Complications During Restoration of Endodontically Treated Teeth, Avoidance & Management
In this lecture, clinicians will explore the critical factors in restoring endodontically treated teeth, focusing on preventing bacterial ingress and mechanical failure. Emphasis will be placed on proper treatment planning, tooth structure conservation, and recognizing and managing complications. Attendees will gain practical strategies to ensure durable and predictable restorative outcomes.
Root canal treatment is the beginning of a pathway toward restoration and oral rehabilitation. It is not enough to remove bacteria, their metabolites, toxins, and antigens from the root canal system; a durable restoration must prevent their reentry. Furthermore, a mechanically unsound restoration invites mechanical failure of the restoration, or worse, the tooth itself. Errors in restoration are often irreversible, so avoidance is paramount. Errors in restoration leading to bacterial ingress or mechanical failure tend to manifest over time, sometimes many years after the procedure.
Topics covered include: endodontic-restorative treatment planning; prevention of bacterial ingress; conservation of tooth structure; appropriate restorative technique; as well as complication avoidance, recognition, and management throughout.
Dentists should be alert to the possibility of restorative complications and be attentive to their prevention, because they generally irreversibly lower the prognosis, but not dramatically.
Learning Objectives:
- Understand the principles of endodontic-restorative treatment planning to optimize long-term outcomes.
- Learn techniques to prevent bacterial ingress and conserve tooth structure during restoration.
- Recognize and manage common restorative complications to maintain the integrity and function of endodontically treated teeth.
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Biography
Shane White is a Professor of Dentistry at the UCLA School of Dentistry, in the Section of Endodontics within the Division of Regenerative and Reconstructive Sciences. A native of Ireland, he received his dental training from Trinity College Dublin. He spent several years in general practice and part-time teaching in Dublin before moving to California, where he received a master’s degree in Oral Biology and specialty residency training in prosthodontics as well as in endodontics from UCLA, and a PhD in Craniofacial Biology from USC.
He enjoys teaching in D.D.S. programs; post D.D.S. programs, endodontic and prosthodontic residency / specialty certificate programs; mentoring student researchers; as well as providing continuing education for practicing general dentists and specialists. Teaching activities include lecture, seminar, technique laboratory, and clinical patient care formats. Over 100 students have received research mentorship, these include BA, MS, PhD, DDS, Advanced Clinical Trainee, Resident, Visiting Scholar, students; Visiting Researchers; and faculty members – they have won over 40 awards, grants and prizes while in his lab. Considerable emphasis has been given to the scientific mentoring of DDS students. Broader interest in curriculum spurred service as chair of the School of Dentistry Curriculum Committee and as developer of a novel portfolio-based endodontic curriculum. He has received a half dozen teaching awards.
His current research interests include dental biological materials, genetic-structural relationships in tooth structure – how teeth are put together and can be engineered, and in patient-centered endodontics and dental outcomes – focusing on the human side. He has won several major awards for his research. He has held a handful of National Institutes of Health (NIH/NIDCR) grants as principal investigator. Dr. White has authored over 130 research papers in both high impact basic science journals as well as in leading clinical specialty journals, as well as many more abstracts and book chapters. His h-index is more than 50. He has been listed in the Stanford University Study as being among the top 2% of scientists worldwide. He has given over 300 invited scholarly lectures around the world.
He served as Chair, University of California Academic Senate, and as Faculty Representative to the University of California Board of Regents, being one of the 3 principal leaders of the University of California in 2016-18. The University of California, considered to be the World’s leading public research university, has over half a million students and employees, and an annual budget of over $40B. Professor White’s record of University of California leadership and service is remarkably broad and deep, initially focused on faculty welfare and budgetary issues. He chaired the University Committee on Faculty Welfare in 2009-10, serving it for an entire decade. He was a member of UCFW’s Health Care Task Force and a chair of UCFW’s Task Force on Investment and Retirement. He was a Senate representative to President Yudof’s 2009-2010 Task Force on Post-Employment Benefits, and to President Napolitano’s 2015-16 Retirement Options Task Force. He also served the UC Retirement System Advisory Board as chair, charged with developing ideas or new approaches to the provisions of UCRS benefits, then a $70B trust. He was 2015-16 chair of the University Committee on Planning and Budget, advising on the annual budget. Currently, he serves the UC systemwide Health Care Task Force again.
In addition to his UC systemwide service, White has a notable record of Senate and departmental service at UCLA, where he served as Chair of the UCLA Division of the Academic Senate in 2020-21, being in office throughout the COVID-19 Pandemic from 2019-23. Previously, he served four terms as chair of the Faculty Welfare Committee, as well as serving the University Emeriti Committee, the Council of Senate & Faculty Executive Committee Chairs, the Legislative General Assembly, the Senate Executive Board, the Council on Planning and Budget, and the Council on Academic Promotion. Currently, he chairs the UCLA Committee on Rules and Jurisdiction. Within the School of Dentistry, he has chaired the Section of Endodontics, the school’s Curriculum Committee and both of its faculty advancement committees. As a professor, and in all of his servant-leadership positions, he has striven to promote access, diversity, equity, inclusion, transparency, and accountability.
He surfs whenever he can.
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