I attended an outstanding lecture today at the IACA meeting by world renowned endodontist, Dr. Stephen Cohen.  As many of you know, Dr. Cohen is the author of the definitive texbook on endodontics, "Pathways of the Pulp."  Although Dr. Cohen could easily retire, he continues to be at the forefront of new technology.  A few highlights from today's lecture: 

1.  To successfully anesthetize "hot" teeth,  use PDL injections at MB, ML, DB and DL.  Dr. Cohen routinely uses 2% lido with 1:100,000 epi.  (makes me wonder why we don't just do PDL injections on all teeth...)

2.  New endoscopes are available with 0.9mm diameter tubing for visualization, instrumentation, irrigation etc.  You can even insert a small forceps to recover separated instruments.

3.  A new technology is available allowing 5 minute instrumentation with a tiny NiTi device, resembling an oblong basket, that conforms to the odd shapes of root canal systems.  Copious irrigation is also performed, cleaning and shaping the entire root canal.  

4. Periapical curretage can now be performed with a tiny NiTi instrument that extends out the apical foramen.  Similar to a "weed wacker," the Ni Ti rotates to pulverize the PA lesion.  Then a more flexible filament is used to finish the "smoothie," followed by copious irrigation and suction.  Amazing.  PA lesions are shown to heal much faster.  No incision, no bone removal.  This is a minimally invasive procedure done through the crown of the tooth.  

Keep your eyes open for easier endo techniques and instruments coming this year.  This will change everything--for the doctor and especially for the patient.