Recent grad looking to become better/faster at Endo

[LaundryHamper]

Hey guys, 2023 grad here who has been working as a GP for about 9 months. I've become pretty comfortable with bread and butter dentistry but I haven't had too much experience with endo, just a handful of anteriors/premolars and am hoping to get better/faster. Does anyone have any recommendations for hands on CE courses that are worth the money? I have watched a number of online/on-demand CE courses from my company and so I feel pretty comfortable with the theoretical aspect of it, now I'm looking for a course that lets me put it into practice. I know the obvious answer is to just do more but I would like to be at a position were I can offer it to patients knowing they won't be in the chair forever and I can assure a quality procedure. Thank you!

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[yappy]

This isn’t what you asked for but let me offer you another perspective. I too am a GP and limit myself to maxillary anterior teeth and some premolars. The reason is because I do not have limited field CT, nor do I have a microscope, and I don’t have an advanced irrigation system like the specialist I refer to does. I also have not done 100s of cases under the supervision of a specialist.
If my root canal goes bad because I don’t have the proper equipment or experience it puts the patient in a bad position of needing a much more costly procedure in the future, retreatment or implant.

Maybe you are more skilled than I, but I could not get the other parts of my practice to line up with me sitting uninterrupted for 1.5 -2 hrs doing a root canal.

 

[TanMan]

A good start. Can go even faster once you learn the basics below.

 

[Boat on the Chesapeake]

Ehhh….the 15 Minute Molar Endo is good for thinking about your workflow and assistant training, which make a big difference in your speed after you’ve mastered the basics. But it shows bad asepsis, poor isolation, under irrigated, did they find MB2? etc. All the useful information would be a view inside the access cavity, which they can’t show. I’m sure that tooth has been extracted by now…

Most endodontists don’t trust the endodontists that do 16 endos/30min appoints a day (see Endo Mastery/Ace Goerig style practice), though I’m sure some high-level clinicians can execute that well. The faster your clean and shape the more you need to irrigate and dissolve tissue (activator, ultrasonic, laser, gentle wave, etc). If you don’t you’ll have good looking RCTs with lesions in a few years. See Versiani’s 3D anatomy to see what you’re really trying to clean, they’re not straight lines, so many isthmuses.

For OP, main advice would be 4x+ loupes and practice on more extracted teeth to get a feel for each step of the process. Then section the roots afterward and see if you missed any canals. Only choose cases with wide easy canals to start and work your way up. Also, fast crowns and fillings are more profitable than slow endo, so don’t try cases above your skill level trying to up production, it will backfire. Do continue to increase your skills if you enjoy endo though, it’s an important part of general practice!

 

[cmjacks5]

Hey guys, 2023 grad here who has been working as a GP for about 9 months. I've become pretty comfortable with bread and butter dentistry but I haven't had too much experience with endo, just a handful of anteriors/premolars and am hoping to get better/faster. Does anyone have any recommendations for hands on CE courses that are worth the money? I have watched a number of online/on-demand CE courses from my company and so I feel pretty comfortable with the theoretical aspect of it, now I'm looking for a course that lets me put it into practice. I know the obvious answer is to just do more but I would like to be at a position were I can offer it to patients knowing they won't be in the chair forever and I can assure a quality procedure. Thank you!

Being “fast” at endo takes time. Endo is not easy. Get comfortable with anterior and premolars first and foremost. Then add molar endo but “slam dunk” endo. Meaning vital cases, large pulp chambers etc etc. Also I am speaking as a endo resident soon to be Endodontist in a month lol. Speed with come.

 

[cmjacks5]

This isn’t what you asked for but let me offer you another perspective. I too am a GP and limit myself to maxillary anterior teeth and some premolars. The reason is because I do not have limited field CT, nor do I have a microscope, and I don’t have an advanced irrigation system like the specialist I refer to does. I also have not done 100s of cases under the supervision of a specialist.
If my root canal goes bad because I don’t have the proper equipment or experience it puts the patient in a bad position of needing a much more costly procedure in the future, retreatment or implant.

Maybe you are more skilled than I, but I could not get the other parts of my practice to line up with me sitting uninterrupted for 1.5 -2 hrs doing a root canal.

You’re a smart man. Loud this up!!!

 

[Molar Whisperer]

This isn’t what you asked for but let me offer you another perspective. I too am a GP and limit myself to maxillary anterior teeth and some premolars. The reason is because I do not have limited field CT, nor do I have a microscope, and I don’t have an advanced irrigation system like the specialist I refer to does. I also have not done 100s of cases under the supervision of a specialist.
If my root canal goes bad because I don’t have the proper equipment or experience it puts the patient in a bad position of needing a much more costly procedure in the future, retreatment or implant.

Maybe you are more skilled than I, but I could not get the other parts of my practice to line up with me sitting uninterrupted for 1.5 -2 hrs doing a root canal.

If I needed endo, I wouldn't go to someone who can do it in less than 30 min. I need him/her to use a microscope on me to verify no internal fractures, resorption, caries, anatomy variations/extra canals, and all pulpal tissue removed. I would want ultrasonics and advanced irrig system because there are a lot of anatomy that can't be instrumented. Dr. Kois once mentioned at a dental convention that there are 2 spectrums of dentists. One is an entrepreneur who is profit driven and the other is a clinician who needs 5 hours to do a crown prep. It can take some time to find that right balance.

 

[Molar Whisperer]

Ironically, I was acquainted with an endodontist who schedules 45 minute appointments. He was convicted of multimillion dollar Covid loan fraud.

 

[TanMan]

Doing your own endo does not make sense if it cannot be executed at your projected/expected production per minute.