American Association of Endodontists
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Transcript of American Association of Endodontists
American Association of Endodontists
oGeneral InformationoMembershipoCertificationoMajor Research and Technology
ChangesoTrends in EducationoChanges in Scope of Practice
American Association of Endodontists
oImpact of Bisphosphonateso Improve Magnification and New
MaterialsoReferral PatternsoPrinciple Health ServicesoChanges over the past 10 YearsoPractice Settings
General Information
General Information The AAE Foundation:o Funded $2.6 million in research grants
o $1.2 million in endodontic educator fellowships
o 11 new endodontic educatorso Annual national workshop
General InformationResults of Foundation Support:oNew dental material usesoMore information on supplemental
intraosseous anesthesiaoGrowing understanding of
microflora
General InformationResults of Foundation Support:oImproved clinical trialso Improved systematic reviewsoIncreased knowledge regarding
dental pulp
General InformationThe Live Learning Center
o Access online endodontic education materials
o Obtain CE creditso View previous and upcoming AAE meetings
General InformationInternational Association for Dental Research:o 2009 Symposium on pulp biology and regeneration
o2010 Symposium on Tissue Injury and Pulp Regeneration
Membership
MembershipFrom 2000-2009:o Active Membership increased by more than
15%
o Auxiliary Membership increased by more than 500%
o Total Membership increased by 35%
o The AAE currently has over 7000 members
Membership Categories
o Activeo Associateo Auxiliaryo Educatoro Honorary
o Internationalo Lifeo Predoctoral Studento Retiredo Student
New Membership Categories
o Predoctoral Studento Educatoro International
All Membership Categories
Gender Trends Among Membership
Membership Projectionso1-2% growth annually
oMembers transitioning into Life and Retired membership
oIncrease in number of International members
AAE Surveys2003-2009 results indicated:
o 80% of people who receive root canal treatment by a specialist would return to one
o 94% of general dentist have positive perceptions of endodontists
o 9 out of 10 general dentists partner with endodontists
Membership Surveys2009 results indicated:
o83% of endodontists provided charitable care to underserved populations.
oThe average specialist performs 10 or more charitable procedures per year.
Certification
Certification
American Board of Endodontics Recent
Changeso 4-year identity requirement eliminatedo Resident/graduate students allowed to
sit for written exam in last year of program
o Track II allows clinicians to submit case portfolio before taking written exam
o Extension of eligibilityo Multi-site testing centers
Preliminary Application Submitted 2006 or After
Step Maximum Time
Part I 3 years
Part II 6 years
Final Application 1 year
Part III 2 years
Track One for Board Certification
o Written Examination – Part Io Case History Portfolio – Part
IIo Oral Examination – Part III
Track Two for Board Certification
o Case History Portfolio – Part Io Written Examination – Part IIo Oral Examination – Part III
Active Diplomates
Endodontic Board Certification Data
CDEL’s Annual Reports of ADA-Recognized Dental Specialty Certifying Boards, 2000-2008
Future Changes in Board Certification
o Online Submission of case portfolios
o Distance technology to conduct oral exams
RecertificationoCandidates who applied for
certification after January 1, 1997 must recertify every 10 years
oComplete 25 Continuing Education Credits
oBegin 3 years before expiration date
Significance of Board Certification
Board Certified Endodontists demonstrate a high level of
accomplishment and commitment to art and science
of current clinical practice.
Major Research and Technology
Changes
Major Research Changeso Dental materialso Pain managemento Endodontic microbiologyo Clinical researcho Regenerative endodontics &
revascularizationo Dental traumao Endodontic diagnosis
Dental MaterialsoMineral trioxide aggregate
(MTA) uses:oRoot end fillingsoPerforation repairsoApical plugs for open apicesoVital pulp protection
oDental bonding agents
Pain ManagementFuture Developments:oLiposomal-encapsulated
anesthetic agentsoTerminal receptor-potential
vanilloid agonists and antagonists
oMediators of pupal and periapical pathosis
Endodontic Microbiology
oBiomechanical debridement protocols
oBacterial-host interactionoInfected root canal spacesoDiverse organism populations
Clinical ResearchResearch methods:o Randomized clinical trialso Systematic reviews of clinical outcomes
o Evidence-based protocols
Regenerative Endodontics and Revascularization
Research:oPulpal regenerationoReprogramming stem cells
Significance:oBetter treatment of children’s
teeth
Regeneration/Revascularization
3 w
8 m
Law, in Petrino Northwest Dent 86:33, 2007
oPre-opoTraumaoColdoSinus tract
oTreatmentoIrrigation
o5.25% NaOCloMedication
oCiprofloxacinoMetronidazoleoMinocycline
o3 weeks lateroIrrigate with 5.25% NaOCl and then H2OoInitiate bleedingoSeal MTA/Composite
Dental TraumaAffects 30% of population
Research Benefits:o Pulp Preservationo Avulsed teetho Pulp necrosis treatmento Root fracture managemento Intrusive luxations
www.dentaltraumaguide.org
Endodontic Diagnosis
2008 Consensus Conference on Endodontic Terminology:
oExpert attendeesoRecognition of research neededoStandardized diagnostic terms
Major Technology Advances
o Special Instrumentso New ultrasonic instrumentso Modalities and disinfecting
solutionso Operatory microscopeo Cone-beam volumetric tomography
Impact of changes/advances
oIncreased predictabilityoBetter outcomesoBetter pain managementoImproved dental injury understanding
oEnhanced treatment options
Trends in Education
Endodontic Programs and Enrollment
Endodontic Program Directors
Increasing Full Time Board Certified Faculty
Initiatives:o AAE Foundation grants and
awardso Educator courseso Networking opportunitieso Annual Session Educator Track
Changes in Scope of Practice
Changes in Scope of Practice
Major conditions routinely treated:
o Pulpal and Periapical Diseaseo Carieso Dental Traumao Periodontal Diseaseo Extensive Restorationso Tooth Fractures or Host Factors
Changes in Scope of Practice
‘Patients with multiple systemic diseases including diabetes experienced decreased retention of endodontically treated teeth and increased need for retreatment by endodontists.’
Mindiola MJ, Mickel AK, Sami C, Jones JJ, Lalumandier JA, Nelson SS. Endodontic treatment in an American Indian population: a 10-year retrospective study. J Endod 2006; 32: 828-32.
Changes in Scope of Practice
‘97% of endodontically treated teeth (nearly 1.5 million teeth) were retained in the oral cavity eight years after initial treatment.’
Salehrabi R, Rotstein I. Endodontic treatment outcomes in a large patient population in the USA: an epidemiological study. J Endod 2004; 30: 846-50.
Impact of Biosphosphonate
s
Impact of Bisphosphonates
‘Bisphosphonates, associated with osteonecrosis of the jaws (ONJ),
has significant medical and dental implications.’
Carter G, Goss AN, Doecke C. Bisphosphonates and avascular necrosis of the jaw: A possible association. Med J Aust 2005; 182: 413-15.
Impact of Bisphosphonates
‘Pathogenesis of ONJ is related to
the profound inhibition of oseoclast function brought on by the Bisphosphonates’
Ruggiebo SL, Drew SJ. Osteonecrosis of the jaws and bisphosphonate therapy. J Dent Res 2007; 86: 1013-1021
Improved Magnification
and New Materials
Increased use of Magnification
oEndodontists use of the MicroscopeoIn 1999 – Increased 52% oIn 2007 – Increased 90%
oRequired by CODA in Endodontic Residency Standards
Implant Dentistry & Endodontics
‘6.6% of Endodontists are placing implants’
Creasy J, Mines P, Sweet M. Surgical Trends among Endodontists: The Results of a Web-based Survey, DDS; 35: 30-34.
Referral Patterns
Referral Patternso60% of patients have treatment
performed by general dentisto19-24% of patients have
treatment performed by endodontists
o38% of patients receive knowledge of endodontics from their dentist
Referral Patterns2005-2007 surveys of general
dentist:o42% report doing all 8% of the root canal procedures in their office
o22% refer most 20% or all 8% of the cases to specialist
o94% consulted with an endodontist over the past 12 months
o68% believe referral to endodontists makes good business sense
Referral Patterns
Principle Health
Services
Principle Health Services
oVital pulp therapyoIndirect pulp capoDirect pulp cap & PulpotomyoNonsurgical endodontic treatmentoExpertise in pulp system anatomyoRecognition of anomalies
Principle Health Services
oTeam work in dealing with complex restorations
oManagement of patients with complicated medical histories
oEndodontic retreatmentoSurgical endodontic treatment:
root-end resection
Principle Health Services
o Biopsyo Root
resection/amputationso Perforation repairo Intentional replantationo Implant dentistry
Principle Health Services
oPost removaloApexification/ApexogenesisoDental trauma managementoIntracoronal bleachingoRestoration of
endodontically treated teeth
Principle Health Services
oCracked tooth managementoPulp regenerationoBiocompatible regenerative materials
oMineral trioxide aggregateoBioceramics
Changes over the past 10
Years
Changes over the past 10 years
oPulpal regenerationoBioceramicsoCone-beam computed tomography
oOperating microscope
Practice Settings
Practice SettingsTrends and Changes:oPrivate Practice increased 2%oSolo Private Practice increased
12%oPrivate practitioners in a
group practice decreased 10%
Practice Settings
Trends and Changes:oMultidisciplinary practices increased 1%
oOther practice settings increased 2%
Practice Settingso Vacancies in dental school endodontic positions decreased 5%o 248 full-time endodontic educatorso 415 part-time educators compensatedo 347 part-time volunteers
o 4,600 active practicing endodontists in U.S.o 200 in federal dental health serviceso 250 full-time educators o 4,150 in private practiceso 800 part-time private practitioners
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