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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