*The price is for both days (including all workshops). The cost of the main scientific program (Day 1) - 499 euros (from 1.08 - 510 euros). The cost of each workshop is 244 euros (optional).

Day 1

09:45 – 11:00

Meetu Kohli

Bioceramics in Endodontics 2022 - Time for change

The advent of MTA about 2 decades ago brought about a significant change in the practice of clinical endodontics. A material that suited our work-space and the periradicular tissue, perfectly. It has been used from coronal most application in the tooth as a pulp cap material to the apical end as a root-end filling material. However, there are limitations to use of MTA e.g., inability to use for routine obturation, it's difficult handling properties and tendency to cause discoloration. Material scientists have worked on overcoming the limitations of MTA by introducing newer generation of Bioceramics. This is going to be an overview of the current research and clinical applications of the bioceramics available to us. Published research will be critically reviewed and clinical cases presented demonstrating the applications for obturation, vital pulp therapy, endodontic microsurgery, reimplantation, perforation repair etc.

11:00 – 12:15

Martin Trope

Evolution of root canal instruments. From Stainless Steel to Adaptive Technologies

Now there is a movement to adapt the tool design to the inner anatomy of teeth and therefore new endodontic instruments have been modeled to integrate all variables essential for predictable canal cleaning. The super-elasticity and shape-memory of the alloy used in new endodontic instruments facilitates adaptation into canal morphology where traditional round instruments are unable to reach. This enables debridement and disinfection without major changes to the original canal shape and ensures minimal removal of intra-canal dentin. This conservatively treated root canal can then be filled using bioceramics that are more dimensionally stable than traditional endodontic sealers.

12:45 – 14:00

Syngcuk Kim

New Advanced Endodontic Microsurgery

As a starter, modern endodontic microsurgery developed and taught at our institution, Penn Endo, will be presented pointing key areas of importance using video clips. These include instruments, materials, biological principles and, most importantly, the success rate. This is followed by the newly developed approach, the 'Bone Window' Technique.

Endodontic microsurgery for a tooth with a large periapical lesion and an intact cortical plate may necessitate the removal of extra bone and cause delayed healing. In such cases, the "bone window" technique offers excellent exposure to the operative field and preserves cortical bone. Cone-beam computed tomographic imaging is essential for a presurgical assessment for indication selection and precise design of the bone window. The use of the 'bone window' technique which is a reliable technique, should be the method of preference when the large lesion with intact buccal plate.

15:00 – 16:15

Samuel Kratchman

Troubleshooting Surgical Complications and replantation techniques based on the latest Upenn studies

The presentation begins with perhaps the most important part of efficiently done microsurgery; positioning of the patient/microscope and doctor. The lecture then continues with management of the mental foramen, sinus perforation and palatal surgery. When microsurgery is not possible then one should also consider intentional replantation as a procedure to save the natural tooth. The latest techniques and several cases of replantations will be discussed with success rates of 88%.

16:15 – 17:30

Domenico Ricucci

Clinical Science of Endodontic Success and Failure. Update in Vital Pulp Therapy

After pulp penetration by caries, necrosis and bacteria are initially confined to the pulp chamber, but soon the pulp degeneration process extends beyond root canal orifices and moves slowly in apical direction. Bacteria are observed forming complex structures, known as "biofilms", on the root canal walls, in irregularities, isthmuses, and lateral canals. Only their complete elimination will lead to endodontic success, with regeneration of trabecular bone and healthy periodontal ligament. Tissue biopsies from failed cases demonstrate how infection from the apical root canal walls or from complex anatomical intricacies can hardly be controlled through conventional treatment procedures. The presence of extraradicular bacteria and their possible role in determining root canal treatment failures is finally discussed.

Day 2. Workshops

09:00 – 11:30

Syngcuk Kim and Samuel Kratchman

The latest trends in Endodontic microsurgery

This hands-on workshop will demonstrate the importance of proper positioning of the microscope/patient/doctor for microsurgery, enabling the practitioner to do the surgery comfortably and efficiently. A complete surgery will be performed on an extracted tooth mounted in a stone model, reproducing real-life situations. The procedure will be performed under the microscope utilizing all the microsurgical instruments as well as the new generation of bioceramic putty for root end fillings. The armamentarium will be discussed in detail, allowing the audience to see each instrument's relevance for the procedure.

12:30 – 15:00

Martin Trope and Samuel Kratchman

Anatomically Directed Endodontics

Evolutionary technologies have resulted in a new generation of instruments designed to access areas that traditional "round" NiTi cannot safely reach. After initial negotiation of the root canal space with a glide path file, these "virtual core" files complete the cleaning to the maximum natural diameter. The native anatomy configuration is sustained and intra-canal dentin conservation is optimized. This conservative root treatment is completed by bioceramic root filling technology that does not shrink, wash out or require excessive preparation on the coronal third of the canal space. Participants will experience the use of these instruments and learn the subtle differences between the use of these files and the traditional NiTi instruments.

15:30 – 18:00

Meetu Kohli and Domenico Ricucci

Effective Retreatment with concurrent perforation repair

This hands-on course offers training in non-surgical retreatment under microscope, with new three dimensional files that allow for effective and easy gutta percha removal from the canals. The key to successful retreatment is adequate disinfection. In order to allow for irrigation and medication to be effect against the persistent intracanal infection, the previously filled gutta percha and sealer have to be efficiently removed. Along with finisher files the re-instrumented canals are cleaner both of debris and biofilm. After biomechanical instrumentation, obturation technique with bioceramic sealer and gutta percha will be demonstrated to reseal the canal hermetically. By the end of the session the participant should be able to remove gutta percha, instrument and obturate a couple teeth of various complexities in an adept structured workflow, which is repeatable, and easily transferable to their clinical practice. An iatrogenic error such a perforation can be disheartening. During this hands-on steps to repair perforations with biocermaic putty will also be discussed.

Domenico Ricucci

General information

Complex endodontics from Domenico Ricucci: 5 cases

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