Robert E. Grover, DDS

“Disease-Specific Treatment: Is Radiographic Elimination of "Disease" Always Good for the Patient?”

The goal of endodontics has been described as the prevention and elimination of apical periodontitis. The primary means to measure this disease-specific outcome is the periapical radiograph where the resolution of an existing periradicular lucent finding is considered to be a “good outcome”. Patients, however, consider a “good outcome” to be a retained, asymptomatic, and functional tooth. It has been reported that up to 38% of endodontically treated teeth have periradicular findings detected with CBCT imaging that were not evident with traditional periapical images. How do we then interpret and manage an asymptomatic, functional tooth with a lucent finding evident in 3D but not apparent in 2D? For that matter, how do we manage any asymptomatic, functional endodontically treated tooth with lucent findings? Will intervention to eliminate the “disease” make the patient better or worse? How do we reconcile the disease-specific goal of eliminating the radiographic lucency with the patient’s preference of retaining an asymptomatic, functional tooth? We will examine how intervention or observation of asymptomatic, functional endodontically treated teeth with periradicular findings may affect the patient.

Attendees will learn:

1. Examine disease-specific oriented treatment and patient-oriented treatment with respect to endodontic retreatment.

2. Examine how the decision to retreat or observe an asymptomatic, functional endodontically treated tooth with a periradicular finding may affect the patient.

3. Recognize that monitoring endodontically treated teeth with persistent apical periodontitis may be a viable treatment option.

About the Presenter:

Dr. Grover was born and raised in Staunton, Virginia. In addition to his endodontics practice, he is Associate Professor of Endodontics at the University of Virginia Department of Dentistry and Assistant Professor of Endodontics at the Virginia Commonwealth School of Dentistry.

He is a graduate of Hampden-Sydney College, the Medical College of Virginia School of Dentistry, and received a certificate of Advanced Graduate Studies in Endodontics from Boston University School of Graduate Dentistry. Dr. Grover served as a dentist in the United States Navy with the rank of Lieutenant. Dr. Grover has been a member of the American Dental Association since 1984, the Virginia Dental Association since 1987, and the American Association of Endodontics since 1993.

Dr. Grover, his wife Brenda and their children Andrew and Sarah, have been residents of Charlottesville, Virginia since 1992.

DISCLOSURE: Dr. Grover has no relevant financial relationships to disclose.

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