Prof. Paul Abbott is the Winthrop Professor of Clinical Dentistry at The University of Western Australia. He is a Specialist Endodontist and works in private practice on a part-time basis. Prior to taking a full-time University position in 2002, he spent 17 years in private specialist endodontic practice in Perth and Melbourne. During this time, he also held part-time academic positions at The University of Western Australia and the University of Melbourne. He was the Dean of the School of Dentistry at The University of Western Australia and Director of the Oral Health Centre of WA from 2003-2009. He has presented over 850 lectures and courses in 45 countries (many countries on numerous occasions). He has published over 205 articles in refereed journals, 24 textbook chapters and 47 Newsletter articles. Since 2015, he has been the Editor-in-Chief of the international journal Dental Traumatology. He has received numerous awards for excellence in teaching and for service to the dental profession, particularly in education and research. In 2015, the Governor-General of Australia appointed Prof. Abbott as an Officer of the Order of Australia (AO) for “distinguished service to clinical dentistry, and to higher education, as an academic, researcher and author, to endodontics as a practitioner, and to professional organisations.”
LECTURE 1:
There are cracks … and there are cracks – but what is a crack and what do I do about a crack?
“Cracked teeth” is one of the most widely debated and disputed topics in dentistry. It is also one of the most misunderstood topics in dentistry. The confusion and misunderstandings stem largely from early work on cracks and the lack of a good definition of a crack in a tooth. Many dentists are confused about cracks and fractures, and they use these terms interchangeably even though they represent different problems in the tooth. The confusion and misunderstanding also stem from the traditional approach to dealing with cracks in teeth which has largely been a mechanical approach. Whilst cracks do represent a weakness in the tooth structure, they are also a pathway for bacteria to enter the tooth and cause pulp disease. The symptoms associated with cracks in teeth come from the pulp and therefore it is essential to diagnose the pulp status and then to manage the bacterial aspect of cracks rather than just dealing with them as a mechanical problem. This lecture will define cracks, explore the effects of cracks on teeth and provide guidelines for the diagnosis and management of teeth with cracks – especially teeth that have reversible pulpitis, which can be managed conservatively.
Learning Objectives:
On conclusion of the lecture, participants will be able to:
· Define cracks and fractures and differentiate between them
· Understand that cracks are an aetiology of various diseases, and not a disease or a syndrome
· Outline the consequences of cracks in teeth
· Discuss the progression of the pulp and peri-radicular conditions caused by cracks
· Outline how to diagnose and assess cracks in teeth
· Manage teeth with reversible pulpitis in a conservative manner
LECTURE 2:
Dilemmas in Case Selection - Which Teeth Should be Endodontically Treated?
It is important to assess the prognosis of every tooth prior to commencing root canal treatment. The prognosis is an evolving thing that can – and should - change over time and with treatment. Prognosis includes two major aspects – the outcome of the treatment and the longevity of the tooth following treatment. The outcome of root canal treatment has been extensively researched and there are several factors that can be used to predict whether healing will occur following treatment. However, most studies have ignored the longevity of the tooth – that is, how long after endodontic treatment will the tooth remain in the mouth in a healthy and functional state. This will be largely dependent on how much tooth structure remains as this determines how well the tooth can be restored and how long the restoration will last. This can only be assessed by examining the remaining tooth structure once the existing restorations, caries and cracks have been removed. Such an approach has been termed “Tooth Investigation” and it allows much better case selection with the ultimate benefits of only treating teeth that have a good prognosis – that is, teeth that are likely to heal and that will remain in the mouth for a long time. This lecture will outline the studies performed by the Lecturer’s group and will show how you can improve your case selection prior to root canal treatment.
Learning Objectives:
On conclusion of the lecture, participants will be able to:
· Define prognosis and its two components
· Outline the deficiencies and problems of most endodontic treatment outcome studies
· Discuss the factors that affect the outcomes of endodontic treatment
· Discuss the factors that affect the longevity of endodontically-treated teeth
· Explain the concept and importance of “tooth investigation”
· Outline how to assess the prognosis of a tooth prior to, and during, endodontic treatment