Dr Gilberto Debelian
Dr. Gilberto Debelian, DMD, PhD Endo Inn, Oslo, Norway
Dr. Debelian has completed his specialization in Endodontics from the University of Pennsylvania, USA in 1991 and received the Louis I. Grossman student award in Endodontics.
He has taught as a clinical instructor and associate professor at the endodontic program at University of Oslo (UIO), Norway from 1991 to 2010. He has concluded his PhD studies at UIO in 1997, which gave him two scientific awards from the European Society of Endodontology (ESE) and from the Norwegian Dental Association both in 1997. He is an adjunct visiting professor at the post-graduate program in endodontics at University of Pennsylvania.
Dr. Debelian maintains a private practice limited to endodontics as well as an advance endodontic microscopy center – ENDO INN in Oslo, Norway.
Dr. Debelian has authored 6 chapter books in Endodontics, one book in Endodontics and written more than 80 scientific and clinical papers.
Three-dimensional cleaning and shaping in endodontics: clinical applications and research
Abstract
Recently a new NiTi wire (MaxWire™) and instrument system (XP-endo®) have been introduced aiming an anatomically driven instrumentation of different root canal anatomies. Using the principles of shape memory of NiTi alloy the MaxWire was developed to be malleable at room temperature (Martensite phase) and transform to a specific shape at body temperature inside the root canal (Austenite phase). XP-endo instruments are designed for 3 uses: 1-XP-endo Shaper – one file for the 3D shaping of the canal; 2-XP-endo Finisher – used after the Shaper (or traditional round files) in order to reach tissues or debris not reached in the shaping phase and 3-XP-endo Retreatment – to efficiently remove obturation materials from the root canal walls left behind after shaping instruments have been used.
Preliminary studies on XP-endo files have shown remarkable efficiency for maintaining the original shape of the canal while producing less dentinal debris blocking the irregular areas or isthmus areas. In addition, even though minimal number of instruments is used, almost no stress is produced on the canal walls. This presentation will explore the technical, biological and clinical aspects of this new three-dimensional cleaning and shaping in endodontics.
Objectives
At conclusion, participants should be able to:
1. Understand the technological challenges of traditional endodontic instruments to predictably clean the root canal.
2. Present the physical and clinical characteristics of the new XP-endo files
3. Demonstrate the clinical use of XP-endo files in primary and retreatment cases
4. Present the latest on-going and published studies
Dr Joerd van der Meer
3D matters and workflow in endodontics
Technology has an enormous impact on our daily lives. The lives that seem to be governed by smartphones, internet and email. Computers have become more powerful and everything seems to revolve around information technology and Big Data. As of now, we are able to make a digital impression of the dentition faster than we can with traditional impression materials. On top of that, 3D printers have become easy to operate and fast enough to produce temporary crowns, bridges and tools chair-side. This means that digital technology has reached the level that it can also be used in endodontic therapy. Not only will this enable us to make our endodontic treatments easier, faster and more predictable, but it may also enable us to make our care more cost-effective.
Learning objectives:
The participants should be able to:
-understand the prociples of digital workflows
-understand the digital imaging technologies employed in digital workflows
-be able to theoretically implement a digital workflow in their clinical endodontic treatment
CV:
Dr. Joerd van der Meer area of expertise is 3D technology and he has a PhD on “3D digital workflows”. He works at University Medical Centre of Groningen and at the Kolff Institute for Biomedical Engineering and Materials Science, where he specializes in the clinical application of 3D technology like the cone-beam CT, 3D scanners, 3D preoperative surgical planning and 3D printing. Since 2009 he has been Honorary Research Associate at the University College of London Eastman Dental Institute.
Dr Meetu Kholi
Dr. Meetu Ralli Kohli is the Director for Continuing Education and International Visiting Scholar Program at the University of Pennsylvania, School of Dental Medicine, Endodontic department. Dr. Kohli earned her B.D.S. degree from Government Dental College, Bangalore, India. She pursued her D.M.D. degree as well as specialty training in Endodontics at the University of Pennsylvania, USA. During the course of her training she received the esteemed Louis I Grossman award, the Samuel R. Rossman scholarship and the Sherrill Ann Siegel award & scholarship for demonstrating excellence in patient care, clinical skills and research. She is on the Scientific Advisory Board as a reviewer for Journal of Endodontics, International Endodontic Journal, Quintessence International and Clinical Oral Investigations. Dr. Kohli has published in national and international peer reviewed journals and has contributed in books on microsurgical retreatment. She is the associate editor of the Microsurgery in Endodontics atlas. Her publications have received and have been recognized as the best clinical research paper by JOE. She has served on the AAE’s Constitution and Bylaws committee and currently serves on the Research and Scientific Affairs Committee. She is a Diplomate of the American Board or Endodontics. Dr. Kohli also maintains a part-time private practice in Pennsylvania, USA.
Bioceramics in Endodontics:
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 extensively investigated in in-vitro, animal and clinical studies. With due diligence in the literature, material has our academic and investigative endorsement. 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. The lecture is an overview of the current research and clinical applications of the newer bioceramics available to us. Published research will be critically reviewed and clinical cases presented demonstrating the applications in various treatment modalities.
At the end of the presentation the participants will be able to:
1. Discuss an evidence based evaluation of the chemical, physical and biological properties of Bioceramic pertaining to Endodontics.
2. Explain the clinical use especially as the sealer
3. Recognize the strength and weakness of the material
Prof Paul Lambrechts
Title: ‘Innovative approach to unravel external cervical resorption’.
Abstract.
External cervical resorption (ECR) is an extremely complex periodontal and endodontic pathology. Diagnosis and differential diagnosis with internal resorption or root caries is confusing and the periapical radiographs have several detection limitations. Since the introduction of high resolution Cone Beam CT (CBCT) the prevalence seems to increase but this is due to improved detection power. Also the etiological multifactorial triggers are becoming more evident. Most common causes are: non-vital walking bleach technique, collateral damage induced by orthodontic treatment, cementum damage induced by extraction of neighbouring teeth, cementum abfraction caused by parafunction like bruxing or nail biting, cementum lesions related to eruption collision, chronic irritation caused by cracks or invagination grooves, periodontal pathology and surgery, trauma and even viral infections.
ECR-teeth often keep their vitality for a long time even in the progressed stages of the Heithersay classification. Treatment options are variable depending on the resorption stage and the understanding of the pathology by the practitioner and his ability to approach the lesion in a minimal invasive microscopic way. The pathology outcome and the treatment success are related to the ability to circumscribe the lesion and seal the defect.
The morphological changes during ECR are numerous at the cementum/enamel/dentin/pulp/bone boundaries and the radiographic visualisation is complex. The Heithersay classification needs further improvement in graphical detail because resorption and granulation tissue invasion is only one part of the story. Substitution by osteodentin and reparative processes are as important as well. Also the portal(s) of entry and portal(s) of exit for ECR need to be specified.
Aim. (The one over-riding purpose of the lecture).
The aim of the ECR lecture is to unravel the morphological alterations and to increase the understanding of the intriguing biological processes that lead to hard tissue resorption, granulation tissue invasion and formation of osteodentin substitute material. The diagnostic power of CBCT is used to link the image acquisition to the morphological and histological changes and to prepare the practitioner to a controlled watchful waiting approach or therapeutic approach.
Objective. (The objective should describe how the aim is achieved).
There are several research tools that help to unravel the ECR pathology and to bring their information together in a 3D understanding of the ECR dynamics.
The synergistic use of clinical surgical microscopy, digital radiography, Cone Beam CT, Micro-CT, Nano-CT, scanning electron microscopy, hard tissue & soft tissue histology and immunohistochemistry helps to visualize the numerous morphological and histological changes in ECR lesions.
The resorption of cementum, enamel and dentin occurs in a dynamic way. Bacterial penetration in dentin tubules and tooth tissue interfaces is becoming evident and can be considered as a maintaining factor in ECR.
The pericanalar root resorption resistant sheet (PRRS), visible as a radiopaque line on digital radiography, is not only composed of a predentin layer, but is thicker than estimated. It includes primary dentin, reactionary dentin and reparative osteodentin.
The formation of intracanalar and intrapulpal reaction calcifications indicate a chronic pulp irritation and is co-responsible for the radiographic cloudy appearance.
The formation of vascularised osteodentin as a substitute for the resorbed enamel, cementum, dentin and PRRS tissue is extremely complex and only histology linked to Nano-CT clarifies the real nature of the dynamic ECR process.
Also the bone turnover of the osteodentin can be proven and is a regular process occurring in hard tissue biology.
Key learning points
• Cone beam CT is essential in the diagnosis of ECR
• Histological and histochemical imaging of the granulation tissue highlights the resorption process.
• SEM-analysis provides a better insight in activity of clastic cells and osteodentin formation.
• The root canal is surrounded by a pericanalar resorption resistant sheet (PRRS).
• Osseoid tissue formation and osseodentin apposition in a coral like manner makes the pathology even more complex.
• The outcome of the minimal invasive treatment is significantly enhanced by better diagnosis.
• Increase understanding when to treat and how to treat.
• Obtaining confidence in the decision making how to determine treatment strategies for ECR.
Speakers focus.
Prof. Paul Lambrechts is extremely focussed on minimal invasive restorative dentistry using advanced diagnosis and treatment protocols. He’s a strong protagonist of microscopic dentistry during all restorative procedures, endodontics and even animal dentistry. Micro, bio and techno in resto and endo are his idealistic goals in clinical dentistry, research and teaching.
PAUL LAMBRECHTS, Prof. Dr. Dent. is born in 1955. He followed Latin-Greek studies at the ‘St. Jan Bergmanscollege’ of Diest. He graduated as a dentist (DDS) in 1978 at the Catholic University of Leuven (K.U.Leuven), Belgium and obtained his PhD at the same university in 1983 based on a thesis investigating dental composites: “Basic properties of dental composites and their impact on clinical performance”. Today, he is Full Professor and Chair of the Department of Conservative Dentistry (K.U.Leuven), and also serves the dental school as Program Director of the dental Bachelor/Master and Master-after-Master programs at K.U.Leuven. He teaches cariology, oral aspects of nutrition and endodontics. During two tenth of his week time, he teaches pre-clinical and clinical conservative dentistry; 4/10 is spent to own clinical activity in the University Hospital, primarily in microscopic endodontics, but also in aesthetic restorative dentistry; for the remaining 4/10, he conducts research in endodontics, more specifically focussing on the development of a concept of minimal-invasive endodontic research, using 3D X-ray Micro-CT scanning, Cone beam CT and Environmental SEM, towards new root-canal preparation and filling techniques. The photodynamic laser-activated disinfection (PAD) techniques are one of the new research challenges of his group, while the pathology of external cervical resorption is one of his favourite study topics. A randomized clinical trial on pulp revascularisation is ongoing. In addition, specific interest goes also to laboratory and clinical research on dental composites, actually focussing on 3D-laser-profiling of clinical wear phenomena and biotribocorrosion. Together with Prof. B. Van Meerbeek, he became in 2003 co-holder of the Toshio Nakao Chair for Adhesive Dentistry. He is (co-)promoter of several doctoral dissertations, and (co-) author of numerous publications (225) together with the Leuven BIOMAT Research Cluster. He gives scientific and post-academic courses all over the world.
Prof. Dr. Roeland De Moor
Ghent University, Department of Oral Health Sciences, Section Endodontics, Gent, Belgium
MOND Latem, Endo and Dental Trauma Clinic & Gent Dental Laser Centre, Sint Martens Latem, Belgium
Laser technology has already been introduced in endodontics since the 1990s. The most interesting options with clear scientific background include cleaning and disinfection of the root canal system, the assessment of pulp vitality with Laser Doppler Flowmetry, treatment of dentinal hypersensitivity and laser bleaching of sclerotic teeth without walking bleach. “Wavelength specificity” is the keyword and this will determine how laser light interacts with the target i.e. enamel and dentin, smear layer, debris, biofilm, irrigation solutions and the dental pulp.
During this presentation the laser-target interaction of the different endodontic wavelengths is explained, special attention is given to the topic of laser cleaning and disinfection with a more specific focus on the power of the bubble (laser activated irrigation – LAI). A comparison is also made with the more popular ultrasonically activated irrigation. High speed images are used to explain how fluid agitation is created during LAI.
Short CV
Prof. dr. Roeland De Moor (MSc Paediatric Dentistry & Traumatology) (MSc in Endodontics and Restorative Dentistry) is extra-ordinary full professor at the Ghent University (UGent – Belgium), head of the research cluster of the Section of Endodontics / Department of Oral Health Sciences, and director of the three-year Master after Master programme in Endodontics. As a guest professor he is involved in laser education at the Dental School of the Vienna Medical University, and he is the programme director of the International Master of Clinical Dentistry – Endodontology. His referral based clinical practice (GDLC – Gent Dental Laser Centre / Jurident) is focused on second and third line (paediatric) endodontics, dental traumatology, judicial orofacial damage assessment and dental laser bleaching at MOND Latem in Sint Martens Latem, Belgium.
The research of his group is focussed on root canal cleaning and disinfection a.o. with laser activated irrigation and light activated nanoparticles, the use of lasers and light in endodontics such as Laser Doppler Flowmetry and dental laser bleaching. Research is also conducted in the field of endodontic quality, minimal invasive endodontic techniques, the use of bioactive materials in endodontics and the build-up of root canal treated teeth.
Dr Federico Moreno Sancho
Dr. Moreno received his degree in Dentistry in 2009 from the European University of Madrid, Spain. He then worked as a general dentist in mixed NHS and private practices in the Lancashire region. During this period, he completed a Postgraduate Certificate in Implant Dentistry at the Trafford General Hospital, Manchester. Between 2012 and 2015 he underwent specialist training in Periodontology at the world-renowned UCL Eastman Dental Institute, London. This program is the only program in periodontology in the UK accredited by the European Federation of Periodontology (EFP). After graduating and obtaining the Membership of the Royal College of Surgeons of England, he became a Clinical Lecturer at the Unit of Periodontology, Eastman Dental Institute, besides working as a periodontist in practices in the North West and London. He has a passion for research and he is currently investigating the use of stem cells and other innovative technologies for periodontal regeneration. Under the leadership of Prof Ian Needleman, Dr Moreno was one of the co-authors of one of the systematic reviews that contributed evidence to the discussion in the 2017 World Workshop for the Classification of Periodontal and Peri-implant diseases.
Abstract
Aims
To discuss the relevance in general dental practice of the British Society of Periodontology’s implementation of the periodontal classification system which was developed from the 2017 World Workshop in Periodontology. Dr Moreno will provide a brief introduction to the new classification and the UK implementation. Cases will be presented for the audience to develop an understanding on the process of using the new system to diagnose gingival and periodontal/peri-implant diseases.
Objectives
– Describe how to use the BSP UK implementation of the periodontal classification system in clinical practice.
– To guide the audience to the relevant literature for further reading to gain more in-depth understanding of the new Periodontal Classification system.
– To demonstrate the use of the new UK implementation with the help of clinical cases.
Dr Phil Tomson
Vital Pulp Treatments – Clinical Considerations
Speaker: Dr Phil Tomson BDS, PhD, MFDS RCS(Ed) RCS(Eng), FDS (Rest Dent) RCS(Ed)
Summary:
Dentists are not recognised as pioneers of tissue regeneration but perhaps should be as they have been using tissue regenerative techniques for almost a hundred years. Our biological understanding of healing of the dental pulp is increasing at an exponential rate. Vital pulp therapies offer a minimally invasive approach to the management of pulpal disease preventing the need for more invasive techniques such as root canal therapy, which can advance the tooth along the restorative cycle. Vital pulp treatments are more predictable than dogma may suggest and careful management of the injured or exposed pulp can result in a predictable successful outcome preserving the defence system of the tooth.
Aim:
The aim of this table clinic is to discuss the evidence base for vital pulp treatments and present practical ways in managing the vulnerable, damaged or diseased dental pulp.
Objectives:
• Outline the evidence base for carrying out vital pulp treatments.
• Discuss indications and outcomes for vital pulp treatments.
• Illustrate and demonstrate techniques to manage the exposed pulp.
Dr Phil Tomson BDS, PhD, MFDS RCS(Ed) RCS(Eng), FDS (Rest Dent) RCS(Ed)
Head of Conservative Dentistry and Endodontics
Senior Clinical Lecturer and Honorary Consultant in Restorative Dentistry
School of Dentistry, University of Birmingham, UK
Phil Tomson is a Senior Clinical Lecturer / Honorary Consultant in Restorative Dentistry and Head of Conservative Dentistry & Endodontics at University of Birmingham School of Dentistry. Following full higher speciality clinical training across all disciplines in Restorative Dentistry he received his inter-collegiate fellowship in 2011 and holds specialist registration with the GDC in Endodontics, Restorative Dentistry, Periodontics and Prosthodontics. He is joint service lead for Endodontics with Birmingham Community Healthcare Foundation Trust and committed to delivering this highest quality of treatment standards for his patients.
Phil completed a PhD in 2013 with research focused on regeneration of the dentine-pulp complex in which he won the Wladimir Adlivankine ESE research prize and was one of the first recipients of the FDS research fellowships from RCS Eng. His current research interests lie in tissue regeneration and engineering of the dental pulp, therapeutic methods in irrigating the root canal system and novel methods of assessing root canal disinfection. He currently supervises several PhD and Master’s research students, has numerous articles in peer-reviewed international journals and is sits on the editorial board of the International Endodontic Journal. He leads postgraduate and undergraduate teaching/training programmes in Endodontics at Birmingham Hospital & School and lectures nationally / internationally on subjects related to the clinical management of pulpal and periradicular disease and his research.
Mr Alyn Morgan
Alyn qualified from Leeds Dental Institute in 1995. After initially working in general dental practice he undertook an MSc in Endodontics at the Eastman Dental Institute, which was awarded with Distinction in 2009. He was admitted to the GDC Specialist List in Endodontics in 2013.
He was formerly the Deputy Director of Endodontic CPD at the Eastman and currently combines working in private endodontic referral practice at U Dentistry in Ilkley with his role of Senior Clinical Teaching Fellow at Leeds Dental Institute, where he is Endodontic teaching Lead. He is currently the Honorary Secretary of the British Endodontic Society.
Aims:
Alyn will review the current UK postgraduate training landscape in Endodontics and how this may translate across to career development opportunities. He will share some insights gained in his journey from GDP to Specialist and Senior Clinical Teaching Fellow at Leeds Dental Institute.