ENDO CONFERENCE

The use of nickel-titanium engine driven endodontic instruments has expanded dramatically since the first attempts at manufacturing endodontic files from super elastic alloy.

Over the years, engine driven shaping of the root canal system became synonymous to  modern  root canal instrumentation.  New cross sectional instrument designs, variable tapers and crown down techniques were introduced and adopted very quickly. Recently reciprocation movement was introduced and challenged rotation in terms of efficiency, simplicity and safety.

In this era of  NiTi instrumentation blast, heat treated NiTi martensitic controlled memory files were introduced and became rapidly very popular.  Their flexibility,  fracture resistance and lack of  super elasticity  allowed for  adequate anatomically driven preparations even for the most challenging canal systems.

Now that everybody is moving towards martensitic flexible files with controlled  memory characteristics, a new generation of files has come to revolutionize instrumentation efficiency and safety.  The new electrical discharge machined (EDM) Hyflex  files  arrived to supplement the successful controlled memory series and reduce the number of files needed to prepare challenging root canal systems.

The aim of this workshop is to introduce you to the new EDM era of rotary instrumentation for the highly curved and the double curved canal systems.

              Workshop objectives:

At the end of this workshop the participant will manage to:

• Understand the biological objectives of root canal treatment manipulation in relation to each anatomical challenge;
• Understand and appreciate the controlled memory thermomechanical processing and electrical discharge machining for the manufacturing of rotary files;
• Establish a roadmap for customized instrumentation protocols with the Hyflex CM & EDM rotary files even for the most challenging cases;
• Practice the suggested shaping protocol in highly curved and doubled curved training blocks with 3 rotating instruments;
• Achieve a three dimensional obturation of the prepared root canal system by using greater taper gutta-percha points in combination with Gutta-flow 2.

Every clinician who has performed endodontics has experienced a variety of emotions ranging from the thrill-of-the-fill to an upset such as the procedural accident of breaking an instrument. During root canal preparation procedures, the potential for instrument breakage is always present.
Many clinicians associate “broken instruments” with separated files, but the term could also apply to a sectioned silverpoint, a segment of a Lentulo, a Gates Glidden drill, a portion of a carrier-based obturator, or any other dental material left inside a canal.
Today, separated instruments can usually be removed due to technological advancements in vision, ultrasonic instrumentation, microtube delivery methods, or a lasso technique. Specifically, the dental operating microscope allows clinicians to visualize most broken instruments, and fulfills the age-old adage, “If you can see it, you can probably do it.”

In this course, a series of sequences will be explained and demonstrated Therapeutic designed to simplify endodontic treatment, so that it complex intervention to become accessible to any dentist. We will learn how to use the WaveOne Gold system as well as the new minimally invasive TruNatomy system – Dentsply Sirona in addressing various clinical cases, but also what to look for in
the timing of an endodontic treatment to successfully complete it.
In this workshop there will be 3 practical parts. In the first part we will prepare with the standard WaveOne Gold sequence an endodontic block (or tooth extracted with access made in advance by the participant) and we will close it with Guttacore and Ah +, using the Thermaprep oven 2.
In the next practical part we will open the previously blocked plastic block with WaveOne Gold and we will prepare a new endodontic block.
The last part of the hands-on is for the TruNatomy system. It will work with this system on a new endodontic block or extracted tooth.

Objectives:
• understanding the biomechanical features of endodontically treated lateral teeth and how they influence the choice of restoration type;
• presentation of the 3 types of preparations specific to endodontically treated lateral teeth: endo-crown for a molar, endo V prep for molars, endo V prep for premolars;
• the participants will learn the techniques for the preparation of the 3 types of preparations on didactic models.

Clinical solutions Endodontic treatment became more predictable than ever before. With the aim of new materials and techniques, we are able to save teeth which were not meant to be. Unfortunately, still the biggest enemy for every doctor is anatomy, which can lead to problems. During this lecture, the participants will learn how to avoid problems during Endodontic treatment and if it happens how to solve it during retreatment. They will get tips which You can use just the next day in Your office.
Workshop objectives:
– Problem-solving during everyday endodontic treatment, starting from creating access, up to the negotiation of the canal space;
– Techniques concerning removing of fracture instruments, metal and fiber posts, closing perforations and passing ledges;
– Planning proper restoration for long term results.
Each procedure is presented step by step basing on clinical cases.

In this course we will get acquainted with the endodontic preparation system WaveOne Gold – Dentsply Sirona and we will take the first steps in the world of dental operator microscope. We will understand what is the focal length, working field, magnification steps and other useful criteria in choosing a new microscope and working positions to make the treatments under magnification easier. In the practical part we will get acquainted with the microscope and we will prepare an endodontic block or extracted tooth (the access cavity must be made beforehand) with the help of the WaveOne Gold system.

In this presentation, we will approach from a surgical point of view, from simple to complex, the failures of the endodontic treatments where the endodontic retreatment of the tooth in question is not possible. The endodontic treatment is a medical procedure frequently used in dental practice to save a tooth.
In order to have a successful and correctly applied treatment, there are a lot of factors involved that need to be taken into account starting from an accurate diagnosis to the actual root treatment, as well as the patient’s general health.
It’s quite common to see failures of the endodontic treatments, but the patients come back to the dental office only after they become symptomatic. If the endodontic treatment fails there are 2 possibilities: endodontic retreatment or surgical one.
In general, the apicoectomy is being reserved for the situations where there the endodontic treatment cannot be done or was unsuccessful.
If after the apical resection the tooth is compromised, the only option available is tooth extraction followed by insertion of an immediate or late implant.
The failure of endodontic treatment can have a disabling effect on the patient.

It has been more than ten years now that reciprocating files were described in the literature and since then they slowly became part of the Endodontics routine for thousands of clinicians all over the world.
The lecture will explain the reason why they have become so popular and the rationale for using them in the best way possible.

In recent years we have heard a lot about minimally invasive Endodontics. The common point is the conservation of tissues, preferably preventing the disease and intercepting its progress, but also removing it with the least possible tissue loss. Today preparation of the root canal and its final shape, that is the corner stone for adequate cleaning and three dimensional obturation, can be managed in a minimally invasive way thanks to modern Nickel Titanium mechanical endodontic intruments, newalloys, design and sequences that improve safety and efficiency in saving tooth structure when shaping canals.
During the lecture will be explained the rational on how to use these instruments and will be shown a predictable and reproducible protocol to achieve the goal of being effective in an easy way.

Clinical management of calcified teeth provides an endodontic treatment challenge and makes up a significant portion of current endodontic practice. Searching for calcified root canals can be challenging and, time-consuming and may create a huge loss of tooth structure that is associated with a high risk of fracture and perforation, compromising the prognosis of the tooth. Nowadays, the use of new technologies has increased the predictability of the treatment of calcified teeth. A new clinical approach for to a tooth with PCO, called “guided endodontics,” has been introduced. This technique consists in the use of a guiding template, which facilitates the localization of severely calcified root canals. With this lecture will be presented, through clinical cases, this form of approach to face this clinical challenge, providing some tips and tricks to achieve the mechanical and biological goals of endodontic treatment.

Occasionally the young pulp of permanent developing teeth may become infected or necrotic due to caries or trauma. Traditionally the treatment of these teeth had been approached through direct pulp capping, pulpotomy, apexogenesis or apexification procedures according to different magnitudes of pulpal damage. The indications, objectives, and type of pulpal therapy depend on whether the pulp is vital or non-vital, based on the clinical diagnosis of normal pulp, reversibly inflamed pulp, irreversibly inflamed pulp or totally necrotic pulp. The greater the pulp damage of the developing permanent dentition is, the greater the challenge. Recently, bioactive materials and regenerative concepts were introduced in order to increase the prognosis of compromised necrotic developing permanent teeth.
Learning objective: the re-establishment of a functional vital tissue that will foster continued root development, dentinal wall thickening, and immune competency. In this lecture single and multiple steps, regenerative protocols will be discussed through the long term observation of relevant cases.

Clinical solutions for Endodontic treatment became more predictable than ever before. With the aim of new materials and techniques, we are able to save the teeth which were not meant to be. Unfortunately, still the biggest enemy for every doctor is anatomy which can lead to problems.
Conference objectives: During this lecture, the participants will learn how to avoid problems during Endodontic treatment and if it happens – how to solve it during retreatment. They will get tips which to be used just the next day in the dental clinic.

The complexity of this type of treatment is also due to the specific biomechanical and biochemical characteristics of this category of teeth.
The clinical concepts regarding the restoration of non vital teeth are varied and controversial and the data from the specialized literature does not offer firm answers for the adoption of one or the other protocols.
What kind of restoration:
for what type of tooth?
for a certain aesthetic result?
for maximum longevity?
During this conference will be presented digital technologies that allow the use of new concepts of restoration of the endodontically treated lateral teeth in a single session, offering an easy-to-implement decision tree based on the latest data from the specialized literature and clinical experience personal for over 10 years.

An increasingly frequent dilemma in restorative dentistry is the question of whether to retain a badly damaged tooth and restore it or to remove and possibly replace it.
Given the ethical difficulties inherent in testing this question, it is unlikely that we will ever see a properly designed clinical trial that will provide an answer. One of the most strongly debated components of this question is whether endodontic treatment and restoration can compete with a dental implant-borne prosthesis in terms of longevity and success.
In deciding whether to extract a tooth or restore it endodontically, the clinician must consider the quality of support the tooth will provide for planned restorations, the predicted longevity, and the role of the tooth in overall rehabilitation plans.
In this conference, I will attempt to provide practitioners with guidelines that might be applied to their daily practices.