Dr Satnam Singh Virdee

Let us think about endodontics differently: The treatment of apical periodontitis

Description & Aims:  The goal of endodontic therapy in teeth with apical periodontitis is to reinstate the original architecture and biological functions of the injured periradicular tissues. Whilst conventional chemomechanical debridement protocols create the endodontic micro-environment necessary to initiate periradicular wound healing, it provides no further stimulus for endogenous regenerative processes thereafter. Persistent periapical lesions may therefore not only represent the presence of a residual intra- or extra-radicular endodontic biofilm, but also an inadequate capacity to simulate physiological regeneration within injured periapical tissues. This could be one explanation for why success rates decrease in larger lesions despite the considerable advances in disinfection armamentarium. To improve success rates in non-vital infected teeth, it may thus be necessary to adopt more biologically driven approaches that not only manage the endodontic microbial load, but also directly stimulate the host response. A recently discovered niche of mesenchymal stem cells within periradicular lesions themselves offer the ideal therapeutic target for such approaches. The following presentation thus presents a body of work that aims to explore one such approach of exploiting the bioactive properties of endogenous dentine extracellular cellular matrix proteins, which have been utilised in vital pulp therapies, to upregulate the regenerative responses of periapical lesion-derived mesenchymal stem cells during root canal treatment of mature permanent teeth diagnosed with apical periodontitis.  

 Dr. Satnam Singh Virdee

BDS, MFDS (RCSEd), PGCert (Dent Ed), FHEA, MEndo (RCSEng), PhD

"Dr. Satnam Singh Virdee is a Clinical Lecturer & Honorary Speciality Registrar in Restorative Dentistry at the Birmingham Dental Hospital and School of Dentistry. He is enrolled on an integrated clinical academic training programme where he has completed his PhD in Regenerative Endodontics and is currently undergoing specialty clinical training in Restorative Dentistry. To date, Satnam has completed his Membership in Endodontics (MEndo) examination with the Royal College of Surgeons of England, widely publishes in high-impact peer-reviewed journals, regularly presents his research at national and international conferences, is the recipient of 14 clinical-academic awards and serves as the Honorary Assistant Secretary to the British Endodontic Society. In addition to this, he is also referred to complex endodontic and tooth wear cases by his colleagues as a part-time practitioner at several specialist practices across the West Midlands."