Dr Chaniotis, to what extent do calcified canals, ledge formation and file fractures pose a unique challenge in root canal system disinfection?
Although the existence of pathological, age-related or iatrogenic root canal blockages (calcifications, ledges and broken files) is not the direct cause of root canal treatment failure, it does adversely affect prognosis in the treatment of periapical periodontitis. These blockages make it difficult for the clinician to eliminate intra-canal infections.

How can endodontists measure calcified canals in the first place, and how can they manage these complex situations?
The diagnosis of root canal blockages is done most of the time with a 2D periapical radiograph. Current high-resolution CBCT imaging provides an additional 3D tool for the evaluation of the geometry and topography of the blockage. The ultimate evaluation of the dimensions, content and negotiability of the blockage is always done clinically. Our ability to negotiate beyond the root canal blockage depends upon various factors. All the factors affecting the negotiability and elimination of root canal blockages will be highlighted in my lecture. Moreover, suggestions on how to overcome these difficulties will be presented.

The day before ROOTS SUMMIT begins, you will be holding a hands-on course on root canal blockage. What makes this course of special interest to endodontists?
The challenging nature of the management of root canal blockages during non-surgical retreatment was a great inspiration. The concept of the root canal blockage course was born out of the desire to teach and practise different techniques for managing current and future blockages. Special models of simulated conditions are used to practise and tackle challenging cases. All participants work under magnification and light provided by dental operating microscopes, and they use top-notch equipment. All this equipment is constantly updated. Attendees will be able to practise the bypassing of ledges, the removal of cast and fibre posts, the negotiation of calcified canals and the management of broken files. These characteristics make it of unique interest to every lover of endodontics!

What instruments will be used during the course, and what techniques will be taught?
Microscopes, ultrasonic instrumentation, engine-driven files, digital sensors and phosphor plates will be available for use in simulated conditions. Each participant will have his or her own equipment to use in working on custom-made phantom heads and special teeth. Instruments and materials from the best manufacturers in endodontics will be provided. Traditional and out-of-the-box techniques will be demonstrated and practised. Some new techniques were inspired by this course and specially developed for it. So, attendees should be prepared for a unique experience.

In a recent study, you spoke about future developments in managing root canal blockage. Could you tell us something about these developments and how you handle them in your courses?
Machine-assisted 3D irrigation devices, lasers, digital workflows, advanced planning software programs, guided endodontic techniques and artificial intelligence will shape the future of endodontics. We always try to highlight and reflect on these future developments in our canal blockage courses.

Why did you decide to present at next year’s ROOTS SUMMIT, and what are you personally looking forward to?
Accepting the invitation to present at ROOTS SUMMIT 2024 was an instant decision. No one can resist the temptation of being a part of it. Having the event take place in Greece for 2024 will be an amazing experience. ROOTS SUMMIT is all about gathering endodontic enthusiasts from around the globe. It’s not only a scientific event but also a cultural blending of endodontists of different origins, cultures and perspectives. I would like to invite you all to visit my home country and to keep the spirit of ROOTS SUMMIT alive.

Tags: