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ESE Pre-congress Symposium: Current advances and controversies in tooth, root and canal anatomy led by Hany Ahmed and Marco Versiani

Over the last century, the complexity of root and canal systems has been well documented using numerous techniques. More recently, technological advances in 3D computed tomographic imaging have given rise to more accurate methods for evaluation of tooth anatomy and also revealed inconsistencies in the classification of the internal anatomy of several tooth types. The main purpose of this pre-congress workshop is to provide participants with up-to-date clinical and laboratory evidence on root and canal anatomy. The key aims are to:

• Present innovations in the field of imaging technology for the study of root and canal anatomy;

• Discuss how these advances in 3D imaging and our better understanding of internal tooth anatomy impact on patient care;

• Summarize our knowledge on the anatomy of human teeth acquired by the most recent in vivo epidemiological studies;

• Engage participants in the discussion of controversies in root and root canal terminology, concepts and classifications.

COST: 130 + VAT Euros (ESE Registered Postgraduate students 90 + VAT Euros)


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PART 1: Advances in tomographic imaging systems for characterization of root canal morphology
Micro-CT and Nano-CT: cutting-edge technology to study root canal anatomy
rightDr Marco Versiani
Dr Marco Versiani

Dr. Versiani received his degree in Dentistry in 1992. Since 1994, he has been working part-time in the Brazilian Military Police Dental Department in which he reached the grade of Lieutenant Colonel. He is a certified specialist in Endodontics (1999), but also in Didactics (1998) and Bioethics (2003). In 2015, Dr. Versiani concluded his Master Degree and PhD studies, as well as 3 postdoctoral programs, at the University of Sao Paulo, in which he is currently a researcher fellow. He has authored books, several chapters and more than 80 peer-reviewed papers in endodontics, being an editorial board member of the International Endodontic Journal. More recently, he published the book 'Root Canal Anatomy in Permanent Dentition'. Dr. Versiani has lectured worldwide focusing on his main research interests that are the influence of root canal anatomy on endodontic procedures using non-invasive 3D X-ray micro-computed tomography, towards the improvement of both chemical and mechanical debridement of root canals.

rightWhat’s new on the study of root canal anatomy with recent non-destructive high-resolution technologies?


A wide morphological variation exits in the root canal system of posterior teeth. Improvements with digital imaging systems in the last decades have enabled the in vivo and in vitro evaluation of the root canal anatomy using non-destructive methods such as cone-beam computed tomography (CBCT) or micro-computed tomography (Micro-CT). This lecture will present results found during Micro-CT analysis of maxillary molars presenting several anatomical variations.


- Describe the advantages of Micro-CT technology over the clearing and CBCT technique.

- Describe the apical anatomy of the mesiobuccal root of first and second maxillary molars.

- Analysis of the C-shaped canal anatomy of maxillary molars.

rightRonald Ordinola Zapata
 Ronald Ordinola Zapata

Dr. Ordinola-Zapata obtained his D.D.S. degree in 2001 from Inca Garcilaso de la Vega University in Lima-Peru. After practicing for 6 years as a general dentist, Dr. Ordinola-Zapata continued his career at the Endodontic Department of the Bauru School of Dentistry, University of Sao Paulo in Brazil where he obtained a Master and a Doctoral degree in Endodontics. Dr. Ordinola Zapata also completed a 2-year AEGD residency program at Larkin Community Hospital in Miami and his Endodontic residency program at the prestigious IB Bender Endodontic Division, Albert Einstein Medical Center in Philadelphia. Currently, he is assistant professor at the Endodontic Division, University of Minnesota, Minneapolis, USA. In his academic career Dr. Ordinola Zapata has published more than 70 scientific papers in peer-reviewed journals and lectured internationally in more than 10 countries. He serves as Associate Editor of the International Endodontic Journal (UK) and is a member of the scientific advisory board of the Journal of Endodontics (USA).

rightEpidemiological studies on canal anatomy in large populations using CBCT: what’s new?


Different root and root canal configuration types can be found in any group of teeth. Therefore, a thorough knowledge of their most common anatomical morphologies and variations may help clinicians to detect those deviations during root canal therapy, enhancing the chance for a successful treatment. Due to the widespread of the Cone-Beam Computed Tomography imaging technology around the world, several prevalence studies on root and root canal anatomy, with origin in different countries, are available in the literature. Globally, these studies show that some groups of teeth have a global tendency for a particular morphology independently of demographic factors or region, while other groups of teeth appear to be closely associated with demographic factors.


To discuss the study design and its limitations, and debate the latest results of anatomy prevalence studies and the factors that may influence those results.


This presentation intends to address the following objectives:

- Perform a quality assessment of published prevalence studies

- Debate the methodology, recommendations, checklists and limitations in order to produce more reliable prevalence studies

- Discuss factors such as age, gender, ethnicity or region in the prevalence study outcomes, and debate some of the latest results.

rightDr Jorge N.R. Martins
Dr Jorge N.R. Martins

Jorge N.R. Martins (DDS, MSc) received his dental degree from University of Lisbon in 2002. In 2008, he completed his post-graduation program at New York University School of Dentistry. Currently he is a part-time faculty member of the Endodontics Specialty Programme at University of Lisbon, and is enrolled in the PhD programme at the same University. In addition, he is author of 40 national and international publications, some of them in top ranked Endodontics journals. Has published 2 book chapters and gave national and international lectures. He is an ESE certified member, and has practice limited to Endodontics since 2007 in Lisbon.

rightCBCT on root canal anatomy: what can’t we see? Advantages and limitations


This lecture portrays the quality and accuracy of cone beam computed tomography (CBCT) in the imaging of dental and adjacent structures, the root canal anatomy respectively. The specific advantages and inherent disadvantages of CBCT in clinical and endodontic application will be briefly discussed, as well as the image quality of the CBCT is compared with the image quality produced by other dental imaging modalities.


The aim of the lecture is to provide the listeners with a basic understanding of how cone beam computed tomography works, allowing them to correctly assess the possibilities of this imaging modality in terms of indications.


Physical and mathematical backgrounds of CBCT technology will be described and compared to other modalities in the field of oral and maxillofacial imaging.

rightMarc Semper
 Marc Semper

Marc Semper graduated in 1993 from the Johann Wolfgang Goethe-University in Frankfurt (Germany), Center of dentistry, oral and maxillofacial surgery (Carolinum). He has been in private practice limited to Endodontics since 2007. Marc Semper has lectured nationally and internationally on Endodontics, Dental Traumatology and Dentomaxillofacial Imaging and CBCT and co-authored the German Guideline on the use of cone beam computed tomography in dentistry. Among others, he is a Board Director of the International Association of Dental Traumatology (IADT), International Specialist Member of the American Association of Endodontists (AAE), Certified Member of the European Society of Endodontology (ESE) and Member of the German Association of Endodontology and Dental Traumatology (DGET). Currently he serves as a reviewer for the International Endodontic Journal.

PART 2: Controversial issues in root canal anatomy and the use of terminology
rightNew findings to explain the complexity of apical canal anatomy


This lecture presents new findings to explain the complexity of apical canal anatomy. The development of new imaging systems has generated substantial data to increase our knowledge regarding apical root and apical root canal morphological characteristics such as bifid apices, canal isthmuses and accessory canals. However, these novel findings make new classifications and definitions inevitable. Making these definitions with universal consensus and without any further complex additions would be much more practical for consistent presentations of the data available from different countries, and for accurate comparisons between experimental and clinical reports.


The aim of this lecture is to present new findings to explain the complexity of apical canal anatomy.

rightAli Keleş
 Ali Keleş

Dr. Ali Keleş received his DDS degree in 2001 from Ataturk University and completed his PhD at the same university. He became an assistant professor at İnönü University in 2010 and received an associate professor degree in 2014. He has been an associate professor at Ondokuz Mayıs University since the beginning of 2015. In 2016, he held a position as visiting professor at Loma Linda University in California. Although his fields of interest include biocompatibility, dental anomalies and retreatment, he has focused on microcomputed tomography studies in recent years. Dr. Keleş has had five projects funded by the National Scientific and Technological Research Council of Turkey on microcomputed tomography and has published numerous scientific papers.

rightAn update on the unique anatomy of C-shaped root canals


C-shaped canal system is a canal anatomical variant with higher prevalence in Asian populations. The main anatomical feature of C-shaped canals is the presence of an isthmus, a fin or a web connecting the two or more root canals with an arc which makes the cross section look like a letter ”C”. C-shaped canal has many variations in canal configuration, a comprehensive knowledge of the variations can help ensure successful debridement, instrumentation, obturation, and restoration.


The presentation will be focused on the prevalence, variation and classification of C-shaped canals. Controversies, concepts and innovations about C-shaped canal system will be discussed also.

rightBing Fan
 Bing Fan

Dr. Fan graduated in 1986 at the School & Hospital of Stomatology, Hubei Medical University. In 1999, Dr. Fan received his PhD at the Hubei Medical University, and currently he serves as the professor and director of Endodontic Center in School & Hospital of Stomatology, Wuhan University and adjunct professor of endodontic department in dental school, Augusta University. Dr. Fan is an active member in international endodontic society and has given many excellent lectures in international conferences. Dr. Fan is a well-known expert in endodontic treatment and had won the second and first prizes in the Competition of Endodontic cases in Asia and Pacific area held by Dentsply Asia in 2001 and 2002. He was also a contributor of the book "pathways of the pulp" (11edition). His current subjects mainly lies in research on C-shaped canal system and Construction of digital permanent teeth database including more than 3000 teeth.

rightControversies in terminology and characterization of the root and canal system: a new approach


This lecture aims 1) To outline the terminological controversies of the root and canal system. 2) To discuss challenges for describing and characterizing the root and canal configuration. 3) To discuss some thoughts on how to solve terminological controversies and challenges for describing the root and canal system.

rightHany Mohamed Aly Ahmed
 Hany Mohamed Aly Ahmed

Dr Hany Mohamed Aly Ahmed (HMA Ahmed) was born in Göttingen, Germany. He is an Egyptian and was graduated from Faculty of Dentistry, Ain Shams University (ASU), Egypt, with a Bachelor's Degree in Dental Sciences (B.D.S.) in 2002. He started his clinical postgraduate program in Endodontics with a Higher Dental Diploma (H.D.D.) degree in 2006, and joined a Master Degree program (M.Sc.D.) at the School of Dental Sciences, Universiti Sains Malaysia (USM) in 2009 which was converted to Ph.D. in 2011.

Dr. Ahmed has been granted a number of awards for his research on the application of Portland cements in Endodontics including the IADR (SE Asian division) for the best laboratory research in 2014. He has also been granted several awards, in Malaysia, Singapore, as a supervisor for several research projects. In 2012, Dr. Ahmed has introduced a new classification for endo-perio lesions, which was published in ENDO. Recently, with experts from Brazil, UK and Hong Kong, he has introduced a new system for classifying the root and root canal morphology, accessory canals and anomalies. Currently, he is a Senior Lecturer of Endodontics at the Faculty of Dentistry, University of Malaya, and he is leading a number of projects related to root canal morphology and endodontic biomaterials in Malaysia and other countries in Europe, Australia, Africa and Asia. Dr. Ahmed has published over 70 articles in recognized international journals such as International Endodontic Journal and Journal of Endodontics. He is a scientific reviewer and editorial board member in several national and international journals. He also is the Deputy Editor-In-Chief of the European Endodontic Journal.

PART 3: Discussion with speakers
Hany Mohamed Aly Ahmed; Ronald Ordinola Zapata; Marco Versiani; Jorge Martins; Marc Semper; Bing Fan; Ali Keleş
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