Vital Pulp Therapy
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Includes Credits
CE Hours: 1.0
Description: This study aimed to assess the effect of cavity designs on instrumentation, obturation and fracture resistance for mandibular first premolars with Vertucci V canal.
At the conclusion of this article, the reader will be able to:
- Discuss which cavity design is appropriate for mandibular first premolars with Vertucci V canal.
- Compare the effectiveness of different cavity designs in instrumentation, obturation and preservation of dentin and fracture resistance.
- Describe the steps of preparing an access cavity for premolars with Vertucci V canal.
Yuxuan Liu, DDS
Yaxu Feng, DDS
Xianhua Gao, DDS
Wei Fan, DDS, PhD
Bing Fan, DDS, MSc, PhD
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Includes Credits
CE Hours: 1.5
Description: Endodontic complications of varying severity can unfortunately occur during most stages of endodontic treatment. This lecture aims to enhance understanding of common endodontic complications and recommends current management and solutions with an evidence-based approach. Preoperative, intraoperative and postoperative issues will be discussed, including possible aetiologies and prevention during root canal therapy. We will address the impact of complications on both patients and practitioners, underscoring the importance of clear communication in preserving the clinician-patient relationship. Attendees will gain current advice and knowledge on how to tackle endodontic complications effectively, fostering excellence in clinical practice and improved patient care.
Learning Objectives:
- Recognize and identify common endodontic complications.
- Implement evidence based management strategies.
- Develop strategies for preventing endodontic complications.
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Includes Credits
CE Hours: 0.75
Description: As Endodontists our mission is to save teeth and our specialized training equips us to do so. Biologic and clinical factors that impact endodontic treatment outcomes are widely studied, discussed, and considered in treatment planning. However, other, external factors also impact our ability to maintain the natural dentition. This session will explore factors that have been shown to impact access to endodontic care and outcomes of endodontic treatment, with an emphasis on oral health policy, economic forces, and clinician decision-making. Further, this session will consider how endodontists can promote oral health equity through clinical practice and advocacy.
Learning Objectives:
- List clinical factors shown to have significant influence on the outcomes of nonsurgical endodontic treatment.
- Discuss nonclinical factors that may impact access to endodontic care.
- Describe national (U.S.) trends in dental care use, insurance coverage, and barriers.
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Includes Credits
CE Hours: 0.75
Description: The purpose of vital pulp therapy (VPT) is to maintain the health of all or part of the pulp in normal or inflamed pulps. This group of treatments includes direct pulp capping, partial and full pulpotomy. For decades, VPT has been recommended and widely accepted as treatment for mechanical or carious pulp exposure of permanent immature teeth, with pre-operative diagnosis of normal pulp or pulpitis, to assure completion of root formation (apexogenesis). Over the past decade, advancements in our understanding of pulp biology coupled with the development of new bioactive materials have expanded the indications for VPT. Recent high-quality scientific evidence encouraged clinicians, and also endodontic associations, to suggest VPT as a predictable approach for treatment of mature permanent teeth with preoperative inflammation, in order to conserve the pulp’s protective mechanisms and great healing capacities. Notably, pulpotomy now offers a viable alternative to traditional root canal treatments for mature permanent teeth with symptomatic irreversible pulpitis. The success of VPT greatly depends on i) the absence of microorganisms, and ii) the pulpal immunocompetence/level of inflammation. Presently, these conditions cannot be reliably assessed through clinical methods alone. Consequently, it is essential to integrate meticulous pre-operative pulp diagnosis with careful intraoperative assessment of pulp tissue to ensure proper case selection. Furthermore, strict adherence to established operative protocols is crucial to improve treatment outcomes.
Learning Objectives:
- Explain the histopathologic basis for clinical application of pulpotomy.
- Describe how intraoperative pulp tissue assessment influences the clinical decision making process.
- Discuss the factors affecting the immediate and long term outcome of pulpotomy.
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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.
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Includes Credits
CE Hours: 0.75
Description: Vital pulp therapy (VPT) has gained more attention in the past decade due to the use of calcium silicate-based cement, understanding of the biological and molecular basis of pulp response to infection and knowing the regenerative capacity of dental pulp stem cells. Calcium hydroxide has been the pulp capping materials for half a century; however, it has not been a popular practice for carious pulp exposure or teeth with symptomatic pulpitis due to low success rates. Furthermore, it has been a clinical perception that pulp capping with Ca((OH)2 would lead to severe canal calcification. For these reasons, VPT therapy has not been a mainstream practice in the endodontic specialty. The introduction of MTA, discovery of dental pulp stem cells, and the advancement of the understanding of pulp inflammation in the past decade led to the resurrection of VPT. This presentation will discuss several key areas concerning VPT that either have been misunderstood or lack of understanding: i) Source of replacement odontoblasts and the quality of the new dentin, ii) progression of pulp inflammation responding to infection, iii) pulp stem cell response to the capping materials, iv) the mystery of pulp undergoing calcific metamorphosis after capping, and v) biological basis of clinical failure and how to improve success rates.
Learning Objectives:
- Describe the source of replacement odontoblasts from the pulp.
- Clarify the nature of pulp calcific metamorphosis.
- Relate the knowledge of the biological and molecular basis of pulp inflammation to diagnosis and treatment outcomes including clinical failures.
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Includes Credits
CE Hours: 1.0
Description: Vital pulp therapy offers a promising approach to significantly prolong the lifespan of a tooth. Over the past decade, the evidence and outcomes associated with vital pulp treatment have evolved substantially. In 2021, the American Association of Endodontists (AAE) released a new position paper on this topic, providing a foundation for updated practices. This presentation will build on that foundation to highlight key aspects of vital pulp therapy, with a primary focus on managing teeth with carious exposures and symptoms of irreversible pulpitis. Through case-based analysis, it will explore treatment options grounded in evidence-based protocols. Additionally, the presentation will address common challenges to implementation, such as coding, scheduling, and material selection.
Learning Objectives:
- Identify appropriate teeth for various treatment options and understand the expected outcomes for each approach.
- Gain a comprehensive understanding of the essential steps involved in performing vital pulp therapy.
- Evaluate the key prognostic factors that influence the success of vital pulp treatment.
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Includes Credits
CE Hours: 1.0
Description: Pulpotomy is a proven treatment option for permanent teeth with pulp involvement, showing high success rates similar to root canal treatment. General anesthesia (GA) is used when traditional dental procedures are not feasible, especially in pediatric cases. Despite its effectiveness, limited data on endodontic treatments under GA is available, with many guidelines favoring extractions. This study aimed to evaluate the success rate of pulpotomies performed under GA on children’s first permanent molars and to identify factors influencing treatment outcomes.
At the conclusion of this article, the reader will be able to:
- Describe the success rates and clinical outcomes of pulpotomy procedures performed under general anesthesia in first permanent molars.
- Identify the factors influencing the choice of endodontic treatment plans under general anesthesia and the criteria for referring patients for GA.
- Evaluate the advantages of pulpotomy compared to root canal treatment, especially in the context of general anesthesia and its clinical challenges.
Shlomo Elbahary, DMD, PhD
Dr. Shlomo Elbahary is a Clinical Associate Professor at the University of Illinois Chicago College of Dentistry, serving in the Endodontic Department. Dr. Elbahary earned his D.M.D. from Tel Aviv University, where he also completed a postgraduate program in endodontics. He later obtained his Ph.D. in radicular microbiology from the University of Amsterdam. With extensive experience in both clinical practice and academia, Dr. Elbahary specializes in endodontic treatments, with a particular focus on young patients, special needs patients, and severe trauma cases. He is passionate about teaching and mentoring students, fostering an environment of excellence and continuous learning in dental education. Dr. Elbahary has numerous publications and chapters in peer-reviewed journals and books and gave numerous presentations internationally.
Dr. Elbahary's scholarly interests include the study of radicular microbiology, bacterial biofilm invasion in dentinal tubules, and the evaluation of endodontic materials and techniques. His research bridges the gap between basic science and clinical practice, aiming to improve treatment outcomes and advance the field of endodontics.
Disclosure(s): No financial relationships to disclose
Bradford R. Johnson, D.D.S., M.H.P.E.
Dr. Johnson completed his DDS at Virginia Commonwealth University, endodontic training at UIC, and earned an MHPE from UIC in 2005. He is a Diplomate and former President of the American Board of Endodontics and a Fellow of both the American and International Colleges of Dentists. He served as President of the Illinois Association of Endodontists, a Board Director for the American Association of Endodontists, and Commissioner for CODA. Dr. Johnson has published over 70 peer-reviewed articles and abstracts and co-authored 18 textbook chapters.
Disclosure(s): No financial relationships to disclose
Ronald Wigler
Graduate of the School of Dental Medicine, Tel Aviv University, and of the Endodontics and Dental Trauma residency program at Rambam Medical Center, Haifa. Lecturer, researcher, and postgraduate program director in the Department of Endodontics, School of Dental Medicine, Tel Aviv University. Has published numerous articles in international journals. Member of the board of the Israeli Endodontic Society and currently serves as the society’s treasurer. Owns a private practice in Tel Aviv specializing in endodontics.
Hagay Slutzky
Hagay Slutzky graduated cum laude from the Hebrew University in 1986 and earned his D.M.D. from Tel Aviv University in 1989, finishing first in his class. He specializes in esthetic dentistry and later completed a specialty in Public Health Dentistry and an M.P.H. from Hebrew University. Since 1989, he has been part of the Department of Oral Rehabilitation at Tel Aviv University. He currently serves as Chief Dental Officer for Clalit Smile, Israel’s largest DSO. Dr. Slutzky is active in several professional associations and is a member of the Israeli national dental advisory board. He has lectured widely and published on esthetic and restorative dentistry.
Sigalit Blumer
Professor Sigalit Blumer is a specialist in Pediatric Dentistry and served as the Head of the Department of Pediatric Dentistry at Tel Aviv University. She has authored numerous articles and research studies in international journals, focusing on child behavior in dental clinics, sleep apnea, and ADHD in children. Her work includes computerized anesthesia and sedation, as well as the oral microbiome and pulp therapy. Professor Blumer has been dedicated to teaching dental students and residents and is an esteemed lecturer both in Israel and internationally, sharing her expertise at various conferences and workshops. She serves on university committees and national boards that shape guidelines for pediatric dentistry in Israel.
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Includes Credits
CE Hours: 1.0
Description: Dental caries continues to be a global problem, with root canal treatment being considered as the conventional management for teeth with inflamed pulps. The current improved understanding of the histopathology and the healing potential of the inflamed pulp, and the use of MTA and hydraulic calcium silicate-based materials, have led to a renewed interest in vital pulp therapy procedures as a minimally invasive treatment approach. This presentation will comprehensively review vital pulp therapy for teeth with deep carious lesions, in terms of treatment planning, selection criteria, clinical procedures, clinical outcomes and patients’ satisfaction.
Learning Objectives:
- Summarize the biological bases that support vital pulp therapy
- Identify the importance for integration of patient’s symptoms with intraoperative clinical findings in the decision making for management of an exposed pulp.
- Explain details of clinical procedures essential for a predictable outcome.
Nessrin A. Taha, BDS, GradDipClinDent, DClinDent, PhD
Dr Taha is professor of Endodontics, former Vice Dean and director of postgraduate clinics at Faculty of Dentistry, Jordan University of Science and Technology. She also Seves as chairman of the scientific and examination committee for Jordan Dental Board Examination in endodontics, and a memer of the ethics committee and institutional review board at king Abdullah University Hospital.
Dr Taha obtained her speciality in Endodontics and PhD from the University of Melbourne in Australia. She is a fellow of the Royal Australasian College of dental Surgeons in both the general stream and the special fields of Endodontics and has been awarded Sutherland Prize for outstanding performance in the colleage examination in 2005. She was also awraded the victorian women dentist prize for outstanding female at the Australian Dental Council Exam.
Dr Taha has a long standing interest in clinical research on preserving pulp vitality and regenerative endodontics, She is currently running several trials on the topic for which short to medium term results have been already published. She lectured on vital pulp therapy in national and international conferences and coauthored a book chapter on the topic. She serves as an editorial board member in the International Endodontic Journal, BMC oral health and Saudi Endodontic Journal.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: 1.0
Description: The aim of the session is to address the controversies in Vital Pulp Therapy. Do we have to remove the full caries disease for direct pulp capping ? or can we leave some carious tissue in contact with the pulp for Indirect pulp capping to avoid its exposure? Is the full pulpotomy actually a reliable endodontic technique? What do the clinical trials say in 2023? Finally what role do the inflammation process play in the healing process. Is the inflammation a helper or a killer? Lets discuss all these questions with the presentation of 4 world wide recognized speakers.
Learning Objectives:
- Describe the role of inflammation in the healing process.
- Describe the destructive role of infection disease in vital pulp therapy.
- Select the right protocol (Indirect Pulp Capping, Direct Pulp Capping or Full Pulpotomy) in every clinical situation.
Stephane Simon, DDS, MSc, PhD, HDR
Stéphane SIMON has been qualified as Doctor in Dental Surgery in 1994 at the University of Reims. He got a certificate in Biomaterials in 1998 (University of Paris 7) and in Endodontology in 2000 (Paris 7). He taught Endodontics from 2001 to 2005 at the University of Paris 7 as Assistant Professor, and from 2006 to 2008 at the University of Birmingham (United Kingdom) as a Clinical lecturer. He has got a Master Degree (MPhil) in Molecular and cell Biology in 2005 (Paris 7), and completed in 2009 his PhD in Pulp Biology in the frame of a co-supervised Thesis between the University of Paris 7 and the University of Birmingham. He was the President of the Pulp Biology and Regeneration Group of the IADR and is still a member of the education committee of the European Society of Endodontology.
From 2012 up to august 2019, he was a full time academic teacher/researcher, awarded as Professor in Endodontics at the Paris Diderot University and was the director of the Postgraduate Endodontic Program at Paris Diderot University (3 years full time program).
He is the author of 8 Endodontic books, authored 8 chapters in clinical books, and three chapters in Tissue engineering books. He has also published 47 papers in per-reviewed scientific journals (Endodontics and Science) and more than 95 papers in clinical per-reviewed journals ; he is also one of the editor of Visualendodontics software.
In 2011, he received the Hans Genett Award from the European Society of Endodontology.
He has a private practice limited to endodontics for 20 years, and is the founder and scientific director of a postgraduate course company named Endo Académie.Disclosure(s): No financial relationships to disclose
Ashraf F. Fouad, D.D.S., M.S.
Dr. Fouad obtained his DDS, Certificate of Endodontics and MS at the University of Iowa.
He served on the faculty and in various administrative roles at University of Connecticut Health Center, the University of Maryland, and the University of North Carolina at Chapel Hill. He is currently Professor and Chair, Department of Endodontics, and Director, Advanced Endodontics Program, at the University of Alabama at Birmingham.
Dr. Fouad has published over 100 peer-reviewed manuscripts, 24 textbook chapters, and 140 abstracts. He edited and co-authored the textbooks: Endodontic Microbiology, as well as the fifth and sixth editions of Endodontics: Principles and Practice. He is a Diplomate and Past President of the American Board of Endodontics, and an Associate Editor of the Journal of Endodontics and Dental Traumatology. He received the Distinguished Scientist Award from the Pulp Biology and Regeneration Group of the International Association of Dental Research.
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
Nessrin A. Taha, BDS, GradDipClinDent, DClinDent, PhD
Dr Taha is professor of Endodontics, former Vice Dean and director of postgraduate clinics at Faculty of Dentistry, Jordan University of Science and Technology. She also Seves as chairman of the scientific and examination committee for Jordan Dental Board Examination in endodontics, and a memer of the ethics committee and institutional review board at king Abdullah University Hospital.
Dr Taha obtained her speciality in Endodontics and PhD from the University of Melbourne in Australia. She is a fellow of the Royal Australasian College of dental Surgeons in both the general stream and the special fields of Endodontics and has been awarded Sutherland Prize for outstanding performance in the colleage examination in 2005. She was also awraded the victorian women dentist prize for outstanding female at the Australian Dental Council Exam.
Dr Taha has a long standing interest in clinical research on preserving pulp vitality and regenerative endodontics, She is currently running several trials on the topic for which short to medium term results have been already published. She lectured on vital pulp therapy in national and international conferences and coauthored a book chapter on the topic. She serves as an editorial board member in the International Endodontic Journal, BMC oral health and Saudi Endodontic Journal.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.
Domenico Ricucci, M.D., D.D.S.
Dr. Domenico Ricucci received his degree in General Medicine from “La Sapienza” University of Rome in 1982, and his DDS from the same University in 1985. Since then on he has maintained private dental practices limited to endodontics. He achieved the National Scientific qualification as full professor in the Italian higher education system in 2018. Dr. Ricucci’s primary research interest relates to pulpal and periapical tissue reactions to caries and treatment procedures, biofilms in endodontic infections, etiology of RTC treatment failure, pulp regeneration/revascularization. Since 1998 he has run his own histology laboratory and has developed considerable skills in hard tissue preparations for light microscopy.
Dr Ricucci has published 113 papers and has lectured both nationally and internationally. He has authored the Textbook and Atlas “Patologia e Clinica Endodontica”, the textbook and atlas “Endodontology. An integrated biological and clinical view”, also translated into Chinese, Russian, Japanese. He has also authored or co-authored 22 book chapters. He is recipient of the Louis I. Grossman International Award by the French Society of Endodontics in 2017, and the Louis I. Grossman Award by the American Association of Endodontists in 2023.
Disclosure(s): No financial relationships to disclose