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Hall 2

Lectures in this Hall are delivered by invited keynote speakers.

This Hall holds 1300 participants

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Vital Pulp Therapy Symposium
Isabelle Portenier, David Ricketts, Dimitrios Tziafas, Lars Bjöndal
9:45
rightCorrelation between pulp tests and pulp condition

Abstract

Accurate diagnosis of pulp pathology is essential for a proper endodontic treatment plan. Understanding of pulpal physiology and neurology is necessary in order to interpret correctly the readings from the diagnostic tests commonly used in dental practice. Electrical and thermal tests are most commonly used to assess pulpal sensibility. However, these tests have limitations and shortcomings. The readings have to be assessed together with other clinical tools such as radiographs to avoid false results which may lead to unnecessary treatment (false negative – treatment of a healthy pulp) and inappropriate treatment (false positive – no treatment of a necrotic pulp). Pulp vitality is the assessment of the true health status of the pulp by examining the pulpal blood flow. Laser Doppler flowmetry and pulse oximetry are such pulp vitality tests which show promising results. However, there are some practical issues that needs to be addressed before these tests can be introduced into dental practices.

Objectives

- Have an understanding of the pulp physiology and neurology

- Discuss the different pulpal sensibility tests and their limitations and shortcomings

- Discuss the pulp vitality tests and their limitations

rightDr Isabelle Portenier
Dr Isabelle Portenier

Dr Isabelle Portenier graduated in 1995 in dentistry at the University of Zurich, Switzerland. Dr Portenier completed a PhD in endodontic microbiology in 2005 and further trained as a specialist in endodontology at the University of Oslo, Norway.

Dr Portenier has held lecturer positions at the University of Bergen, Norway and Geneva, Switzerland.

She currently holds a part time position as a lecturer and researcher at the Department of Preventive, Restorative and Paediatric Dentistry of the University of Bern. She also has a private practice limited to Endodontics in Nyon, Switzerland.

10:30
COFFEE BREAK
11:00
rightTreatment of the deep carious lesion

Abstract

In contemporary practice, dental caries should be managed preventively, but if this preventive approach fails and the lesion progresses a decision has to be made to remove caries and treat the lesion operatively. Knowing that operative intervention has an impact on pulpal health, this presentation will give evidence for when a dentist should treat a tooth operatively, it questions accepted teaching in relation to how much caries needs to be removed and indeed does an indirect pulp cap exist or is this synonymous with today’s conventional cavity preparation. In a tooth with no signs or symptoms of pulp pathology and a deep carious lesion, conventional caries removal can lead to pulpal exposure. The prognosis of a direct pulp cap in such a situation will be briefly discussed and the presentation will challenge whether the carious lesion can be treated in such a way, based upon the microbiology, structure and behaviour of the lesion, with an aim to minimise pulpal damage and hence preserve the vital pulp.

Objectives

Objectives

1. Have an understanding of the restorative cycle and the impact that operative intervention has on pulpal health.

2. To re-evaluate and give guidance as to when to restore a carious lesion.

3. To describe the inter relationship between the carious process and pulp dentine complex reactions.

4. Describe how the balance between the carious process and pulp dentine complex reactions can be influenced by managing caries from a more biological approach rather than a surgical approach.

rightDavid Ricketts
 David Ricketts

David Ricketts, Professor of Cariology and Conservative Dentistry / Honorary Consultant in Restorative Dentistry, Dundee Dental School, University of Dundee, Scotland

David Ricketts qualified at Guys Hospital Dental School, London, now GKT Kings College, London in 1986. He worked in hospital and General Practice for two and a half years and returned to Guys Hospital to study for an MSc in Conservative Dentistry in 1989. During this period his main research interest in Cariology, and in particular caries diagnosis and its appropriate management, began and led to a PhD which was gained in 1995. He has published widely in his research area and in other aspects of restorative dentistry and has spoken on such topics worldwide. His research has led to collaboration with colleagues in numerous European Countries, the Middle East and North and South America.

In 1999 David moved to Dundee and was promoted to Senior Lecturer / Honorary Consultant in Restorative Dentistry in 2003. In 2006 he became leader of the Section of Operative Dentistry, Fixed Prosthodontics and Endodontology at Dundee Dental School and in 2007 became Professor in Cariology and Conservative Dentistry.

David was Associate Editor of Caries Research 2010 to 2014 and sits on the Editorial board of Dental Update He has contributed to a number of text books on Cariology and is the joint Editor and contributor to two text books on “Indirect Restorations” and “Advanced Operative Dentistry: a practical approach”.

In 2013 he and his co-authors completely re-wrote a Cochrane Systematic review on Operative caries management in adults and children. This review challenges conventional wisdom of complete caries removal during cavity preparation and has implications for the management of deep caries in helping to preserve pulpal health.

11:45
rightStrategies for vital pulp protection and therapy

Abstract

The pulpo-dentinal repair capacity has provided restorative dentistry with various treatment strategies aiming to maintain pulp tissue in a healthy and functional state, whenever the dentin-pulp complex has been compromised by caries, trauma or restorative procedures. In the present lecture the therapeutic validity of strategies used in today practice for protection of the unexposed pulp and treatment of the pulp exposure in cases of iatrogenic or traumatic injuries will be reviewed. First, an introduction will be given to the biological basis of the mechanisms underlining healing of the reversible pulp injury and repair of the dentinal defect. Furthermore, the clinical factors that play key role in vital pulp therapy will be discussed. Issues that have been related to successful outcome of vital pulp therapy include three clinical parameters: a) operative procedures for complete removal of injurious challenges, b) restorative procedures for effective short-term protection of the treated area from bacterial micro-leakage and possible chemical insults and c) selection of the appropriate protective or capping materials to stimulate dentinogenic events by specific and well-controlled biological mechanisms. Treatment modalities used in today practice will be evaluated on the basis of the above clinical parameters and existing evidence from preclinical experimental studies, controlled clinical trials and recent meta-analyses.

Aims

This lecture reviews the status of knowledge regarding the therapeutic value of current treatment modalities in vital pulp protection and therapy.

Objectives

1. Describe the basic biological aspects of healing and repair in the pulp-dentin complex. 2. Understand the role of various clinical parameters for the successful outcome of vital pulp therapy in cases of iatrogenic or traumatic injuries. 3. Understand the relationship between specificity of capping material and the long-term maintenance of pulp vitality and function

rightDimitrios Tziafas
 Dimitrios Tziafas

Dimitrios Tziafas is Professor of Endodontology. He received his DDS (1977) and PhD (1984) from Aristotle University of Thessaloniki, Greece (AUTH). Post-doc research in Institute Biologie Medicale, Universite Louis Pasteur, Strasbourg, France.

He served as Lecturer, Assistant Professor and Associate Professor from 1984-2003 and then as Professor and Chair of the Department of Endodontology at AUTH from 2003 -2013. Director of Master Programs in Endodontics in School of Dentistry, AUTH (2003-2011) and European University College, Dubai from 2013-2015. President of IADR – Continental European Division (2006-2008). Guest Editor of the Journal Advances in Dental Research (2001 vol. 15), and Chairman of the 42nd IADR-CED meeting (2007). Member of the Research Committee of European Society of Endodontology.

Research interests: biology and regeneration of dentin-pulp complex and pathogenesis of pulp inflammation. He published 5 invited reviews and 45+ research papers in international peer-reviewed scientific journals (Endodontology and Basic Science), a monograph on Reparative Dentinogenesis and textbooks chapters relating to Pulp Biology. 25+ lectures as invited keynote speaker and 100+ research presentations in international meetings and congresses.

12:30
rightGuidelines for progressive stages of deep and extreme deep caries
A journey from partial caries removal to pulpotomy

Abstract

Understanding pulp inflammation is crucial in endodontics. Inflammation is a two-edged sword comprising the platform for beneficial mineralization as well as unwanted pulp necrosis followed by bacterial infection and progression of apical inflammation. Concomitantly, it is a clinical task to deal with the borderlines of reversible pulpitis and irreversible asymptomatic pulpitis. Research has shown that a suggested treatment may vary when the deep carious lesion is examined, reflecting a low level of evidence. However, recent clinical randomized trials have started to emerge perhaps making treatment decision more easier to perform regarding a pulp invasive approach versus a non-invasive pulp approach, but global networking are indeed needed to solve the classical dilemma of being able to safe the pulp or not. The lecture will present examples of deep carious lesions and suggested treatments. Variables such a penetration depth of the carious lesion, caries progression and patient age may play a role for a proper prognosis. A suggested guideline for deep carious handling is presented based on published clinical data, involving a journey from partial caries removal to pulpotomy, including two categories of pulp-capping (class I and class II).

Aims

The aim of this presentation is to present aspects of the deep carious dilemma and to incorporate recent advances in clinical research into a practice based guideline in order to obtain a higher degree of treatment consensus.

Objectives

To raise the insight of deep caries pathology and treatment

To be familiar with a suggested practical guideline for treating the deep carious lesion

To be aware of limitations in the guidelines

rightLars Bjørndal
 Lars Bjørndal

Dr. Lars Bjørndal (born 1963) graduated in 1988 as a dentist from the University of Copenhagen, Denmark. In 1992 he got his Ph.D. thesis on the topic: Caries progression in enamel and the pulp-dentin organ using thin undemineralized tooth sections. In 2011 he received his Dr. Odont. thesis entitled: Endodontic treatment: reason, prevention and quality - shaping factors. From 1993-1998 he was assistant professor at the Department of Cariology and Endodontics, University of Copenhagen. In 1999-2001 he received specific postgraduate endodontic specialist courses in collaboration with the universities in Copenhagen, Denmark, Malmö and Gothenburg, Sweden. At present, he is associate professor at the University of Copenhagen, Denmark, and Head of Endodontic and the Special Clinical Unit receiving referrals at the Institute of Odontology, University of Copenhagen, Denmark. In addition, he works once a week in a dental office only devoted to endodontic referrals. He has for several years been giving endodontic hands-on courses nationally, including Symposia covering the status of endodontology. He has been Secretary in the Scandinavian Endodontic Society (SES) from 1999-2001. In 2007 he hosted the SES biennial congress in Denmark. He is second time president of the Danish National Endodontic Society (2014-), and country representative for the European Society of Endodontology (ESE), as well as a certified member of ESE. He has been giving invited lectures around the world (Europe, Asia, North and South America), and the topics have been within the field of deep caries lesion pathology and treatments and factors concerning endodontic treatment quality. He has authored and co-authored numerous international and national articles, including book chapters and reviews covering his research, and is at present reviewer in several international Journals.

13:15
LUNCH
14:00
Poster Presentations. Trade Exhibition Open
15:00
rightInternational Association of Dental Traumatology guidelines

Abstract

The management of dental trauma remains a significant clinical challenge affecting health-care providers and patients alike. Falls, accidents and sport-related injuries are the most frequent causes of dental trauma. Patients can present with a wide variety of injuries ranging from crown or root fractures, to injuries to the supporting periodontal structure, including luxations and avulsions. Treatment is complex, time consuming, expensive and requires a multidisciplinary approach.

Aims

This presentation will discuss the current IADT guidelines, with emphasis on current evidence-based literature supporting therapeutic modifications, as well as new philosophies to be considered for future guidelines.

Objectives

1. Become familiar with dento-alveolar traumatic injuries and their complications. 2. Implement the most recent, state-of-the-art diagnostic and treatment modalities. 3. Learn new concepts under research and development and its implications on upcoming guidelines.

rightProf Nestor Cohenca
Prof Nestor Cohenca

Dr. Cohenca received his dental degree from the National University of Asuncion, Paraguay. In 1994, he completed the endodontic program at the Hebrew University in Jerusalem cum laude and received the Best Graduate Student Award. He then served 11 years on faculty at the school while maintaining a private practice limited to endodontics. He is a Diplomate of and was an examiner for the Israel Board of Endodontics and past-president of the Israel Endodontic Society. From 2003 to 2005 he served as a clinical assistant professor and coordinator of Trauma and Sports Dentistry at University of Southern California. Thereafter, Dr. Cohenca joined the University of Washington where he completed his endodontic certificate in 2008 and served as Tenured Professor of Endodontics and Pediatric Dentistry from 2005-2014. He was the Director of Endodontics and the Multidisciplinary Traumatology Unit at the School of Dentistry, the Center for Pediatric Dentistry, and Seattle Children’s Hospital. Currently he serves as Affiliate Professor at the University of Washington and maintains a private practice limited to Endodontics in Bellevue and Everett, WA. In 2010, Dr. Cohenca became a Diplomate of the American Board of Endodontics and received an honorary membership to Omicron Kappa Upsilon National Dental Honor Society. He has published more than 60 peer-reviewed articles, 8 chapters and a new book entitled “Disinfection of Root Canal Systems: The Treatment of Apical Periodontitis”. Cohenca serves as President-Elect of the International Association of Dental Traumatology and was one of the pioneers in the use of CBCT. He is well known as one of the experts on root canal disinfection, CBCT, dental traumatology and Endo-Pedo related topics. Dr. Cohenca is fluent in Spanish, Portuguese and Hebrew.

15:45
rightPulp stones - an obstacle to endodontic therapy

Abstract

It is commonly believed that pulp stones and denticles are rare. Often they are not recognized during diagnosis and successful root canal treatment is more difficult or even prevented by their presence. This lecture will present a clinical perspective on the various investigations on pulp stones and denticles that have been published.

Objectives

The possible genesis of pulp stones, their incidence and relations to further diseases will be discussed.

Their impact on endodontic therapy will be demonstrated.

Clinical and radiographic appearance, as well as failure and treatment possibilities will be illustrated by multiple clinical cases.

Removal of pulp stones will be demonstrated, along with which instruments to use and how to prevent treatment failures.

rightDr Carsten Appel
Dr Carsten Appel

Curriculum Dr. Carsten Appel received his dental degree from the Faculty of Dentistry of the University of Bonn, Germany in 1993. He is working in private practice. Since 2001 he is lecturing on endodontics. He has limited his work to endodontics since 2004. He received the recognition as an endodontic specialist by the European Dental Association (EDA) in 2003 and by the German Society of Endodontology (DGEndo) in 2006. He is a certifi ed member of the ESE. From 2005 - 2013 he was the president of the German Society of Endodontology. Actually he is still board officer. Dr. Appel authored several scientific articles in the field of endodontics and is co-author of an endodontic textbook. In clinical endodontics his areas of special interest include instrumentation strategies, apical anatomy and methodical aspects of root canal obturation. Beside his work in private practice he is lecturing on endodontics throughout Germany, is actually involved in endodontic research projects at the University of Bonn and is teaching in the post-graduate endodontic program of the University of Düsseldorf, Germany.

16:30
COFFEE BREAK
17:00
rightEndodontic Outcome – CBCT - a paradigm shift

Abstract

There is a gradual realization that the conventional method of assessing the outcome of endodontic treatment with periapical radiographs is outdated and not particularly accurate. This presentation will describe the results of the first series of prospective clinical trials assessing the outcome of PRIMARY and SECONDARY endodontic treatment with CBCT by the KCL research group. New and important prognostic factors influencing the outcome of endodontic treatment will also be described. I will also describe how these factors have changed the way I manage my patients in practice, as well has how they have modified the way we teach our postgraduates at KCL.

Aims

To discuss the impact of using CBCT to assess the outcome of endodontic treatment and re-treatment.

Objectives

• Understand the limitations of periapical radiography for assessing the outcome of endodontic treatment,

• Discuss the impact of a more accurate imaging system (CBCT on the outcome endodontic treatment,

• Gain an insight into new prognostic factors which have an impact on the outcome of treatment.

rightDr Shanon Patel
Dr Shanon Patel

Shanon Patel (BDS, MSc, MClinDent, FDS, MRD, PhD) Consultant/Senior Lecturer in Endodontics.

Shanon divides his time between working in specialist practice in central London, and teaching future Specialist Endodontists as well as supervising Masters and PhD students in the Endodontic Postgraduate Unit at Kings’ College London (KCL). His PhD thesis assessed the use of CBCT in the management of Endodontic problems.

His primary research interests reflect some of challenges he faces in in everyday practice and include the management of root resorption, dental trauma and the applications of CBCT in Endodontics.

His expertise in CBCT led to him being asked by the European Society of Endodontology to lead a working party to devise a position statement on the use of CBCT in Endodontics which was published in the IEJ in 2014. Shanon is also a visiting Professor at the National University of Malaysia.

He has published over 55 papers in peer reviewed scientific journals, several book chapters, as well as co-editing 3 textbooks 'The Principles of Endodontics' (Oxford University Press) and ‘Pitt Ford’s Problem Based Learning in Endodontics’ (WIley-Blackwell). The second edition of ‘The Principles of Endodontics’ was published in march 2013, and is now established as essential reading for undergraduates in the UK.

17:45
rightNovel methods to assess the volume and content of bone defects.

Abstract

The primary objective of any IMAGING technique for DIAGNOSIS, TREATMENT PLANNING, TREATMENT AND FOLLOW-UP of APICAL PERIODONTITIS is to detect the pathologic structures and to assess their size and development. Furthermore, the imaging procedure should yield information (if possible) on the histopathology of a lesion in order to enable a differential diagnosis and the selection of adequate therapeutic measures. The increasing development of CBCT is allowing the clinician and the researcher in the field of endodontology to assess the presence, location and size of apical periodontitis (among the other information) with great precision; the measurement of the volumes is one of the latest development of its use. In addition to this, the development of non-invasive and therefore safer imaging technology (which does not use ionizing radiation) such as Ultrasound real -time echotomography and Magnetic resonance imaging (MRI) have become a revolutionary diagnostic complement to traditional radiology in many cases. The ultrasound imaging is the only exam that possess the sensitivity to detect bone lesions in the jaws while assessing their volume, their solid or fluid content and their internal and external blood supply at the same time. It also permits the immediate and late follow-up of endodontic treatment based on the changes in volume, density and vascular perfusion. MRI has several advantages over CT/CBCT in the diagnosis of soft tissue lesions and should be left to differential diagnostic problems when abnormal spreading of lesions occurs in the bones and when there is the involvement of soft tissues, nerves and vascular supply.

rightElisabetta Cotti
 Elisabetta Cotti

Elisabetta Cotti, DDS, MS, received her DDS from the University of Cagliari – Italy. In 1991 she received a certificate and a MS in Endodontics from the University of Loma Linda- California. She is the Chairman of the Department of Conservative Dentistry and Endodontics at the School of Dentistry, University of Cagliari- Italy. She is currently the Director of the 1-year Post Graduate Programme (Master) in Endodontics at the University of Cagliari. She teaches in the Advanced Education Programs in Endodontics at the University of Bologna and she is Lecturer in the Department of Endodontics Loma Linda University, USA. She is active member of the AAE, of the Italian Association of Endodontics (SIE) where she has served as executive member for ten years, of the European Association (ESE) where she has served as Country Delegate for seven years. She is the Past President of the Italian Society of Dental Traumatology (SIDT). She also works in private practice limited to Endodontics. She is author of several papers in the field of Endodontics and has a specific interest in periapical pathology, immature teeth, complex case management, imaging techniques and interactions between apical periodontitis and systemic conditions.

18:30
SESSION ENDS
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