Endodontic treatment, which involves the diagnosis, prevention, and treatment of the infected dental pulp or periapical inflammation, presents several challenges. It is very important to know the limits of endodontics and how to deal with these in order to achieve the goals of the endodontic treatment.
The challenges can appear from the diagnostic to the obturation step and are caused by multiple factors like:
– complexity of the root canal system – with supplementary canals, isthmuses and lateral canals. Identifying and treating all the canals is a challenge in the endodontic practice, leading to incomplete cleaning and shaping of the root canal system.
– calcified canals: Calcification of the root canal system can make it challenging to locate the canals and complete the cleaning and shaping procedures.
– severely curved root canals: Extremely curved canals are difficult to access and can lead to the fracture of endodontic instruments. Retrieval of fractured instruments can be challenging and time-consuming and can jeopardize the result of the endodontic treatment.
– obturation is following disinfection and shaping of the root canal space. The cleaned and shaped root canal system is filled with a biocompatible material. Obturation techniques have improved significantly in recent years, but achieving a complete seal of the canal system remains a challenge.
– retreatment can be considered if the failure of the primary treatment occurs. Retreatment of failed cases can be complex, requiring removal of previous root canal fillings, identification of missed canals, and negotiation of complex anatomy.
The lecture will highlight aspects like the use advanced technology such as cone-beam computed tomography (CBCT), dental operating microscopes (DOM), ultrasonic instruments and flexible NiTi instruments to optimize the endodontic treatment in the daily practice.
Dr. Peter Kiefner M.Sc. (Endodontics)
private practice, limited to endodontology and traumatology in Stuttgart/Germany
Doctor of Dental Sciences (Dr. med. dent), Tübingen, Germany
Düsseldorf Dental Academy /Medical School of the Heinrich Heine University Düsseldorf, Master of Science in Endodontology
specialist member of the European Society of Endodontology (ESE)
member of the German Endodjntic Society (DGET) and other endodontic societies (AAE, VDZE, etc)
more than 100 presentations, courses, demonstrations, hands-on courses and supervisions both nationally and internationally
author and co-author of articles in peer-reviewed scientific journals
presentations at international endodontic congresses
guest lecturer in Endodontology at the Department of Restorative Dentistry and Periodontology at the University Würzburg (chair Prof. Dr. G. Krastl)