Final programme for Clinical Endodontics Symposium in Dubai / From mentorship to mastery: Prof. Damiano Pasqualini on advancing endodontics / Increasing success in autotransplanted third molars through digital planning
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DTMEA_No.5. Vol.15_ET.indd
PUBLISHED IN DUBAI
www.dental-tribune.me
Vol. 14, No. 5
Final programme for Clinical
Endodontics Symposium in Dubai
By CAPP Events & Training
The Clinical Endodontics Symposium (CES) will make its debut as a
focused event within the CAD/CAM
Digital & Oral Facial Aesthetics 37th
Int’l Dental ConfEx on 15-16 November 2024 at the prestigious Madinat
Jumeirah Arena & Conference Center in Dubai. This event promises an
in-depth look at the latest advancements in endodontics, gathering
leading experts, researchers, and
practitioners to share cutting-edge
techniques and innovations.
Attendees can expect a comprehensive programme covering
essential topics, from modern root
canal treatments and advanced diagnostic tools to the integration of
digital technology in endodontic
procedures. Highlights include
presentations from renowned
speakers such as:
Prof. Federico Foschi, UK – Overview of advancements in modern
endodontics.
Dr. Antonis Chaniotis, Greece –
Techniques for managing complex
root canal systems.
Prof. Gianluca Gambarini, Italy –
Streamlining procedures to improve treatment quality.
Prof. Damiano Pasqualini, Italy –
Success in modern surgical microendodontics.
Dr. Mohamad Zaafrany, Egypt –
Guide to managing separated files.
Prof. James Prichard, UK – Management of curved canals with heattreated alloys.
Dr. Muhannad Takruri, Jordan –
Best practices for endo ledge management.
The symposium also includes
hands-on courses led by Dr. Chaniotis
and Prof. Pasqualini, offering practical training in managing root
canal blockage, apical periodontitis, and surgical microendodontics.
CES 2024 is an unparalleled opportunity for dental professionals
to gain expertise, network with
peers, and stay at the forefront of
endodontic innovation. Mark your
calendar for 15-16 November 2024,
and join us in Dubai for this landmark event in endodontics.
For more information on the
event, visit www.cappmea.com
AD
THE
RACE
ACE
LEGACY
SAFE. EFFICIENT. SOFT CONTROL.
www.fkg.ch/race-evo
[2] =>
DTMEA_No.5. Vol.15_ET.indd
INTERVIEW
02
Endo Tribune Middle East & Africa Edition | 05/2024
From mentorship to mastery:
Prof. Damiano Pasqualini on
advancing endodontics
By Dental Tribune MEA
All instruments are made with
XTS technology, a dark Aluminium
Titanium Nitride coating that does
not shine under the light of the
magnification device, dazzling the
operator like traditional instruments. It also offers a very nice contrast with surrounding soft and
hard tissue and materials during
surgery. These instruments allow
the operator to perform the surgery with simplicity and without
stress, increasing the confidence
and results of the clinician and the
satisfaction of the patient.
As anticipation builds for the
upcoming CAD/CAM & Digital
Dentistry & Facial Aesthetic Conference 2024 in Dubai on 15-16 November, let's take a moment to
shine a spotlight on one of the esteemed speakers. Prof. Damiano
Pasqualini, a leading expert in endodontics and an Associate Professor at the University of Turin, will
share his extensive knowledge in
modern surgical MicroEndodontics. Prof. Pasqualini's innovative
approaches have significantly advanced the field, and his lecture
promises to be a highlight of the
event.
Prof. Pasqualini, as a leading
expert in endodontics, many clinicians admire your innovative
techniques and insights. What
experiences have most shaped
your approach and success in
this field?
I think every successful path
starts with a mentor who inspires
you, guides you and passes on their
passion and skills to you. For me he
was Prof. Berutti, a dear friend and
skilled endodontist, a pioneer in
Italy and in the world of minimally
invasive and micro-surgical endodontics. Subsequently, my constant passion for updating and my
enthusiasm in embracing new
technologies have led me to this
point. New biomaterials and the
digital world have also offered microsurgical endodontics unexpected opportunities until a few
years ago: guided, static and dynamic techniques, virtual and augmented reality to facilitate the
learning curve of young operators,
artificial intelligence as a diagnostic
aid and decision making are just
some exciting examples of the evolution in this field.
What inspired you to focus
on the field of surgical Micro
Endodontics, and how have you
seen it evolve over the years?
My career in clinical and university began 25 years ago in the Oral
Surgery division, but since the beginning I have always been fascinated by the elegance of the search
for precision and detail of Endodontics. It was a natural evolution
to move and grow in the Endodontics Division and combine surgical
and endodontic skills through the
binoculars of an operating microscope. Enthusiasm for microsurgical endodontics has grown with intervention, appreciating its low invasiveness, improved quality of life
Prof. Damiano Pasqualini, a leading expert in endodontics and an Associate Professor at the University of Turin.
(Image: Prof. Damiano Pasqualini)
and high long-term success rates.
For many years it seemed that the
specialty was always the same, that
it did not offer interesting novelties
and that it could not counter the
overwhelming power of implant
marketing, in short, that it was destined to disappear. In fact, in recent
years there has been an exciting return of interest all over the world,
with an exponential spread of
courses, conferences, workshops
and hands-on. I think this is partly
due to recent guided and imaging
technologies, but above all because the costs of managing medium-term implant failures have
pushed clinicians, insurance companies, and scientific societies to
enormously re-evaluate the importance of preserving an individual's
natural
dentition,
including
through advanced techniques such
as modern surgical endodontics.
What motivates you to share
your knowledge and insights in
dentistry?
I was born as a private practicioner and later I embraced the
university world. Currently, twothirds of my day is spent in university with the triple mission of research, teaching and clinic of complex endodontic cases and patients
with special needs. I purposely
maintain a private clinical practice
to preserve the connection to the
real world of everyday clinical activity like most of my colleagues.
However, the teaching activity,
both in the under-graduate and
post-graduate programs, is for me
a human and professional satisfaction and a continuous stimulus to
improve that I would not give up
for anything in the world.
Your upcoming lecture at the
CAD/CAM & Digital Dentistry &
Oral Facial Aesthetic Conference
2024 will delve into modern surgical MicroEndodontics. How do
you see conferences like this one
contributing to the advancement of dental techniques?
It is an honor to be invited as a
speaker at one of the most popular
events in the world. The program
and the network created by CAPP
go well beyond the days of this important event full of lectures, workshops, in-person and virtual meetings, important social media activities, they positively influence the
progress of dental specialties and
have an important impact on the
entire community
Could you discuss the innovative microsurgical instruments
featured in your lecture and how
they enhance the performance
and outcomes for both clinicians
and patients?
In my lecture and hands on
workshop the microsurgical endodontic EasyEndo Black kit will be
presented and discussed. It is an
original set of instruments inspired
to simplicity and clinical comfort,
designed by Elio Berutti and myself
in collaboration with HuFriedyGroup. Each instrument combines
simple shapes that any clinician
feels confident in and precise indications for use. One instrument for
every single step of the complete
procedure to achieve a predictable
successful outcome with no stress.
How do you envision the role
of advanced technology evolving in the near future, and what
impact do you anticipate these
advancements will have on patient care?
Microsurgical endodontics is
for sure one of the specialties that
in recent years has benefited from
the most advanced technology,
such as 3D imaging, digital planning and guided surgery of complex cases, but the real strength of
the specialty is the solidity of the
scientific data, of the biological and
surgical principles on which it is
based. Preclinical and clinical training must certainly be strengthened
to allow more and more operators
to successfully embrace these natural tooth preservation techniques.
What advice would you give
to clinicians who are new to MicroEndodontics and looking to
incorporate these techniques
into their practice?
Microsurgical endodontics is
by no means reserved for a few talented clinicians. With basic surgical
training, appropriate specific training and the correct equipment, everyone can perform a successful
and satisfying surgery for the clinician and patients. If you improvise,
the result will be bad and the stress
will be maximum, so you will abandon the procedure and label it as
too complex. Like any surgical discipline, training is crucial, as well as
the equipment must be adequate
and efficient, but it is also necessary to have the patience to follow
a physiological learning curve by
selecting simple clinical cases initially and then over time of increasing difficulty.
Thank you
[3] =>
DTMEA_No.5. Vol.15_ET.indd
CLINICAL CASE
A2
Endo Tribune Middle East & Africa Edition | 05/2024
Increasing success in
autotransplanted third molars
through digital planning
A two-year follow-up case report
By Dr Johnny Onori, Spain
Introduction
Autotransplantation involves
relocating a patient’s own tooth,
whether fully erupted, partially
erupted or not yet erupted, from
one location to another in the patient’s mouth. This procedure has
garnered significant clinical interest, emerging as a viable therapeutic alternative to dental implants
for tooth replacement. Traditionally, autotransplantation studies
have focused on immature teeth,
limiting its applicability to younger
patients. However, recent research
indicates its potential as a treatment for mature teeth as well.1
Advancements in cell biology
and technique have propelled its
popularity, allowing for greater
precision in treatment. One of the
key advantages of autotransplantation today is the integration of
technologies that enhance precision in tooth relocation. This advancement positions it as a compelling option, even considered by
some as the treatment of choice in
the case of irreparable teeth. With
the assistance of technology such
as CBCT and intra-oral scanning,
dentists can perform autotransplantation with higher predictability than ever before. This underscores its efficacy as a solution for
tooth replacement, as endorsed by
the European Society of Endodontology in its latest statement on
this topic in 2022. 2
When considering autotransplantation, several conditions must
be met to ensure its success. With
digital planning, we can create a
bio-replica of the tooth intended
for transplantation. This allows us
to prepare the recipient socket by
slightly enlarging it, reducing pressure and minimising mechanical
damage to the future donor tooth.
It is crucial to avoid injuring the
periodontal ligament during this
process, as it plays a vital role in the
integration of the transplanted
tooth into the socket. 3
Extra-oral time should not exceed 15 minutes, in order to prevent hypoxia-induced cell damage,
which can lead to inflammatory
root resorption. Additionally, the
transplanted tooth should be kept
out of occlusal contact to prevent
interference with periodontal healing. The success of donor tooth reattachment relies on preventing
bacterial invasion of the clot between the root and socket. In some
cases, flap refinement and suturing
may be necessary before tooth in-
sertion. Using a semi-flexible splint
can stabilise the donor tooth and
allow for physiological movement
under occlusal loading.4–6
Equally important is root canal
treatment. Utilising advanced technology and biologically compatible
materials, such as the new generation of bioceramics like CeraSeal
sealer and CeraPutty (both Meta
Biomed), ensures optimal outcomes. These materials not only
seal the apex of the tooth, but also
prevent infection spreading from
the periapical area, reducing the
risk of inflammatory root resorption and treatment failure.7 Root
canal treatment is a critical factor in
achieving long-term success, underscoring the importance of prudent material selection.
The success of dental autotransplantation hinges on meticulous case and patient selection.
This case report aims to elucidate
how digital planning, employing
CBCT and intra-oral scanning, can
enhance the success of autotransplantation and how utilising a
3D-printed bio-replica aids in recipient bed preparation, reducing
the risk of periodontal ligament injury, thereby boosting success and
minimising extra-oral time.
1
Fig. 1: Panoramic radiograph taken before the treatment.
2a
2b
2c
Figs. 2a–c: 3D reconstruction of the STL file (a). Coronal section of the CBCT scan showing the extent of the carious lesion
(b). Coronal section of the CBCT scan showing the extent of the carious lesion with measurements (c).
3a
3b
4
Figs. 3a & b: Intra-oral scans. Teeth in occlusion (a). Mandibular arch (b). Fig. 4: 3D-printed bio-replica of the tooth.
Case report
A 39-year-old male patient with
no contributing medical history
presented to the dental practice
with complaints of pain and tenderness in tooth #47. Clinical and
radiographic examination revealed
a significant subgingival distal carious lesion near the nerve, attributed to the adjacent third molar
(Fig. 1).
After discussion with the patient, it was determined that tooth
#47 could not be retained and re-
quired extraction. However, there
was a possibility of preserving an
appropriate donor tooth—the
mandibular right third molar—to
replace the second molar. To enhance the success of this procedure, digital planning was deemed
necessary (Figs. 2a–3b). Upon explanation of the treatment plan, the
patient consented to the proposed
treatment.
This case report outlines a
methodology for digital planning,
utilising advanced technologies,
including the Helios 600 intra-oral
scanner (Eighteeth) and Hyperion
CBCT unit (MyRay). These tools enabled the creation of a 3D-printed
bio-replica (Fig. 4), facilitating precise visualisation and planning of
subsequent procedures.
The treatment involved the extraction of the non-restorable
tooth within five minutes, during
which the fit of the 3D-printed bioreplica was meticulously assessed
and adjusted as needed. After extraction, autotransplantation was
performed, carefully ensuring that
the transplanted tooth was out of
occlusion (Figs. 5a–6b). A semiflexible splint INTERLIG, Angelus)
was then placed for two to five
weeks to provide the necessary
support and stabilisation.
After splint removal, the focus
shifted to the final phase of treatment. Endodontic procedures were
conducted meticulously on the
► Page A3
[4] =>
DTMEA_No.5. Vol.15_ET.indd
CLINICAL CASE
A3
Endo Tribune Middle East & Africa Edition | 05/2024
◄ Page A2
transplanted tooth to ensure its
long-term viability and functionality within the oral cavity. An overlay,
planned digitally, was placed to further support its structural integrity
(Figs. 7a & b).
This comprehensive approach
underscores the integration of advanced digital technologies in dental procedures. It highlights the importance of precise planning and
execution for successful outcomes
in complex dental interventions
(Figs. 8a–13).
Conclusion
Autotransplantation of third
molars offers a reliable treatment
option for replacing lost teeth. It
stimulates bone formation at the
transplanted site, maintaining masticatory function and reducing financial costs for patients by avoiding the need for implants. It is crucial to recognise that the integrity
of the periodontal ligament stem
cells is a significant prognostic factor in this treatment. Gentle and atraumatic extraction of the donor
tooth enhances success.
6a
5a
5b
5c
5d
5e
Figs. 5a–e: Surgical procedure step-by-step.
6b
7a
7b
Figs. 6a & b: Periapical radiography after surgery (a). Periapical radiography 20 days after surgery and after root canal treatment (b). Figs. 7a & b: Overlay before (a) and after placement in the patient’s mouth (b).
8a
8b
Figs. 8a & b: Intra-oral scans. Before (a) and after treatment (b).
11
12
9
10
Fig. 9: Sagittal section of the CBCT scan seven
months after treatment.
Fig. 10: Periapical radiograph at seven months
showing almost complete healing and no signs of
inflammation.
13
Fig. 11: Panoramic radiograph taken two years after treatment. Fig. 12: Periapical radiograph taken two years after treatment. Fig. 13: 3D reconstruction of the STL file two
years after treatment.
After preparing the recipient
socket to approximate size, the fit
of the donor tooth replica is confirmed using radiographic imaging.
Success is also influenced by factors such as root canal treatment,
semi-flexible splint placement and
occlusal restoration. The synergy of
these components is vital for the
success of the autotransplanted
tooth.
Editorial note: This article was first
published in roots international mag-
azine of endodontics, Vol. 20, Issue
1/2024.
Please scan this QR code for the
list of references.
Dr Johnny
Onori graduated from the
Universidad Central de Venezuela in
Caracas in Venezuela. He undertook studies in endodontics at the
International University of Catalonia
in Barcelona in Spain and, more
recently, completed the international endodontic programme at the
University at Buffalo in New York in
the US. He is an endodontist with the
Red Cross of Venezuela. Dr Onori is a
member of the American Association
of Endodontists, European Society
of Endodontology and Asociación
Española de Endodoncia (Spanish
endodontic society).
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/ From mentorship to mastery: Prof. Damiano Pasqualini on advancing endodontics
/ Increasing success in autotransplanted third molars through digital planning
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