Announcing the winners, Julian Webber, founder of the Harley Street Centre for Endodontics and creator of the award, said he was impressed and proud of all the entries in 2016. Deciding who should take the first three places had been very challenging for him and his co-judges: colleague and endodontic specialist Trevor Lamb and Professor Andrew Eder, of the UCL Eastman Dental Institute and Pro-Vice-Provost at UCL.
“As we looked through these entries, supported by extensive references and a highly rigorous approach, from diagnosis and presentation of options to the shaping, cleaning and obturation of canals, at every stage using the correct technique, we had to keep reminding ourselves that these young dentists were effectively still in training. They are rising stars in the field of endodontics and a credit to their teaching hospitals and tutors.”
Emphasising how difficult it had been to rank three such fine entries, Julian declared Satnam Singh Virdee the winner. “His was the most technically challenging case. The tooth had been treated before, but poorly, and the canals were curved with apices close to the maxillary sinus. This was the kind of case for which a specialist referral would normally be warranted.”
David Bretton, who took second place, presented a routine endodontic case but executed to a very high standard and his entry communicated strongly his passion for endodontics.
Jasneet Gulati, who is now working in Singapore and could not be at the event, took third place with his treatment of an 18 year old who required MTA for apical closure, demonstrating extensive skill and achieving an excellent result.
Satnam Singh Virdee, who is now a restorative dental core trainee at Cardiff Dental Hospital is the winner of an X-Smart IQ WaveOne Gold starter kit with dual cordless motor and iPad mini from Dentsply; David Bretton, an associate in general practice, wins a P5 Newtron XS ultrasonic irrigation unit with Endo Success retreatment kit from Acteon; and Jasneet Gulati , now in Singapore, wins a Morita ZX apex locator from Quality Endodontics Distributors (QED).
Summaries of entries with before and after radiographs:
Satnam Singh Virdee
A 36 year old male patient was referred to the Leeds Dental Institute where he was treated by Satnam, at that time a dental core trainee. The patient complained of constant pain with episodes of acute infection for which the patient had been given repeat courses of antibiotics. The tooth had been root treated before but not protected by a crown.
The radiograph showed radiolucency below the root leading to a diagnosis of chronic apical periodontitis due to an infected root canal. The previous treatment was unsatisfactory – poorly condensed, not to appropriate length, no evidence of MB2 instrumentation. The MB canal curvature was greater than 400 with apices in close proximity to the maxillary sinus. The treatment was carried out in 2015 and a year later, a follow-up radiograph showed healing and the patient was free of symptoms. Commenting on his entry, Satnam said: “Since graduating in 2013, I have developed a significant passion to expand my knowledge within the field of endodontics. I particularly enjoy its technically complex but conservative nature, working to a considerably fine level of detail and the infinite variation that is associated with each case. I believe it is the documentation of this endodontic procedure that best demonstrates this enthusiasm in addition to my procedural knowledge, clinical aptitude and academic understanding of the subject that has developed throughout a postgraduate elective period of endodontic training as a dental core trainee.
The difficult nature of this case has also presented many streams of discussion which on reflection with senior colleagues, has directed me to important landmark studies expanding my academic knowledge and allowing me to practice more evidence based endodontics. It has also contributed to the development of other practitioners as this case report has been orally presented at a regional level to undergraduate and postgraduate dentists.
Completing this case represents the summation of my academic and clinical skills to date. As a young practitioner, it has enhanced my confidence, helped me consolidate existing skills whilst simultaneously acquiring new ones, contributed to the development of others and reinforced my desire to want to pursue a long term career within the field of endodontics.”
David Bretton’s case study
A 30 year old female patient presented with a broken lower tooth which was causing her pain and she was referred into hospital where she was seen by David for treatment. The broken tooth had been previously filled and decay had penetrated close to the pulp. It needed root filling and restoring if it was to be saved. David’s diagnosis was pulp necrosis and symptomatic apical periodontitis. The tooth was treated over two appointments and despite his inexperience, he achieved an excellent result. He commented in his entry: “As an undergraduate, I was always passionate about endodontics. Entering general practice in my foundation year, I was concerned for my future; many practitioners I spoke to had negative feelings and experiences with endo. I was worried that it would not be possible to continue as I had at undergraduate level. What I did know was that I wanted to save teeth. I was determined to keep my passion and love for endo and provide ethical, high quality care, whatever ‘system’ I was working on. Moving through foundation training and onto an associate position in mixed practice, I have been able to do this.
I feel this case represents a common scenario that many GDPs face on a regular basis. The quality of care/endo in this case exemplifies what most GDPs should be able to aim for, particularly with some of the technology/systems now available to us. It is a well evidence based case and this awareness of the literature is essential if we are to provide our patients with the best possible care.
Jasneet Gulati’s case study
An 18 year old male patient was referred into Charles Clifford Dental Hospital because he wanted treatment for his ‘ink tooth’. Jasneet, a dental core trainee in restorative dentistry, took on the case. The patient had a discoloured tooth as a result of a sporting accident as a child and the tooth had already been root treated twice. Internal bleaching had been carried out but had not been fully effective and an attempt had been made to conceal the internal staining by covering it with white filling material. The tooth was still causing problems but it was the appearance that concerned the teenager who had been bullied at school.
Jasneet saw the 18 year old patient over seven appointments and using MTA for apical closure – a technique requiring extensive skill – he repaired and restored the tooth, achieving an excellent result. He commented on his entry: “This case was a stimulating challenge for me. Through case based discussions with my supervising consultant, and the literature review I carried out, I enhanced my knowledge of the management of open apices, case selection and endodontic material properties. Overall, this was a great learning curve for me and I look forward to further enhancing my endodontic skills.”
