“We try to preserve as much healthy tissue as possible”

The adventure began in Rome in Italy in 2022, and the first meeting was a success, attracting participants from many parts of the world. After that first experience, we wanted to continue. The second edition was held in Barcelona in Spain the following year and the third in Paris in France. In Paris, we had almost 600 participants from 61 countries, including Australia and New Zealand. That success encouraged us to continue because our participants want clear, independent scientific information, and that is the approach that we intend to maintain. Dental Tribune International has been a partner from the beginning, and we are very grateful that this cooperation has continued as the meeting has developed.

The guiding principle behind Endo Sapiens is that biological understanding should inform clinical practice. Where do you see the greatest gap between current biological and histological evidence and endodontic practice?
Yes, this is central to the Endo Sapiens approach. We try to connect clinical practice more closely with biological knowledge. This emphasis arose from the observation that most clinicians, regardless of their level of experience, focus on techniques, materials and procedures. These are, of course, very important. A dentist cannot be successful without good clinical skills. However, we encourage clinicians to look more deeply at the biological basis of treatment.

We therefore place much greater emphasis first on normal tissue physiology and then on the pathological processes affecting the tissue. In endodontics in particular, we focus on the disease process associated with caries. We seek to emphasise the underlying biological processes: how the pulp tissue responds to the microbial challenge associated with progressing caries and how inflammation develops.

“We encourage clinicians to look more deeply at the biological basis of treatment.”

When treatment is performed at a later stage, we try to reach agreement on procedures such as direct pulp capping, partial pulpotomy and complete pulpotomy, which can allow us to maintain the vitality of at least part of the pulp. In the past, teeth diagnosed with irreversible pulpitis arising from deep caries were generally treated with root canal treatment. Today, we seek to practise minimally invasive dentistry: we try to preserve as much healthy tissue as possible.

This connection between biology, histology and clinical practice is also reflected in the Endo Sapiens programme. During the meeting in October, you will be leading a masterclass on vital pulp therapy. What will participants learn from the session?
During the meeting, there will be several masterclasses. Mine will focus on vital pulp therapy. Dr Gilberto Debelian will demonstrate clinical procedures in non-surgical endodontic retreatment, Dr Allen Ali Nasseh will present a microsurgical approach to molar apicectomy.

Vital pulp therapy is relatively new as a practical teaching topic because we face a challenge in providing hands-on training: the clinical environment of a vital tooth, including bleeding and pulp tissue, cannot easily be reproduced in a model. In vital pulp therapy, we are not treating hard, mineralised tissue alone; we also need to account for the pulp. We have therefore worked with companies to develop models that simulate pulp tissue and bleeding. These offer, of course, only an approximation of the clinical situation, but I think we have succeeded.

After discussing the biological basis, pathology and diagnostic aspects, I will demonstrate direct pulp capping, partial pulpotomy and complete pulpotomy using these models and contemporary bioceramic materials. This will allow participants to observe each step of the procedures.

Your new book, Vital Pulp Therapy and Clinical Endodontics: A Biological Approach, is also being presented at the FDI congress. How does the book build on these themes?
Although “vital pulp therapy” appears in the title of the book, it is really a textbook of endodontics that places particular emphasis on vital pulp therapy. The first chapter deals with the laboratory procedures used to process teeth and periradicular tissue for histological examination, which is an important part of the book. We focus on histology because it allows us to show tissue morphology at the cellular level. The first chapter therefore deals with the techniques used to produce histological sections. The following chapters move from the biology of normal tissue to the tissue response to caries and then to the treatment of deep caries, including the procedures used in vital pulp therapy, presented step by step.