Clinical Endodontics I: Diagnosis, Instrumentation and Treatment

The aim of this seminar is to introduce residents to the structure, learning outcomes, assessment strategy, and requirements of the Endodontic Residency Programme, as well as to the development of Endodontics and its role in contemporary dentistry.

The seminar provides an overview of the historical development of Endodontics, the role of the European Society of Endodontology (ESE) and the American Association of Endodontists (AAE) in the development of the specialty, the establishment of clinical guidelines and educational standards, and the principles of evidence-based endodontics. Residents are introduced to the structure of the residency programme, clinical and academic requirements, assessment methods, maintenance of the clinical logbook and portfolio, principles of professional ethics and quality assurance, and opportunities for lifelong learning, research, and professional development.

The resident acquires knowledge of the operating microscope, including its optical principles, ergonomic use and application in endodontic diagnosis and treatment. Magnification and illumination are selected according to different clinical situations to optimise visualisation of the operative field. The resident applies the operating microscope during access cavity preparation, root canal localisation, instrumentation, obturation and the management of procedural complications, while also utilising its documentation capabilities. The role of the operating microscope in improving treatment quality and supporting evidence-based endodontic practice is critically analysed.

The resident acquires effective communication skills in endodontic practice, establishing a professional relationship with patients throughout the diagnostic, treatment and follow-up phases. The resident develops the ability to explain diagnoses, treatment options, potential risks, prognosis and alternative treatment approaches, ensuring informed consent. The seminar also addresses communication with patients experiencing acute pain, dental anxiety and complex clinical situations, as well as strategies for improving patient adherence to the treatment plan and long-term follow-up.

The resident acquires knowledge of the principles of diagnosis and management of endodontic emergencies. The seminar covers the differential diagnosis of symptomatic irreversible pulpitis, symptomatic apical periodontitis, acute apical abscess and other acute endodontic conditions, together with treatment algorithms, principles of pain management, indications for pharmacological therapy and antibiotic use, and the prevention of complications. The resident develops clinical decision-making skills in the management of endodontic emergencies based on current scientific evidence and international clinical guidelines.

The aim of this seminar is to provide residents with an advanced understanding of caries diagnosis, caries risk assessment, and the role of vital pulp therapy in contemporary minimally invasive and evidence-based dentistry. The seminar covers the aetiology of dental caries, diagnostic methods, caries risk assessment, and treatment planning for deep carious lesions and pulp exposure. Residents gain knowledge of the biological rationale, indications, contraindications, treatment modalities, and the use of bioactive materials in vital pulp therapy, as well as current international guidelines and scientific evidence supporting the preservation of pulp vitality.

The resident acquires knowledge of the principles of diagnosing pulp and periapical diseases based on clinical, radiographic and functional examinations. The classification and diagnostic criteria for pulp and periapical diseases are analysed in accordance with internationally recognised professional recommendations and clinical guidelines. The resident evaluates the patient's medical and dental history, clinical signs and symptoms, and diagnostic findings, performs pulp sensibility and vitality testing, percussion, palpation, periodontal probing and mobility assessment, formulates a diagnosis and develops an appropriate treatment plan.

The resident acquires knowledge of the principles of diagnosis and differential diagnosis of orofacial pain by evaluating pain of odontogenic and non-odontogenic origin. The resident analyses the patient's medical and dental history, the characteristics of pain, clinical signs and diagnostic findings to differentiate pulp and periapical diseases from disorders affecting other orofacial structures. The indications for additional diagnostic investigations and referral to other healthcare professionals are evaluated, enabling the resident to establish an accurate diagnosis and develop an appropriate treatment plan.

The resident acquires knowledge of the role of intraoral periapical and panoramic radiography in Endodontics, including their indications, advantages and limitations. The resident evaluates the appropriate use of radiographic imaging modalities according to the clinical situation and interprets radiographic findings in the diagnosis of pulp and periapical diseases, treatment planning and assessment of treatment outcomes. Radiation protection principles, image quality criteria and common interpretation errors are also discussed.

The resident acquires knowledge of the use of cone beam computed tomography (CBCT) in Endodontics by evaluating its indications, diagnostic accuracy and limitations. The resident analyses CBCT images in the assessment of pulp and periapical diseases, root canal system anatomy, treatment complications and treatment outcomes. Radiographic findings are interpreted in accordance with radiation protection principles, and the appropriate use of CBCT is determined according to the clinical situation and current international clinical guidelines.

The resident acquires knowledge of the principles and role of rubber dam isolation in endodontic treatment, ensuring asepsis, control of microbial contamination and patient safety. The indications and contraindications for rubber dam isolation are evaluated, and the most appropriate isolation technique is selected for different clinical situations, including single-tooth isolation, multiple-tooth isolation, the split-dam technique, inversion techniques and isolation of extensively damaged teeth. The resident also selects appropriate clamps, frames and auxiliary isolation materials. The most common errors in rubber dam isolation, strategies for their prevention and the importance of operative field isolation for ensuring treatment quality and long-term prognosis are critically analysed.

The resident acquires knowledge of the principles of access cavity preparation in Endodontics by evaluating the indications, advantages and limitations of traditional and minimally invasive approaches. The role of tooth anatomy, pulp chamber morphology and root canal system anatomy in access cavity design is analysed. The resident selects the most appropriate access cavity design according to tooth anatomy and the clinical situation, ensuring root canal localisation, straight-line access and maximum preservation of sound tooth structure. The use of ultrasonic instruments, magnification and illumination during access cavity preparation, as well as the prevention and management of common procedural errors, are also discussed.

The resident acquires knowledge of the anatomy of the root canal system, its anatomical variations and their significance in the planning and execution of endodontic treatment. The resident evaluates root canal anatomy according to the Vertucci classification and analyses root canal configurations, lateral and accessory canals, isthmuses, C-shaped canal systems and other anatomical variations. The operating microscope and cone beam computed tomography (CBCT) are used to assess root canal anatomy, facilitate root canal localisation and support treatment planning.

The resident acquires knowledge of the metallurgical properties of nickel–titanium (NiTi) instruments, the effects of heat treatment on instrument flexibility and cyclic fatigue resistance, and the design principles of different NiTi instrumentation systems. The resident analyses the kinematics of continuous rotation, reciprocation and adaptive motion, and evaluates the indications, advantages and limitations of different NiTi instrument systems. The most appropriate instrumentation strategy is selected according to root canal anatomy, while adhering to the principles of safe canal preparation, prevention of instrument fracture and current evidence-based endodontic guidelines.

The resident acquires knowledge of the role of irrigation in the chemical preparation of the root canal system and the control of intracanal microbial contamination. The resident analyses the properties, mechanisms of action, indications, concentrations and interactions of the most commonly used irrigants and develops irrigation protocols according to the clinical situation. Irrigant activation techniques, including passive ultrasonic irrigation (PUI), sonic activation, negative-pressure irrigation systems and other contemporary activation methods, are evaluated with regard to their effectiveness in improving root canal cleaning and disinfection and their influence on treatment outcomes.

The aim of this seminar is to provide residents with an advanced understanding of the physical, chemical, and biological properties of bioactive materials and their role in contemporary endodontics. The seminar covers the classification, composition, setting mechanisms, bioactivity, biocompatibility, and interactions of bioactive materials with dental and periapical tissues. Residents are introduced to the general clinical indications, selection principles, and the influence of material properties on treatment outcomes, based on current scientific evidence.

The resident acquires knowledge of the principles of root canal obturation by analysing the importance of three-dimensional obturation of the root canal system for the long-term prognosis of endodontic treatment. The indications, advantages and limitations of different obturation techniques, materials and instruments are evaluated, and the most appropriate obturation technique is selected according to the root canal anatomy and the clinical situation. The resident analyses the criteria for assessing obturation quality, common procedural errors and complications, interprets follow-up radiographic examinations, and evaluates treatment outcomes in accordance with current evidence-based clinical guidelines.

The aim of this seminar is to provide residents with an understanding of the aetiology, diagnosis, and management of tooth surface loss and its impact on pulp health, tooth structural integrity, and endodontic treatment planning. The seminar covers the different forms of tooth surface loss (attrition, abrasion, erosion, and abfraction), their aetiological factors, diagnostic methods, and differential diagnosis. Residents are introduced to the principles of treatment planning, assessment of tooth preservation and restorative options, and the role of the endodontist within a multidisciplinary approach to patient care, based on current scientific evidence.

The resident acquires knowledge of the aetiology, pathogenesis, classification and diagnostic principles of endodontic–periodontal lesions. Clinical and radiographic findings are analysed, and the condition of the pulp and periodontal tissues is evaluated to establish the origin of the lesion and determine its prognosis. Appropriate treatment sequencing and management strategies are selected according to the type of lesion, while the importance of interdisciplinary collaboration with periodontology specialists is emphasised. Scientific evidence regarding treatment outcomes and prognosis is critically analysed.

The aim of this seminar is to provide residents with an understanding of the principles of evidence-based endodontics, research methodology, and the role of epidemiology in clinical decision-making. The seminar covers study designs, the hierarchy of evidence, the principles of research methodology, systematic reviews, clinical practice guidelines, and the epidemiology of pulpal and periapical diseases. Residents are introduced to the application of scientific evidence in treatment planning and evidence-based clinical decision-making in accordance with contemporary endodontic guidelines.

The aim of this seminar is to provide residents with an understanding of the role of biostatistics in endodontic research and evidence-based clinical decision-making. The seminar covers the fundamental concepts of biostatistics, data types, descriptive statistics, commonly used statistical methods, interpretation of statistical significance and confidence intervals, and the clinical relevance of research findings. Residents develop the ability to interpret statistical results and critically evaluate their presentation in scientific publications in order to apply research evidence appropriately in clinical practice.

The aim of this seminar is to develop residents' ability to critically appraise the endodontic scientific literature and interpret clinical evidence to support evidence-based clinical decision-making. The seminar covers the principles of critical appraisal of scientific publications, assessment of the quality of endodontic clinical research, interpretation of systematic reviews, meta-analyses, and clinical practice guidelines, as well as evaluation of the quality and strength of evidence. Residents develop the ability to integrate scientific evidence into endodontic treatment planning and treatment delivery by assessing its applicability to different clinical situations, including vital pulp therapy, non-surgical root canal treatment, endodontic retreatment, and endodontic microsurgery.

The aim of this seminar is to integrate residents' theoretical knowledge and clinical skills through the analysis of a wide range of endodontic clinical cases. Residents evaluate patient history, clinical and radiographic findings, establish a diagnosis and differential diagnosis, assess prognosis, and formulate evidence-based treatment plans in accordance with contemporary clinical guidelines. Particular emphasis is placed on the development of clinical reasoning, evaluation of alternative treatment options, and evidence-based clinical decision-making.