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Lecture Synopses

Issues in managing the persistent endodontic infection (Ken M. Hargreaves, DDS, PhD)

This evidence-based and practical presentation is designed to provide effective and practical strategies for managing dentoalveolar infections. The biology of infections is used as a foundation to allow the practitioner to select the best combination of dental and pharmacological treatments to manage dental infections. In addition, potential adverse effects and their management will be reviewed. Want to know which antibiotic to use? How to manage most endodontic infections with local treatment instead of antibiotics?  Which endodontic procedures offers the optimal way to reduce/eliminate endodontic pathogens? This presentation will answer these questions and provide practical clinical tips for useful solutions.

 At the conclusion, participants should be able to:

  1. Apply a practical method that combines non-pharmacological treatment with the appropriate antibiotics for managing dental infections.
  2. Recognize the rapidly growing bacterial strains resistant to current antibiotics, and to manage this problem.
  3. Describe clinical outcome studies comparing one appointment to multiple appointment procedures.

Pushing the envelope with 3-D imaging (Mohamed I. Fayad, DDS, MS, PhD)

Diagnostic information directly influences clinical decisions. Accurate data lead to better treatment-planning decisions and potentially more predictable outcomes. CBCT is an emerging technology that can offer the clinician clinically relevant information that cannot be gathered from conventional radiography. The ability to assess an area of interest in 3 dimensions eliminates the superimposition that is inherent in conventional radiographic imaging. Cone-beam technology currently has numerous applications in the dental field. CBCT is having great impact and is changing dramatically case diagnosis, treatment planning and treatment outcomes in the daily practice. Conventional 2- dimensional radiography uses defined criteria for non-surgical and surgical outcome assessment. However, these radiographic healing criteria are not applicable for 3- dimensional radiography. This presentation will focus on how CBCT technology and a new imaging software e-VOLDX has provided clinicians with a different understanding of the dynamics of dental disease as well as healing. Based on the information provided from CBCT volumes, changes in treatment protocols and armamentarium will be presented. 

 At the conclusion, participants should be able to:

  1. Import CBCT dicom images into e-VOLDX software and Navident dynamic navigation to plan and treat complex non-surgical and surgical cases.
  2. Apply CBCT imaging for diagnosis of pain, cracked teeth, vertical root fracture and resorptive defects.
  3. Utilize 3-D information to establish a correct strategy to enhance successful outcomes well before the start of treatment.

Guided endodontics (David W. Kelliny, DDS)

Endodontics has seen significant technological advances in the last decade enhancing the precision and predictability of treatment. Although endodontic treatment is a predictable treatment modality, certain case limitations can lead to complications and poor outcome. These limitations include, among others, difficult canal access, severely obliterated canals and inaccessible surgical sites. This presentation will introduce innovative digital technology related to 3D printing and treatment planning for endodontic cases. Advancements in digital dentistry have made such cases predictable and highly successful. It also increases patients’ acceptance to treatment. Understanding this technology allows to perform minimally invasive procedures with lower risk to the patient.

 At the conclusion, participants should be able to:

  1. Recognize case limitations that can lead to treatment complications.
  2. Describe the principles of guided endodontics.
  3. Apply the concepts of guided endodontics for challenging cases.

Endo-Resto continuum: A pathway to endodontic success (Ove A. Peters, DMD, MS, PhD)

The conventional understanding was that endodontic success is determined solely by apical health. However, it has become evident from reported outcome studies that long-term retention is an important measure for the long-term effectiveness of root canal treatments. Underpinning this strategy, steps like access cavity preparation and coronal flaring have been subjected to scrutiny. Moreover, a generation of novel root canal instruments were introduced aiming to address dentin preservation specifically, built on the understanding that endodontic excellence will follow a restoratively driven path. For a restoratively driven approach, clinical endodontics must take into consideration aspects of treatment planning and restorative parameters in addition to the typical steps of root canal treatment. This presentation will update clinicians’ knowledge regarding the impact of restoration type and the oral environment, for example chewing force, on the overall successful outcome of root canal treatment. The second major focus will be on instrument performance in shaping constrained spaces, such as small accesses and coronal curves. Ultimately, this lecture will present a balanced view of benefits and potential drawbacks of a reconsidered path to endodontic excellence.

 At the conclusion, participants should be able to:

1. Assess and manage outcome expectations for root canal treatment.
2. Highlight the importance of tooth restoration on long-term endodontic outcomes.
3. Recognize design elements and usage of the newer root canal instrument systems.

Digital Endodontics: using ultrasounds for the characterization, differential diagnosis and management of lesions in the maxillary bones (Elisabetta Cotti, DDS, MS)

In the last 20 years, constant advances in imaging and exponential growth of the use of CBCT, have significantly changed the practice of endodontics. ULTRASOUNDS REAL-TIME imaging has been introduced to the endodontic field circa 15 years ago, as a potential supplement to 3D imaging systems, and, to date, has proved to be the only advanced and safe examination tool to differentially diagnose multiple lesions in the mandibular and maxillary bones. Ultrasound, not only allows the detection and measurement of the lesions, but also possesses the sensitivity of assessing volume, solid/ fluid or mixed content, and the blood supply of endodontic lesions as well as other lesions in the jaws. Furthermore, the technique enables immediate and late follow- ups and is safe since it does not emit ionizing radiation.

 At the conclusion, participants should be able to:

  1. Describe the principles of ultrasounds imaging.
  2. Assess the limitations of other imaging techniques.
  3. Recognize the advantages of using ultrasounds to complement other imaging techniques.

Endodontic Considerations for Young and Elderly Patients (Yaara Berdan, DDS)

 Standard endodontic treatment can pose challenges for the clinician, mainly in diagnosis, case selection and treatment. Notwithstanding, treating young and elderly patients often requires additional clinical considerations and specific therapeutic approaches. This presentation will review challenges and solutions to treating patients at both ends of the age spectrum. 

 At the conclusion, participants should be able to:

  1. Describe specific endodontic procedures and clinical considerations when treating the young patient.
  2. Describe specific endodontic procedures and clinical considerations when treating the elderly patient.
  3. Apply the concepts learned to provide predictable endodontic care for young and elderly patients.

Predictable and minimally invasive removal of separated instruments (Yoshitsugu Terauchi, DDS, PhD)

Retrieval of separated instruments from the root canal system can be challenging and often frustrating. When a NiTi instrument fractures, it usually occurs at the apical one-third of the root canal, or beyond a curve in the canal. Consequently, the separated instrument often prevents the clinician from successfully preparing the entire root canal system, thereby compromising treatment outcome. Although the reported success rate of instrument retrieval using ultrasonics is high, the non-standardized protocol is still unpredictable in terms of removal time. Additionally, a major disadvantage of traditional instrument removal techniques is the excessive removal of sound dentin during retrieval attempts, which may lead to iatrogenic accidents such as perforation and/or root fracture. A recent study has shown that instrument retrieval is highly predictable if a standardized protocol is followed. In this presentation, treatment planning based on CBCT imaging and a predictable and minimally invasive instrument retrieval protocol will be demonstrated and discussed.

 At the conclusion, participants should be able to:

  1. Describe the accurate diagnosis and treatment plan for safe instrument retrieval.
  2. Make a predictable and minimally invasive preparation for instrument retrieval.
  3. Recognize the most predictable and minimally invasive removal procedures of separated instruments.

The John I. Ingle International Endodontic Symposium

Live Online Symposium

December 2-3, 2022

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