A complete listing of currently available online programs is provided below. To access course materials and claim CE credits you must be registered and logged-in and courses of interest must be selected and purchased. Once purchased, course material links are provided from within the User Records section of this website. Courses are Peer Reviewed and approved for ADA CERP continuing education credits.
* Advanced Diagnostics For Dental Hygienists Master Class Teaching Unit 1
Limitations of Conventional Endodontic, Periodontic and Restorative Diagnostic Tests
Authored by:
Marwan Abou-Rass, DDS, MDS, Ph.D
Expiration Date:
CE Credit Hours:
1.0
Format:
Webinar
Fee:
$25.00
The report of the Swedish Council on Health Technology Assessment on the Methods of Diagnosis and Treatment in Endodontics (2012), disclosed “Extensive shortcomings in the scientific basis underlying methods applied for endodontic diagnoses and treatment.” Along the same lines, primarily written for practicing dental hygienists, the author analyzes the conventional patient examination diagnoses methods used in endodontics, periodontics, and restorative dentistry and presents a patient examination and diagnosis protocols, which are clinical- efficient, evidence-based, and patient-centered.
Educational Objectives
The content of unit one is organized to accomplish three objectives:
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Identify the shortcomings of the conventional diagnostic tests used in clinical Endodontic, Periodontic, and Restorative Dentistry.
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Describe the technical and biologic limitations of the Diagnostic Imaging of Periapical, Bitewing, Panoramic Radiographs.
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Describe the components of the evidence-based, biology- oriented best practices in Endodontic-Periodontic -Restorative diagnostic process.
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* Advanced Diagnostics For Dental Hygienists Master Class Teaching Unit 2
The 4R Operational Diagnosis Protocol For Dental Hygiene Practice
Authored by:
Marwan Abou-Rass, DDS, MDS, Ph.D
Expiration Date:
CE Credit Hours:
1.0
Format:
Webinar
Fee:
$25.00
The 4R Operational Diagnosis (4ROD) is a protocol for the clinical data collection and biologic assessment of the dental diagnostic findings of the patient signs, symptoms, Dentin, Endodontium, and Periodontium of a tooth of interest.
Using the 4ROD protocol generates eight sets of diagnostic findings which the clinician can evaluate to reach a definitive diagnosis by the end of the dental appointment. The sets of diagnostic findings are:
1. Patient Pain Profile questionnaire (PPP)
2. Dental history
3. Social and Medical history
4. Diagnostic imaging PA or/and BW of the tooth of interest.
5. Pulpal health status findings
6. Periodontal health status findings
7. Tooth structure status findings
8. Restorative dentistry findings
The R1.(Report findings); the Patient Pain Profile (PPP) is the highlight of the 4ROD protocol. PPP is assessed using the standard criteria of pain profile: Onset, Quality, Quantity, Duration, and Subsidence.
The R2.(Radiographic findings); focuses on the use of PA and BW radiographs as the most practical and accurate intra-oral radiology. R2 utilizes the 10 Areas of Diagnostic Interest protocol developed by the author to systematize the radiographic interpretation of Periapical Radiographs.
The R3. (Response testing); eliminated the use of Electric, Heat, Percussion, Bite, and Palpation tests as endodontic tests. R3 streamlined the pulpal response testing into Cold Pulp Test, and Fistula tracking, and Periodontal testing into the standard PI, BOP, PD, CAL, MMI tests.
The R4 Restorative and tooth structure findings focuses on visual and clinical examination of the tooth and gingiva Warning Signs.
Educational Objectives
The content of unit two is organized to accomplish the following objectives:
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Use the eight diagnostic reports generated from the use of the 4R Operational Diagnosis (4RROD) in endodontics related periodontic and restorative dentistry treatments
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List the 10 Areas of Diagnostic Interest (ADI)
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Describe the Best Practices in the Diagnostics of Endodontics, Periodontics, and Restorative Dentistry
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* Advanced Diagnostics For Dental Hygienists Master Class Teaching Unit 3
7 Reasons for Difficulty In Diagnosing Oral and Dental Pain
Authored by:
Marwan Abou-Rass, DDS, MDS, Ph.D
Expiration Date:
CE Credit Hours:
1.0
Format:
Webinar
Fee:
$25.00
The author identifies seven reasons or factors that complicate the diagnosis of oral and dental pain.
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The clinicians' insufficient application of biologic principals in dental practice.
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Heavy reliance on technical and inadequate diagnostic tests.
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The variance of Patient's pain threshold.
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The anatomic density of oral-maxillofacial structures may cause intermingling of the signs and patterns of pain
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Lack of correlation between pain and pathology.
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The Radiographic findings do not correlate with Pathologic findings.
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Overlapping and mixing of Pulpal and Periodontal Pathologies.
Fortunately, 90% of the Patient's oral and dental pains encountered in dental practice are "Toothaches." Therefore, the author recommends two clinical approaches for making accurate diagnosis of Dental pain. The first requires understanding of the anatomic and pathologic basis of dental pain, selecting specific tests, identifying and taking account of the above seven influencing factors. The second approach embraces Walden Bell's advice: "A good rule for any Examiner is to consider all pains about the mouth and face to be of dental origin. A Toothache until proven otherwise."
Learning the unit content empowers practicing dental hygienists with the academic knowledge and diagnostic skills to converse with and educate patients, collaborate with dentists to deliver quality dental care effectively.
Educational Objectives
The content of unit two is organized to accomplish the following objectives:
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List the seven reasons that complicate the diagnosis of oral and dental pain.
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Describe the normal and abnormal diagnostics of the 10 ADI
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Explain how do tooth sensibility and toothache occurs as explained by the hydrodynamic theory
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Identify the factors that Influence the Patient's pain threshold.
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* Advanced Diagnostics For Dental Hygienists Master Class Teaching Unit 4
Diagnostics of Tooth Resorption Parts One and Two
Authored by:
Marwan Abou-Rass, DDS, MDS, Ph.D
Expiration Date:
CE Credit Hours:
1.0
Format:
Webinar
Fee:
$25.00
The dental school teaching considers Tooth resorption a "rare phenomenon" that affects the internal, external, or apical surfaces of teeth. The causes are physiologic, idiopathic, pathologic, or following orthodontic treatment. The Differential Diagnosis and treatment of the different types of root resorptions depends on the characteristics of the radiographic image of the resorption defect.
The current knowledge of root resorption is entirely different. Root resorption is no longer considered a rare phenomenon. Root resorption is a common iatrogenic, pathologic complication of substandard dental patient care. According to Tsesis et al., 2008, 71.2% of root resorption is of Endodontic etiology, followed by 14.6% of Orthodontic-etiology and 10.2% of Oral pathology etiology. Therefore, because the causes are known, most root resorption problems are preventable.
The author presents key academic concepts and suggestions on what should the patient be told when in the dental hygiene process of care, a dental hygienist encounters a root resorption situation.
The content of unit 4 empowers practicing dental hygienists with the academic knowledge and diagnostic skills to exercise their role as the primary providers of evidence-based preventive oral healthcare information and at the same time, assist and collaborate with dentists in the diagnostic aspects of patient care.
Educational Objectives
Unit 4 content has been organized to achieve the following objectives:
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Describe the current knowledge of root resorption in modern dentistry.
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Diagnose root resorption problems with the 4R operational diagnosis protocol.
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Describe the author's classification of the problem- based root resorption
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Outline what the dental hygienist should tell the Patient about the different types of root resorption
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* Advanced Diagnostics For Dental Hygienists Master Class Teaching Unit 5
Diagnostic Imaging Interpretation of Teeth with Endodontic Diseases and Treatments for Dental Hygienists
Authored by:
Marwan Abou-Rass, DDS, MDS, Ph.D
Expiration Date:
CE Credit Hours:
1.0
Format:
Webinar
Fee:
$25.00
According to the ADA- statistics, an average of 22 million endodontic treatments performed is performed annually in the USA. Therefore it is destined that the practicing dental hygienists have to interpret OPG, PA, and BW radiographs of patients with one or more of the followings : Endodontic pathologies, Standard Endodontic Treatments, Substandard and Failing Endodontic Treatments, Endodontic Posts and Cores, and Surgical Endodontic Treatments.
Dental Hygienists should be able to inform, dialogue, and educate patients about their endodontic problems and efficiently collaborate with the dentists in the provision of proper, efficient, and quality care.
Endodontics, Periodontics, and Restorative Dentistry constitute the core of the General Dentistry Practice. The author presents more than 200 radiographs that espouse that concept.
"The 10 Areas of Diagnostic Interest" (10 ADI).is used for the assessment and interpretation of the radiographs presented in this unit. The protocol offers an evidence-based, systematic approach for radiographic examination of the standard and abnormal anatomic component of the Endodontium and Periodontium of teeth imaged with Periapical (PA) and Bite-wing (BW) radiographs.
Educational Objectives
Unit 5 content has been organized to achieve the following objectives:
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List the Ten Areas of Diagnostic Interest (10 ADI) protocol.
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Describe the radiographic features in the health and disease for each area of the 10ADI protocol
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Interpret (PA) and (BW) radiographs of the dental Pulp, periapical, periradicular disease, and Standard and substandard endodontic treatments
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Use the collected diagnostic data to converse and educate patients about their problem
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Communicate the diagnostic findings to the attending dentist and collaborate in the provision of efficient Quality care.
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* Advanced Diagnostics For Dental Hygienists Master Class Teaching Unit 6
Warning Signs of Restorative, Endodontic, and Periodontic Pathology Encountered in the Dental Hygiene Process of Care
Authored by:
Marwan Abou-Rass, DDS, MDS, Ph.D
Expiration Date:
CE Credit Hours:
1.5
Format:
Webinar
Fee:
$35.00
75% of dentoalveolar infections are of Endodontic and Periodontic origin. These infections are biologically interrelated, pathologically slow-paced, and usually, progress unchecked because of their asymptomatic nature. Fortunately, the etiology of dentoalveolar diseases is well known and, therefore, preventable. The causes are bacterial coronal and apical microleakage, developmental tooth anomalies, and tooth alignment abnormalities.
A Warning Sign is a diagnostic clinical or radiographic finding of change of an established clinical or radiographic norm detected during the examination of the Patient's mouth, gingiva, or teeth. Diagnostically, the Warning Signs manifest as changes in tooth or gingiva; anatomy, color, structure, texture and/or radiographic appearance. Pathologically, the changes are an indication of underlying pulp, periapical, or periodontal pathology. Conceptually a Warning Sign should be considered as "The Tip of the Iceberg."
Educational Objectives
Unit 6 content has been organized to achieve the following objectives:
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Define coronal and radicular micro-leakage and discuss its relevance to endodontic and restorative treatment outcomes.
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Describe the concept of dental warning signs, and it's a clinical application to the dental hygiene process of care
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Categorize the most common warning signs of tooth and gingiva encountered in clinical and radiographic examinations.
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* PART I. Introducing the 4Rs Operational Diagnosis Protocol: A Comprehensive Systematic Approach for Endodontic Diagnosis
Authored by:
Marwan Abou-Rass, DDS, MDS, Ph.D
Expiration Date:
CE Credit Hours:
3.0
Format:
Webinar
Fee:
$75.00
The detection and diagnosis of the TSC is perhaps the most difficult aspect in the management of the cracked, fissured and fractured teeth in dental practice. In this five parts series the 4Rs operational diagnosis protocol(4Rs OD) is used as a best dental diagnosis practice.
The protocol was specifically developed to remedy the shortcomings of the conventional Endodontic diagnosis tests.
The protocol helps the clinician to use the skills of: hearing, seeing and acting to accurately learn the patient problem.
The(4Rs OD) protocol provides the clinician with multidisciplinary, systematic approach for collecting, analyzing, and synthesizing the examination data into diagnostic, treatment planning, and prognostic decisions.
The 4Rs OD consists of the followings assessment tests:
R1: Report of the patient assessment
R2: Radiographic assessment
R3: Response testing assessment
R4: Restorative and tooth structure assessment
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* PART II. How Tooth Structure Cracks Complicate and Affect Dental Treatments - Four (4) Teaching Cases
Authored by:
Marwan Abou-Rass, DDS, MDS, Ph.D
Expiration Date:
CE Credit Hours:
1.5
Format:
Webinar
Fee:
$35.00
In this webinar, we will focus on the complications that may occur when the clinician misdiagnoses, or inadvertently overlooks an existing tooth structure crack in a tooth receiving restorative or endodontic treatment.
Part II provides four-case studies where patients have developed serious complications resulting in tooth extraction.
The lessons learned from each case study and the clinical errors provide guiding principles for the clinician to follow in their practice.
Guiding principles presented are:
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Performing endodontic treatment or re-treatment thru existing single unit old restorations is not advisable. If the restoration is defective, mediocre and planned for future replacement, it must be removed as part of the diagnostic procedures and before endodontic treatment.
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The restoration being saved is often the cause of the endodontic treatment failure or the associated complications.
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Consider that surgical endodontics is not a substitute for -standard endodontic treatment.
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* PART III: Definitions, Classification, Etiology and Initiation Mechanism of Tooth Structure Cracks
Authored by:
Marwan Abou-Rass, DDS, MDS, Ph.D
Expiration Date:
CE Credit Hours:
2.0
Format:
Webinar
Fee:
$45.00
Clinical management of cracked teeth in dental practice is an area replete with misunderstanding and misinformation. First, the literature lacks prospective studies and clinically useful universal definitions. Second, although cracked teeth problems vary significantly in diagnosis, treatment and prognosis. The literature terminology does not specifically differentiate between “Fractured teeth”, “Cracked teeth”, “Cracked Tooth Syndrome”, “Green stick fractures” and “Incomplete coronal fractures”.
The author’s 3x3 Tooth Structure Cracks (TSC) classification, grouped the various terminologies which relate to the cracked or fractured teeth problems, under one term “Tooth Cracks”. Then defined and classified the “cracks” according to their anatomic, physical and pathologic characteristics.
Physically, “Tooth Cracks” are classified into:
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Line Cracks
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Fissure Cracks
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Fracture Cracks
Anatomically, “Tooth Cracks” are classified into:
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Marginal Ridges
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Grooves
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Surfaces
Pathologically, “Tooth Cracks “are classified into:
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Contributory
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Noncontributory
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Partially Contributory
The webinar presentation shows how to differentiate between the harmless “noncontributory crack” and the harmful “contributory crack”.
Contributory cracks cause reversible and irreversible pulpitis, pulp calcification, pulp necrosis, periapical and periradicular lesions. On the other hand, noncontributory cracks could be microscopically visible microcracks or clinically visible line. These cracks remain at the early initiation or development stages for years. They remain still and stationery, cause no pulpal or periodontal pathology as long as they are not pressured, and stressed by new forces or loads. Forces such as root filling condensation or traumatic fitting of a post.
Updated information about the etiology and initiation mechanism of tooth cracks is presented focusing on:
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Abusive restorative procedures that cause coronal cracks
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Abusive mechanical endodontic procedures that cause radicular cracks
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Abusive post placement procedures
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Dental occlusion factors
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* PART IV: 7 Symptomatic Cracked Teeth with Pulpal, Periradicular & Periapical Involvements: Diagnosis and Treatment
Authored by:
Marwan Abou-Rass, DDS, MDS, Ph.D
Expiration Date:
CE Credit Hours:
2.5
Format:
Webinar
Fee:
$50.00
Part IV of the series focuses on the diagnosis and treatment of seven cracked teeth cases with symptomatic endodontic disease conditions. The selected cases represent a sampling of contributory and noncontributory line, fissure and fracture cracks.
The pathologic relationship between pulp calcification and tooth structure cracks (TSC) is reviewed, focusing on the diagnostic imaging aspects of pulpal calcification.
Detailed descriptions and discussion of the patient pain profile, the 10 ADI (Areas of Diagnostic Interest) response testing results for each of the seven cases are presented.
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*PART V: How and Why Substandard Endodontic Treatments Fail: The Importance of Investigating and Ruling Out Cracks Prior to New Treatment Planning
Authored by:
Marwan Abou-Rass, DDS, MDS, Ph.D
Expiration Date:
CE Credit Hours:
4.5
Format:
Webinar
Fee:
$95.00
In the introduction of the program, the author reveals an alarming 24%-60% global prevalence of Apical lesions in teeth with inadequate root canal treatment. The literature’s histopathologic term used in describing these lesions is Apical Periodontitis. (AP). The statistics are alarming because the “Standard Normal” prevalence of Apical lesions in endodontically untreated teeth is 1½% - 7%.
This program stands for the management of teeth with substandard endodontic treatment failures because of the evidence-based relationship between abusive endodontic treatment, and root structure cracks initiation and propagation. Abusive endodontic treatment is one form and a principal cause of substandard endodontic treatment. More on this relationship discussed in Part III of the master class series.
The program is composed of Seven (7) Chapters planned to include the most clinically relevant facets of the inadequate or sub-standard endodontic treatment.
This program offers concepts, methods and guiding principles based on evidence, and tested clinical practices. The goal is to enhance the clinicians understanding of endodontic treatment diagnostics and the relationship between endodontic treatment and tooth structure cracks.
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