New system for classifying tooth, root and canal morphology
Knowledge of tooth, root and canal morphology is a prerequisite for effective root canal treatment. With current advances in technology and increasing body of knowledge on root and canal morphology, the deficiencies of the existing systems used for classifying root canal
morphology have become more apparent. A new system for classifying the root and canal morphology was proposed recently, which provides detailed information on tooth notation, number of roots and root canal configuration in addition to accessory canals and anomalies. This lecture aims to present an overview of the new system, and its potential applications in education, research and clinical practice.
1) To present an overview of the new system for classifying tooth, root and canal morphology.
2) To discuss potential applications in education, research and clinical practice.
3) To present two years of experience with the new system - advantages and challenges.
4) To discuss future plans for universal adoption.
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.
The root apex - the complexities of apical canal anatomy
Dr Ashraf Elayouti
Dr Ashraf ElAyouti received Bachelor degree in dentistry and doctor of dental surgery in 1988, Alexandria University. After serving 2 years in the Marine as a dental surgeon and another 5 years at the University of Hamburg, he received his doctoral degree, Dr. med. dent., in 1998. Subsequently he worked at the department of Conservative Dentistry, Division of Endodontology, Tübingen University. Since January 2005, head of Endodontology (prov.) and senior lecturer and supervisor of doctoral and research programs in Endodontology and associate Professor. His main research interests are physical properties of dentin and 3-D Dental Imaging.
Session chair: Kurt Ebeleseder
The association of clinical signs and symptoms with specific endodontic microorganisms
Bacteria and their by-products are the primary cause of pulpal and periradicular pathologies; of the development of signs and symptoms of endodontic origin; of the acute manifestations during or after endodontic treatment, known as flare-ups; and of the failure of endodontic treatment. Bacteria possess virulence factors including: a) their structural cell components, such as lipopolysaccharides (LPS; i.e. endotoxin), present in Gram-negative bacteria, and lipoteichoic acid (LTA), present in Gram-positive bacteria, which can cause indirectly tissue injure by activation of the immune response; b) their metabolism products, which can cause direct damage to pulp tissue. Although no absolute correlation has been demonstrated between any specific type of bacterial species and the aetiology of pulpal and periapical alterations, strong evidence suggests that Gram-negatives are involved in the development of clinical features of acute periapical inflammation such as pain, swelling and exudation, as well as with larger size of periapical radiolucent area. On the other hand, Gram-positives may be associated with resistance to intracanal medicaments, may play a major role in biofilm formation and may provide bacterial resistance to antibiotics or chemical substances. Nevertheless, the combinations between bacteria, particularly between Gram-positives and Gram-negatives, are more potent in the development of clinical signs and symptoms than the single strains. The endodontic treatment should reduce the levels of microorganisms and their virulence factors in the root canal system in order to re-establish the health of the periapical tissues. It is concluded that a better understanding of the association between bacteria and their virulence factors with the clinical and radiographic aspects presented by the patients is important to the establishment of appropriate therapeutic procedures, which will lead to a more predictable outcome of the endodontic treatment.[Supported by FAPESP (15/23479-5, 17/16516-7); CNPq (308162/2014-5) & CAPES]
The aim of this lecture is to discuss the association of bacteria and their virulence factors with some endodontic signs and symptoms and with several aspects related to the endodontic treatment outcome.
* Discuss the role of bacteria in the endodontic disease
* Discuss the virulence factors of Gram-negatives and Gram-positives
* Discuss the association of virulence factors such as LPS and LTA with the development of clinical features; with the resistance to disinfectants, intracanal medicaments and antibiotics; and with the biofilm formation.
* Discuss the role of combinations of bacteria in potentiating the development of clinical signs and symptoms.
* Discuss the role of the endodontic treatment in reducing the levels of microorganisms and their virulence factors in the root canal system.
Prof Brenda P Gomes
Brenda P F A Gomes graduated in Dentistry from the Pontifical Catholic University of Minas Gerais, Belo Horizonte, MG, Brazil. She is specialist in Endodontics and has a MSc in Endodontics from the Federal University of Rio de Janeiro; and a PhD in Restorative Dentistry, in the Endodontic field, from the University Dental Hospital of Manchester, UK. She has postdoctoral degrees from the Ohio State University, in Columbus, OH, US and from the Forsyth Institute, Cambridge, MA, US. She works for the State University of Campinas-UNICAMP, Brazil, since 1997, being a Professor in Endodontics since 2011. She has more than 150 full length papers published in peer-reviewed journal of international standard. She has experience in Dentistry, particularly in Endodontics, acting on the following subjects: endodontic microbiology, endotoxins (LPS), LTA, cytokines, antimicrobials, chemical substances, instrumentation techniques, intracanal medicaments and retreatment.
Pulp revitalization procedures in immature and mature teeth
Regenerative endodontic therapy is a biologically driven procedure designed to replace the damaged tissue including dentin, root structures, as well as cells of the pulp-dentin complex. Endodontic science today benefits from the latest technologies and uses all the evidence-based knowledge to define novel clinical principles and practices aiming to mimic the nature itself like never before. Parallel to the advancements in the field of tissue engineering and regenerative endodontics the strategies in pulp regeneration are improved.
The aim of the current lecture is to discuss the revitalization procedures both for mature and immature teeth based on personal case reports with long-term follow-up. The advantages and the limitations of extending the indication and scope of revitalization procedures to mature teeth will also be discussed
• To review the importance of pulp-dentin complex regeneration,
• To review the current literature in the pulp revitalization procedures,
• To review different clinical cases and regeneration protocols,
• To review the future perspective for revitalization of both mature and immature teeth.
Dr Tugba Turk
Tugba Turk is an Associate Professor at the Department of Endodontology, Ege University, School of Dentistry, Izmir, Turkey. She is also lecturer at University of Rome, La Sapienza, Dental School, Italy.
She received her DDS degree from the Ege University where she also completed her Ph.D. and received an associate professor degree in 2017.
As a full-time faculty member, Dr. Turk is involved with undergraduate and graduate teaching, and she supervises Ph.D. students. She has published several articles, received several awards for her scientific studies and has presented lectures both nationally and internationally. She is a member of the European Society of Endodontology, the Turkish Endodontic Society and The Society of Stem Cell and Cellular Treatments.
Dr. Turk’s research interests include minimal invasive endodontics, regenerative endodontics, dental stem cells, tissue engineering, and scanning electron microscopy. She actively performs clinical regenerative endodontic therapies involving a large number of patients.
Poster Presentations / Trade Exhibition
Session Chair: Peter Brandstätter
Working length determination: dynamic and three-dimensional
A proper apical limit for cleaning, shaping, and filling procedures has been directly correlated with the success of endodontically treated teeth.
Current literature supports the use of electronic apex locators as the preferable method for intra-operative working length determination because they are more reliable in locating the apical constriction. However, in a clinical scenario, the subsequent evaluations of the apical limit position are usually performed by using periapical radiographs. Disparities and challenging situations might be related to the limitations of each method, anatomic complexities, and the dynamic nature of the working length throughout the endodontic procedures.
Recently, new software and rendering tools have been introduced to enhance the visualization of the root canals in cone-beam computed tomographic (CBCT) scans. Thus, for the cases presenting with a diagnostic CBCT scan, the apical anatomy and trajectory of the root canals can be analyzed in three dimensions and a pre-operative working length can be estimated.
Additionally, the trajectory of the root canals is modified by the shaping procedures, which might result in small variations in their total extension. Thus, monitoring and adjusting the working length is essential to maintain the apical limit within dentinal walls throughout the Endodontic treatment. Although the incorporation of apex locators into endodontic motors aims to control the apical limit of preparation automatically, their functionality and accuracy are still controversial.
This presentation aims to discuss the determination of the apical limit for the endodontic procedures from a three-dimensional and dynamic perspective, as well as the advantages and limitations of different methods for working length determination.
1. Revise the concepts of apical anatomy and their correlation with apical limit determination
2. Discuss the three-dimensional and dynamic aspects of the working length throughout the Endodontic procedures.
3. Limitations and potential benefits of electronic devices and dedicated software for working length determination
4. Correlate some of the research outcomes to the clinical scenario
Dr Lucila Piasecki
Dr. Piasecki graduated in Dentistry from the State University of West Parana, Cascavel, Brazil (2003) and in the same institution completed the Specialization in Endodontics (2005). She obtained the Master's of Science degree (2011) and Doctorate (2014) focused in Endodontics at the Pontifical Catholic University PUCPR, Curitiba, Brazil. Dr. Piasecki joined the academic career in 2008 at the Paranaense University. Later she was also an invited professor in the Post-Graduation in Endodontics of the State University of West Parana, Cascavel, Brazil (2009-2016) and served as a part-time faculty of Endodontics at the Pontifical Catholic University PUCPR, Curitiba, Brazil (2013-2015). In 2015 she received a post-doctoral training at Sapienza University of Rome, Italy in the research lab of Dr. Gambarini. Currently, Dr. Piasecki is an Assistant Professor at the Division of Endodontics of the State University of New York at Buffalo, NY, USA. As a full-time faculty, she is teaching and mentoring research in Endodontics for predoctoral and graduate students. She is also a faculty of the graduate school of the University at Buffalo and Assistant Director of the Advanced Program in Endodontics. Dr. Piasecki also serves as the course director of the discipline "Introduction to Digital Dentistry" which has been recently implemented at UB Dental School. Dr. Piasecki is a member of the American Association of Endodontics and Brazilian Association of Dentists. She has published scientific articles in peer-reviewed journals, and is involved in laboratory and clinical research as well in the development of technologies in Endodontics.
Endodontic screening for patients with cardiovascular disease
presentation of a consensus protocol
One controversial issue in the relationship between oral care and cardiovascular diseases is how and
whether to manage oral infections prior to cardiovascular surgery or other cardiovascular invasive procedures.
To date, the guidelines of the US and EU cardiology and cardiac surgery associations have expressed incomplete and inconsistent information on the issues. From a systematic literature review, it became clear that a consensually validated protocol for the reproducible dental screening of patients awaiting cardiac interventions was never created and that the treatment options to be provided, their prognosis and timing in relation to the condition of patients had never been considered. A consensus work was then completed by a panel of experts from six dental, cardiologic, and cardiac surgery Italian scientific societies on the development of a consistent strategy to adopt when screening patients for dental/periodontal infections, and on the feasibility of providing dental treatment before cardiovascular surgical procedures depending on the physical conditions of the patient.
The aim of this lecture is that the protocol created following the consensus is discussed since it may become a model to be used by the Heart and Dental teams, in Europe in the pre-interventional preparation of patients awaiting cardiovascular interventions.
The discrepancies in the guidelines, the motivation behind the creation of the consensus, the results of the consensus in terms of screening protocol, definition of dental foci, definition of the average conditions of patients waiting for cardiac suregry will be explained.
Elisabetta Cotti, DDS, MS,
received her DDS from the University of Cagliari – Italy and the specialty and MS in Endodontics from the University of Loma Linda- California.
Since 2000, she is Professor of Restorative Dentistry and Endodontics, and 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 Post Graduate programme (Master) in Clinical 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 at 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 apical periodontitis, immature teeth, complex case management, imaging techniques and interactions between apical periodontitis and systemic conditions.
Session chair: Tomas Kupec
Treatment planning for post-treatment disease
Hani F. Ounsi
Prof. Ounsi graduated from the school of dental surgery, University of Montpellier, France. He holds a post-graduate degree in endodontics, a master in medical and biological sciences, a research master in oral biology from Saint-Joseph University in Beirut where he taught endodontics, and a PhD in Dental materials from the University of Siena. Prof. Ounsi is presently an assistant professor at the department of restorative dentistry and endodontics of the Lebanese University and a visiting professor at the department of endodontics and restorative dentistry of Siena University. He is the editor of the International Journal of Oral and Dental Sciences, the editor of International Journal of Oral and Dental Sciences, and an associate editor of the Lebanese Dental Journal, Journal of Contemporary Dental Practice, and the International Journal of Endodontic Rehabilitation. He also serves on the scientific advisory board of the Journal of Endodontics and the Saudi Endodontic Journal, and he is a reviewer for the Journal of Endodontics, International Endodontic Journal, Dental Traumatology, Journal of Applied Oral Science, and the Open Dentistry Journal. He is a fellow of the International College of Dentists and a member of the American Association of Endodontists. He authored and co-authored more than 50 publications, and presented and conducted more than 200 lectures, conferences, and courses in 5 continents.
Tips and tricks during root canal retreatment
Dr. Mohammad Hammo Graduated from Jordan University in 1992 (BDS), and continued his higher education in Endodontics in saint-Joseph University in Lebanon 2001( DESE). Dr. Hammo has been lecturing locally and globally (more than 150 international conferences in more than 25 countries. He has publications in different scientific journals. He owns the Hammo Endodontic Clinics in Amman; additionally he is a consultant endodontist in Qatar and Bahrain. He is the former president of Scientific Committee of Jordan Dental Association, and also he is serving as the director of Endodontic Program in British Academy of Implant and Restorative Dentistry (BAIRDS), and Expert in Dental XP group. Dr. Hammo has been one of the most active endodontists on Facebook. He has thousands of followers across the globe. He has been the virtual mentor for many clinicians by virtue of his case sharing on the social media.
Invited speaker and sponsored lecturer for Eighteeth Medical