American Association
of Endodontists
o General Information
o Membership
o Certification
o Major Research and Technology
Changes
o Trends in Education
o Changes in Scope of Practice
American Association
of Endodontists
o Impact of Bisphosphonates
o Improve Magnification and New
Materials
o Referral Patterns
o Principle Health Services
o Changes over the past 10 Years
o Practice 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 educators
o Annual national workshop
General Information
Results of Foundation Support:
o New dental material uses
o More information on supplemental
intraosseous anesthesia
o Growing understanding of microflora
General Information
Results of Foundation Support:
o Improved clinical trials
o Improved systematic reviews
o Increased knowledge regarding
dental pulp
General Information
The Live Learning Center
o Access online endodontic education
materials
o Obtain CE credits
o View previous and upcoming AAE
meetings
General Information
International Association for
Dental Research:
o 2009 Symposium on pulp
biology and regeneration
o2010 Symposium on Tissue
Injury and Pulp Regeneration
Membership
Membership
From 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 Active
o Associate
o Auxiliary
o Educator
o Honorary
o International
o Life
o Predoctoral
Student
o Retired
o Student
New Membership
Categories
o Predoctoral Student
o Educator
o International
All Membership
Categories
Gender Trends
Among Membership
Membership Projections
o 1-2% growth annually
o Members transitioning into Life
and Retired membership
o Increase in number of
International members
AAE Surveys
2003-2009 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 Surveys
2009 results indicated:
o 83% of endodontists provided
charitable care to underserved
populations.
o The average specialist performs 10 or
more charitable procedures per year.
Certification
Certification
American Board of
Endodontics Recent Changes
o 4-year identity requirement eliminated
o 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 eligibility
o Multi-site testing centers
Preliminary Application
Submitted 2006 or After
Step
Part I
Maximum Time
3 years
Part II
6 years
Final Application
1 year
Part III
2 years
Track One for Board
Certification
o Written Examination – Part I
o Case History Portfolio – Part II
o Oral Examination – Part III
Track Two for Board
Certification
o Case History Portfolio – Part I
o Written Examination – Part II
o 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
Recertification
o Candidates who applied for
certification after January 1, 1997
must recertify every 10 years
o Complete 25 Continuing
Education Credits
o Begin 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 Changes
o
o
o
o
o
Dental materials
Pain management
Endodontic microbiology
Clinical research
Regenerative endodontics &
revascularization
o Dental trauma
o Endodontic diagnosis
Dental Materials
o Mineral trioxide aggregate (MTA)
uses:
oRoot end fillings
oPerforation repairs
oApical plugs for open apices
oVital pulp protection
o Dental bonding agents
Pain Management
Future Developments:
o Liposomal-encapsulated
anesthetic agents
o Terminal receptor-potential
vanilloid agonists and antagonists
o Mediators of pupal and periapical
pathosis
Endodontic Microbiology
oBiomechanical debridement
protocols
oBacterial-host interaction
oInfected root canal spaces
oDiverse organism populations
Clinical Research
Research methods:
o Randomized clinical trials
o Systematic reviews of
clinical outcomes
o Evidence-based protocols
Regenerative Endodontics
and Revascularization
Research:
o Pulpal regeneration
o Reprogramming stem cells
Significance:
o Better treatment of children’s teeth
Regeneration/Revascularization
3
w
8m
Law, in Petrino Northwest Dent 86:33, 2007
oPre-op
oTrauma
oCold
oSinus tract
oTreatment
oIrrigation
o5.25% NaOCl
oMedication
oCiprofloxacin
oMetronidazole
oMinocycline
o3 weeks later
oIrrigate with 5.25%
NaOCl and then H2O
oInitiate bleeding
oSeal MTA/Composite
Dental Trauma
Affects 30% of population
Research Benefits:
o Pulp Preservation
o Avulsed teeth
o Pulp necrosis treatment
o Root fracture management
o Intrusive luxations
www.dentaltraumaguide.org
Endodontic Diagnosis
2008 Consensus Conference on
Endodontic Terminology:
o Expert attendees
o Recognition of research needed
o Standardized diagnostic terms
Major Technology
Advances
o Special Instruments
o New ultrasonic instruments
o Modalities and disinfecting
solutions
o Operatory microscope
o Cone-beam volumetric tomography
Impact of
changes/advances
oIncreased predictability
oBetter outcomes
oBetter pain management
oImproved 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
awards
o Educator courses
o Networking opportunities
o Annual Session Educator Track
Changes in
Scope of
Practice
Changes in Scope of
Practice
Major conditions routinely treated:
o Pulpal and Periapical Disease
o Caries
o Dental Trauma
o Periodontal Disease
o Extensive Restorations
o 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
Biosphosphonates
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
o Endodontists use of the
Microscope
oIn 1999 – Increased 52%
oIn 2007 – Increased 90%
o Required 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 Patterns
o 60% of patients have treatment
performed by general dentist
o 19-24% of patients have treatment
performed by endodontists
o 38% of patients receive knowledge of
endodontics from their dentist
Referral Patterns
2005-2007 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 therapy
oIndirect pulp cap
oDirect pulp cap & Pulpotomy
oNonsurgical endodontic treatment
oExpertise in pulp system anatomy
oRecognition of anomalies
Principle Health Services
o Team work in dealing with complex
restorations
o Management of patients with
complicated medical histories
o Endodontic retreatment
o Surgical endodontic treatment: rootend resection
Principle Health Services
o
o
o
o
o
Biopsy
Root resection/amputations
Perforation repair
Intentional replantation
Implant dentistry
Principle Health Services
oPost removal
oApexification/Apexogenesis
oDental trauma management
oIntracoronal bleaching
oRestoration of endodontically
treated teeth
Principle Health Services
oCracked tooth management
oPulp regeneration
oBiocompatible regenerative
materials
oMineral trioxide aggregate
oBioceramics
Changes over
the past 10
Years
Changes over the past
10 years
oPulpal regeneration
oBioceramics
oCone-beam computed
tomography
oOperating microscope
Practice
Settings
Practice Settings
Trends and Changes:
o Private Practice increased 2%
o Solo Private Practice increased 12%
o Private practitioners in a group
practice decreased 10%
Practice Settings
Trends and Changes:
oMultidisciplinary practices
increased 1%
oOther practice settings
increased 2%
Practice Settings
o Vacancies in dental
school endodontic
positions decreased 5%
o 248 full-time
endodontic educators
o 415 part-time
educators compensated
o 347 part-time
volunteers
o 4,600 active
practicing
endodontists in U.S.
o 200 in federal dental
health services
o 250 full-time
educators
o 4,150 in private
practices
o 800 part-time private
practitioners
The AAE Works for YOU!