IFEA 2026 Global Endodontic symposium

Event and IFIA Announcements

Dr. Gopi Krishna opened the fourth Global Endodontic Symposium, held on October 16 for World Endodontic Day. He described the day as an opportunity to celebrate endodontics and encourage the public to preserve natural teeth.

The International Federation of Endodontic Associations (IFIA) announced that Costa Rica had become its 50th member country. The federation’s public-awareness theme for the year was “Save your teeth and save your smile,” shared in multiple languages.

IFIA’s website, ifiaendo.com, was described as a future resource center for symposium recordings, position statements, patient-awareness videos, and other educational resources. The federation also publicized its annual $6,000 research grant, with applications due December 31.

The next IFIA World Endodontic Congress was announced for New York, September 14–17, 2028.

Lecture 1: Francis Andreasen — Dental Pulp Response to Traumatic Injuries

Andreasen’s central message was that the pulp is not necessarily doomed after trauma. It can recover and continue to function, so clinicians should avoid diagnosing pulp death or beginning root-canal treatment on the basis of a single early sign.

Key Concepts

• The injury type and extent matter. Luxation and avulsion injuries can affect the full pulp, while root, crown-root, and crown fractures affect a more limited portion. The injury category helps guide prognosis and treatment.
• Andreasen emphasized the roles of blood circulation and bacteria in pulp survival. An intact blood supply supports the pulp’s defenses; compromised circulation, especially when combined with bacterial contamination, raises the risk of necrosis.
• A negative sensibility test immediately after trauma does not by itself prove necrosis. Neural response may take weeks to return. Andreasen cited research in which responses began after about five weeks and could take up to three months.
• Temporary discoloration can occur during healing. Color, sensibility tests, and radiographs should be interpreted together rather than in isolation.
• A mature tooth that undergoes premature root-canal treatment may be more vulnerable to fracture. In immature teeth, preserving vitality can support continued root development.

Assessment and Follow-Up

• Document the injury carefully. Record color, displacement, mobility, tenderness to percussion, and other relevant findings at the initial visit. Andreasen recommended using a simple visual chart to compare findings at follow-up.
• Estimate prognosis from the injury pattern and root maturity. She highlighted the type of luxation and whether the root apex is open or closed as especially useful predictors.
• Use multiple kinds of evidence: sensibility testing, crown color, and radiographs. When testing sensibility, account for the different response thresholds of immature and mature teeth.
• Take reproducible radiographs. Andreasen favored consistent views and angulations to assess displacement and subsequent changes. She considered CBCT useful when indicated, but advised against delaying care while searching for a scanner if conventional radiographs are available.
• Allow time for healing when appropriate. She generally recommended reassessment after roughly two to three weeks rather than treating solely because a tooth initially fails to respond to testing.
• Watch for signs that may justify intervention, including arrested root development, progressive loosening associated with infection, failure of expected periodontal healing, persistent tenderness, or resorption patterns suggesting infection. She distinguished surface resorption with an intact lamina dura from more concerning inflammatory resorption.
• Radiographic changes do not always indicate infection: healing can also produce radiolucency. Follow-up and clinical context are important.

Trauma-Specific Treatment Points

Andreasen described transient apical breakdown (TAB) as a temporary resorptive process that can occur during healing, including after some luxation injuries and root fractures. She advised recognizing it and avoiding unnecessary treatment when the pattern is consistent with healing.

Root fractures can heal in different ways: with hard-tissue union, connective tissue between fragments, bone and connective tissue, or non-healing associated with pulp necrosis. Treatment decisions should reflect the type of healing and the condition of the coronal pulp.

For a root fracture with pulp necrosis, Andreasen described treating the coronal portion of the canal rather than automatically treating the entire root or removing the apical fragment.

Her overall clinical principle was “hands off” when observation is biologically appropriate—while recognizing that observation requires planned follow-up and readiness to act. She also noted that limited prospects for follow-up, planned restorative treatment, or special patient circumstances may favor treatment over watchful waiting.

Lecture 2: Arnaldo Castellucci — Working Length in Root-Canal Treatment

Castellucci argued that working length should be based on the actual canal terminus, rather than estimated from a standard distance short of the radiographic root tip.

Main Arguments

• Short preparation and filling can leave untreated anatomy. Castellucci associated many failures with incomplete apical cleaning or missed canals and emphasized that root canals may have lateral branches and other complex anatomy.
• He argued that extruded filling material is not automatically the cause of failure. In his view, a more significant problem is inadequate apical sealing, often associated with transportation or distortion of the foramen.
• He questioned the practical usefulness of relying on a presumed cementodentinal junction or apical constriction as a precise clinical endpoint, arguing that these structures vary and may not be consistently identifiable.
• He distinguished the radiographic apex from the apical foramen: they may not coincide, and the foramen can be difficult or impossible to see on a two-dimensional radiograph.

Working-Length Approach

• Use an electronic apex locator to identify the foramen. Castellucci argued that electronic devices detect the foramen rather than the apical constriction.
• In his described protocol, the “00” reading marks the foramen. If a clinician chooses to stop short, he advised measuring that distance rather than assuming the locator’s intermediate readings correspond to a fixed fraction of a millimeter or to the constriction.
• Use radiographs alongside electronic measurement, particularly to assess anatomy and confirm the clinical picture.
• Maintain apical patency with a small file, according to his account, to avoid leaving debris packed at the foramen.
• Shape and disinfect the canal system, then obturate it three-dimensionally. He described combining mechanical preparation with irrigation, including negative-pressure irrigation and ultrasonic activation.
• Apical size should be case-dependent: clinicians should gauge the canal and select an appropriate preparation size rather than use a single size for every tooth.

Discussion and Difference of Perspective

During the Q&A, Castellucci maintained that he generally prepares to the foramen, whether treating vital or necrotic pulp.

Andreasen distinguished traumatic injuries from ordinary caries-related endodontic cases. In trauma cases, she said, pulp tissue may remain vital or grow back into the canal; she would preserve such tissue rather than instrument through it.

The speakers therefore presented different approaches in trauma-related cases, reflecting different clinical contexts and philosophies. The discussion did not establish a single agreed protocol for every case.

Speakers, Moderators, and Other Featured Sources

Featured Speakers and Moderators

• Dr. Gopi Krishna — IFIA president; opened and closed the symposium and made federation announcements.
• Professor Francis Andreasen — first keynote speaker; lectured on pulp response and management after dental trauma.
• Professor Arnaldo Castellucci — second keynote speaker; lectured on working length and apical preparation.
• Professor Henry Kim — moderator for Andreasen’s session.
• Dr. Betina Basrani — moderator and introducer for Andreasen’s session.
• Dr. Elizabeth Cotti — moderator and introducer for Castellucci’s session.
• Dr. David Jaramillo — moderator for Castellucci’s session.
• Unidentified narrator or voice in the World Endodontic Day social-media reel — described endodontists as dental specialists in saving natural teeth.

Researchers, Authors, and Other Sources Cited

• Yngve Andreasen — referenced in discussion of periodontal-ligament healing.
• John West — cited for research on apical portals and root-canal treatment outcomes.
• Walter Hess — referenced for studies illustrating complex root-canal anatomy.
• Herb Schilder — Castellucci’s mentor; cited for canal cleaning, shaping, obturation, and maintaining apical patency.
• Bruce Lipton — cited by Andreasen for ideas about cellular environments and gene expression.
• Yuri Kutler, David Rosenberg, and Yoshi Nakamura — referenced in Castellucci’s discussion of apical anatomy, working length, and electronic apex locators.
• Bergenholtz — cited in discussion of infection in periapical granulomas.