success rate ranging from 80% to 88% for endodontic retreatment; thus, it is a procedure with a predictable prognosis when well performed. Prognosis will be affected by the type of previous treatment and anatomical alterations occurred during primary treatment. Numerous technologies such as operative microscope, CBCT, and ultrasound are available to help execute the different procedures that could demand this therapy. Overall, clinical procedures include: removal of pins or posts and other core materials; removal of guttapercha, silver cones, management of ledges, root perforations and in some cases, even separated instruments. The main objectives of this clinical lecture are to describe some of the most common clinical situations that occur during endodontic retreatment and to highlight the importance of this practice for tooth conservation.
Learning Objectives:
- Recognize the importance of diagnosis and evaluate the causes of primary treatment failure
- Perform safe and predictable protocols to approach the different difficulties that a retreatment case may present
- Describe the available technologies such as operative microscope, CBCT and ultrasound for the management of retreatment cases
- Includes Credits
CE Hours: 1.0
Description: This randomized clinical trial aimed to compare the effectiveness of endodontic retreatment of teeth with posttreatment apical periodontitis (PTAP) performed in 1 visit versus 2 visits on the reduction of cultivable bacteria (colony-forming units [CFUs]), lipopolysaccharides (LPSs), lipoteichoic acid (LTA), and the periapical lesion volume (mm3) after 18 months of follow-up.
- Compare the effectiveness of endodontic retreatment performed in one visit versus two visits on teeth with post-treatment apical periodontitis (PTAP).
- Assess the periapical lesion volume (mm3) of teeth with post-treatment apical periodontitis (PTAP) who underwent endodontic retreatment in one or two visits after an 18-month follow-up period.
- Evaluate the efficacy of endodontic treatment in one or two visits, taking into account microbiological and tomographic features.
Cassia Cestari Toia, DDS, MSc, PhD
Rayana Duarte Khoury, DDS, MSc,
Bruna Jordao Motta Corazza, DDS, MSc,
Esteban Isai Flores Orozco, DDS, MSc, PhD
Marcia Carneiro Valera, DDS, MSc, PhD
- Includes Credits
CE Hours: 1.0
Description: The decision of which modality of secondary endodontic treatment to perform is multifactorial and clinician dependent. The literature surrounding the long-term survival of nonsurgical retreatment compared with surgical retreatment remains equivocal and warrants further investigation. This 7-year retrospective study seeks to compare the outcome of nonsurgical retreatments with that of root-end surgeries performed on teeth without prior nonsurgical retreatment.
- Evaluate the outcome of nonsurgical retreatments with that of root-end surgeries performed on teeth without prior nonsurgical retreatments.
- Identify the best treatment modality for a failed non-surgical root canal therapy
- Discuss the pros and cons of root-end surgery and nonsurgical retreatment.
Enida Haxhia, DDS
Mohamed Ibrahim, D.M.D.
Dr. Ibrahim is a professor and Director of Predoctoral Endodontics at Marquette University, school of Dentistry. Dr. Ibrahim earned his BDS, MS and endo training from Mansoura University, Egypt. He got a PhD via Joint supervision program between Mansoura University and Cologne University in Germany in the field of endodontic microbiology and disinfection. He also earned a Dr. Med Dent from Cologne University, Germany in endodontic hydrodynamic disinfection. Dr. Ibrahim has published several papers in Journal of Endodontics, International endodontic Journal, Journal of dental education and other international journals. He authored two book chapters about Biocompatibility of dental biomaterials and Injectable Gels for Dental and Craniofacial Applications. He also lectured and presented in endodontics nationally and internationally. Dr. Ibrahim is a reviewer at Journal of endodontics and other peer reviewed journals
Pradeep Bhagavatula, BDS, MHP, MS
- Includes Credits
CE Hours: 1.5
Description:
Conventional endodontic therapy has proven to be a very predictable treatment modality. However, it may occasionally fail. Treatment inadequacies are the major cause of endodontic failure. Signs and symptoms of endodontic treatment failure include radiographic apical/periapical radiolucency, swelling, sinus tract and pain. This presentation summarizes important evidence-based aspects to help dentists identify endodontic treatment failures, determine potential causes of failure, and determine appropriate steps to address the failure. Retreatment success rates may be attributed to improved instrument properties and advanced technologies. The efficacy of contemporary endodontic approaches and technologies such as magnification and illumination, CBCT, XP instruments, ultrasonic devices and multisonic machines, as well as retreatabilty of bioceramic sealers with regards to endodontic retreatment outcomes will also be discussed.
In conclusion, participants will be able to perform endodontic retreatment using more predictable and safe approaches.Learning Objectives:
- Discuss diagnostic methods and treatment plan for endodontic failures Discuss new instruments, materials and technologies used as supplementary techniques for endodontic retreatments
- Discuss endodontic retreatment outcomes
Renato M. Silva, D.D.S., M.S., P.h.D.
Dr. Silva received his DDS from the University Gama Filho, Rio de Janeiro, Brazil, in 1994. He received his endodontic certificate from both Brazil (University Gama Filho) and US (University of Texas Health Science Center at Houston). Dr. Silva received his MS (2002) in Endodontics and PhD (2006) degree in Oral Sciences from University of Sao Paulo, Brazil. He also completed a postdoctoral fellowship in Human Molecular Genetics at the University of Pittsburgh. Dr. Silva worked as an Assistant Professor at University of Pittsburgh from 2007 to 2011, and Associate/Professor/Department Chair at University of Texas at Houston from 2011 to 2021. Dr. Silva is currently a Professor and Chair of the Department of Endodontics at The University of Pittsburgh, School of Dental Medicine. Dr. Silva has edited a textbook about Endodontic retreatment and published several peer-reviewed articles in the field of Endodontics and Human Genetics. He is a board-certified endodontist and maintains a faculty practice limited to 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.
Bruno M. Crozeta, DDS, MS, PhD
Graduated in Dentistry from the University of the Region of Joinville (UNIVILLE - Brazil) with a complementary internship at the University Friedrich Alexander Universität (FAU-Erlangen-Germany). Master in Clinical Dentistry / Endodontics and Specialist in Endodontics from University of Positivo (FOUP - Brazil), PhD in Endodontics from Ribeirão Preto Dental School (USP - Brazil) with an internship from the University of Texas Health Science Center at Houston (UTHealth - USA) and Post Doctoral in Endodontics at Unigranrio (Brazil). Dr. Crozeta works as an endodontist in Ribeirão Preto (Brazil) and has published several articles in the field of 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: 1.5
Description: Considerable advancements have been made in the recent years in endodontic surgery with a consistently high success rate in published outcome studies. Till today, the decision to proceed with endodontic surgery as the first treatment option following a failed non-surgical initial treatment is still a point of debate, particularly when the quality of root canal is inadequate at the time of treatment. In this presentation we will review the most current literature on the outcome of surgical and non-surgical endodontic retreatment. We will also identify clinical scenarios where endodontic retreatment is necessary and others where it would be detrimental to the survivability of the tooth.
- Evaluate the potential outcomes of endodontic surgery.
- Explain the necessity of proper treatment planning.
- List guidelines for decision-making in the day-to-day clinical practice.
Adham A. Azim, D.D.S., B.D.S.
Dr. Azim is an Associate Professor, Director of the Post-graduate program and Chair of the Department of Endodontics at the University of the Pacific, Arthur A Dugoni School of Dentistry. He maintains a private practice limited to Endodontics. He is also the Founder and Chief Editor of Endolit.
Dr. Azim earned his BDS from Cairo University, where he also did his endodontic training. He later completed his Endodontic certificate at Columbia University, and since then, he has been a full-time Educator. Dr. Azim is a Diplomate of the American Board of Endodontics. He has lectured all over the world and has been awarded several times for his research work. He has more than 30 publications in peer-reviewed journals and 4 text-book chapters contributions such as “Ingle Endodontics” and “Endodontics: Principles and Practices”. He is a member of the Scientific Advisory Board of the Journal of Endodontics, and a reviewer for multiple other Endodontic journals such as International Endodontic Journal, the Journal of Dental Traumatology and JADA.
Speaker 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.
Adham A. Azim, D.D.S., B.D.S.
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:FKG Dentaire, Switzerland (Self) : Honorarium (Status: Terminated --- 2020), the company paid me honorarium for giving a course in Switzerland in Dec 2019
