August 2014 E-Newsletter

Lasting First Impressions and APICES 2014 Recap

Dear Residents and New Practitioners,

My name is Melissa Marchesan, and I am the new chair of the Resident and New Practitioner Committee. I am enthusiastic about my appointment, and I am interested in your feedback. I am currently wrapping up my full-time appointment at Nova Southeastern University, and I am in the processing of moving to University of Tennessee Health Science Center in Memphis where I have accepted a full-time position. 

On behalf of all the members of the Resident and New Practitioner Committee, I would like to extend a special welcome to first-year residents who have just started their endodontic journey! We realize what a busy time this is for all residents. Those that graduated over the summer are also feeling the pains of transition, but the committee hopes that, with some sound advice and guidance, this quarterly e-newsletter will steer you through this unique time in your career. 

August 8 – 9 marked the 11th annual Advanced Program in Clinical Endodontics Symposium, APICES 2014, at the University of Texas Health Science Center at Houston! For those of you who are unaware, APICES is the only meeting of its kind created entirely by endodontic residents and solely for endodontic residents. I would like to take this opportunity to thank everyone who contributed in their own special way to make APICES a grand success! APICES 2014 brought record numbers with the highest attendance to date; 200 residents attended the meeting! I am sure each one of us made new introductions, broadened our outlooks and brought back memories to cherish in the coming months. Without a doubt, residents, faculty and staff from the University of Texas Health Science Center at Houston put on a great show that gave residents ample opportunity to mingle, get quality education and have a blast at the same time. I thank all our speakers and sponsors for their time and effort at the program.

In this issue of The Paper Point, the committee will introduce themselves and bring you a recap of APICES 2014, a “Crazy Case” presented by one of our committee members, a Residency Program Profile and an in-depth look at interviewing for full-time employment within private practice and educational institution settings. 

The goal of this committee is to work together as a team and make ourselves known as your voice in the AAE. We are always interested in your ideas for The Paper Point for the coming year. If you would like us to focus on any specific area, please come forth; your suggestions and ideas are welcome. Looking forward to hearing from you!

Melissa Marchesan, D.D.S, M.S., Ph.D., Resident and New Practitioner Committee Chair



First Impressions Are Everything

Contributors: Peter A. Morgan, D.M.D., M.Sc. and Anne E. Williamson, D.D.S., M.S.

Each year, endodontic residents and new practitioners all over the country embark on the next chapter of their lives by entering the job market. The first step is the interview. Though it seems daunting, it is the first impression you will make on your potential employer and colleagues. Below you will find information and tips from two different types of employers on how to succeed.

Private Practice, Peter A. Morgan, D.M.D., M.Sc.

In today’s world of endodontic private practice, patient flow is one of the biggest concerns. In general, most practices are looking to increase the number of patients that are referred to them. A big concern for recent grads is cash flow, since most have built up serious debt while getting their education. For a recent graduate looking for a position in a private practice, these facts make finding the perfect position somewhat difficult. However, when the right match is made, both of these problems can be solved.

One could make the case that existing practice owners have the advantage in the employment market since there are many recent grads and fewer positions available. While this may be true, in general, it is essential for practices to grow. Matching the practice needs for more patient flow with the right grad in need of cash flow can create a valuable scenario for both parties. Your goal in the interview process is to convince the practice owners that you are that right person.

The most important concept for the young endodontist seeking a position in a private practice is to be committed to bringing value to the group. In the past, many practices needed another doctor because they had too many patients! Getting hired and succeeding then was relatively easy. Today most practices need to grow, and one of the best ways to accomplish that goal is to bring in a new younger endodontist who can build relationships with peers. It is important to understand that your role will be to make that practice stronger by bringing added value.

There are two parts to the job-seeking process: the practice’s position and your position. To form a successful business relationship with the potential for long-term engagement, both sides must be committed to making the process work. From your perspective, it is very important to evaluate the practice in the same way your prospective employers are evaluating you. This gives you the best opportunity to end up in the right place.

When evaluating a practice for employment, make sure that the practice is committed to:

Creating a positive social environment with the partners, associates, managers and staff. You should meet the doctors and visit with the staff and office manager. These individuals play a vital role in integrating a new member of the group. Make sure that you sense that the doctors and staff are welcoming, receptive to change and interested in your success.

Creating a positive work environment. Observe the office and the environment. How does the practice present itself to new patients? Do they have up-to-date technology and adequate staff? Most importantly, do the doctors in charge have a plan for your success? A good way to evaluate this is to ask about how they book new patients. If they are truly interested in you being successful, they will willingly provide some patients for you in the beginning. This is very basic as it provides a way for you to begin to meet the existing referral base by discussing cases you have done for the referring doctor’s patients. If in the interview the owner/doctors tell you that you will only get to treat patients that you have developed yourself, or after their appointment book is filled for weeks, you may want to look for a practice with a different philosophy.

Creating an opportunity for practice development. Do they have a plan to make the new associate busy? Do they have a strong marketing program that will be used to introduce you to the referral base? Is there potential for you to develop new referrals? Is there a person on staff who helps the doctors with introductions and marketing?

The obligations of the New Associate: While you are evaluating the practice they are also evaluating you. They will be very interested in how you will bring value to the existing practice. In other words, what can you do for them?

When discussing how you would benefit the practice, keep the following points in mind:

First and most importantly, be a good endodontist. Don’t worry about production immediately. On the contrary, do good cases and make patients and referring doctors happy. The best marketing tool is a successful case and a happy patient.

Work hard at integrating into the existing culture. A successful career lasts a long time and there will be plenty of time for you to effect change in the practice you join. Just don’t try to do it all at the beginning. Respect that the staff and doctors have reasons for their routines and take time to learn from them. They will respect you for it.

Form successful relationships with the existing referral base and grow that base by expanding it to your peers in the dental community. This is very important and it takes dedication, time and hard work. It can take years to develop the trusted relationships that result in a busy schedule.

Be willing to take on projects that benefit the practice, not just you. In this way you demonstrate your value to the success of the overall practice. An example may be that you help to create a protocol about a treatment routine that you have learned in your training that would be new to the practice.

And lastly, distinguish yourself by becoming indispensable! If you do good cases and have positive relationships with the staff and referral base, and you are willing to truly invest yourself in the success of the practice, your position will be secure. They will not want to live without you!

Education, Anne E. Williamson, D.D.S., M.S.

Congratulations! You have been invited for an interview!

While the interview process for a faculty position may be similar for a variety of positions (e.g., clinical track versus tenure track), the qualities important for the candidates may be highly variable. For example, if the available position is for the tenure track, you will be expected to be productive in several areas including research, scholarship, teaching and clinical service and may be required to have an M.S. or Ph.D. degree. In this instance, a candidate with a research pedigree and experience will be desirable. If the position is for a “research intensive” individual, the research pedigree will be even more important. For a clinical track position, a candidate should have a solid record of teaching and clinical experience and should expect to fulfill a crucial role in the teaching mission of the school. If a potential candidate is interested in being a graduate program director, then they must be a Diplomate of the American Board of Endodontics.

The interview process itself typically consists of the candidate meeting individually with all of the current department faculty members and the administrators of the school (dean, associate deans, etc.). Oftentimes the candidate will also meet with individuals in other departments to learn as much about the school and the various programs as possible. Most formal interviews involve a lecture that the candidate delivers to the department and anyone else interested in attending. These lectures are usually 45-60 minutes in length.

One of the primary goals the interviewee should set out to accomplish is to learn as much as possible about the expectations of the position as well as the dynamics of the department and how it fits into the infrastructure of the school. It is very important to be sure that this position is a good fit for you. This includes not only the position itself, but also the location of the dental school, hospital or clinic, the size of the city and, believe it or not, the climate!

Other things interviewees may be interested in are the quality of the school system, cultural activities, restaurants, entertainment opportunities and so forth. So, before you go, do your homework and be prepared to ask questions!



Meet Your 2014-15 RNP Committee

The Resident and New Practitioner Committee was established by the AAE to provide greater service to residents and new practitioners. The Committee coordinates with the AAE Board of Directors and other committees and groups. The 2014-2015 committee members are dedicated to improving the RNP experience at the AAE by providing the best resources and guidance while serving as your voice to the organization. Below are the committee members serving you this year! Please feel free to reach out to them at if you have any questions or suggestions!

Not Pictured: Tyler Peterson, D.D.S., New Practitioner


A New Age of APICES

After bringing in record registration numbers during the summer, APICES 2014 was bound to be a banner meeting. The resident planning committee at the University of Texas Health Science Center at Houston spent nearly a year putting together a top-notch scientific program and first-class social events. For the first year, APICES began on Friday afternoon and ended after the social event on Saturday night, leaving Sunday for travel. The new schedule was extremely well received by all parties. Check out the images below to get an idea of exactly what the weekend was like!

Friday, August 8

After checking in to the Marriott Medical Center in Houston, residents joined leadership from the family of AAE organizations to “Get to Know Your Specialty.” During the two-hour presentations, leadership from the AAE, AAE Foundation, College of Diplomates and American Board of Endodontics shared how the four organizations are unique and work together.

Get to Know Your Specialty

During “Get to Know Your Specialty,” residents had the opportunity to ask questions and voice their opinions about issues the organizations are facing.


Friday Night Social Event

After a networking happy hour, residents were treated to a night at Minute Maid Park to see the Houston Astros take on their cross-state rivals.



Saturday, August 9

Scientific Program

Saturday morning kicked off bright and early with four world-class speakers, tours of the UT School of Dentistry at Houston and multiple breaks to network with generous corporate partners.

Saturday Night Social Event

Saturday night brought cooler weather, great food and lots of dancing at The de Gaulle, a restaurant bar in Houston modeled to look like a vintage Charles de Gaulle Airport in Paris. Residents, corporate partners and speakers enjoyed getting to know one another better in a fun, casual atmosphere.

A special thanks to the co-chairs of the APICES Planning Committee, Drs. Valerie Okehie and William Pack, and their co-residents and faculty at UT School of Dentistry at Houston. Their hard work and dedication to a successful meeting were undoubtedly the reason attendees had a valuable experience. 

See you in 2015 at the University of Minnesota!

Crazy Case
By Scott Brezinsky, D.D.S.


A 19-year-old female presented to the clinic with a chief complaint: “I have a tooth that had a root canal started and it wasn’t finished, and now part of the tooth broke off” (patient points to tooth #18). The patient’s dental history revealed that nonsurgical root canal therapy (NSRCT) was initiated on tooth #18 one year ago, and her referring dentist’s treatment plan was to evaluate #18 for completion of NSRCT, extract #17 and restore #18 with a full coverage restoration (Figures 1 – 6).

A thorough clinical and radiographic examination revealed a diagnosis for tooth #18 of pulpal: previously initiated, periapical: condensing osteitis. The prognosis for #18 in regard to NSRCT and coronal restoration was deemed questionable due to the extensive loss of coronal tooth structure. Alternative treatment options were discussed with the patient to include: extraction and replacement with an implant, extraction without replacement, or extraction and autotransplantation of impacted tooth #1 or 17. After all aspects of treatment options were discussed, the patient consented to extraction of #18 and autotransplantation of impacted #1 or 17.


The patient was pre-medicated one hour prior to the procedure with 2 g of amoxicillin and 600 mg of ibuprofen. The patient pre-rinsed with 0.12% chlorhexidine. Profound anesthesia was achieved. Using a surgical operating microscope at 5X magnification, a full thickness mucoperiosteal flap was reflected to expose #17 and 18 area. An osteotomy was made to expose #17 and an atraumatic extraction of #17 was completed using luxators and forceps. #18 was subsequently extracted using forceps.

The apical papilla of #17 was present and the root development assessed and determined to be half developed. The decision was made to also extract #1 as it was thought to possibly provide a better candidate for autotransplantation. A full thickness mucoperiosteal flap was reflected to expose #1. Atraumatic extraction of #1 was completed using luxators and forceps. The apical papilla of #1 was also present and the root development was determined to be half developed as well.

Both #1 and 17 were immediately placed in Hank’s Balanced Salt Solution and kept moist at all times. Based on the root morphology, crown form and fit of the tooth into the extraction site of #18, tooth #17 was determined to be the best candidate for the autotransplantation (See Figure 7). #17 fit into the #18 extraction site passively with adequate clearance for occlusion. #18 extraction socket was flushed with 20 mL of sterile saline, and 0.5 cc freeze-dried bone allograft mixed with calcium sulfate was placed in the extraction site of #17. Tooth #17 was fit into the extraction site of #18. A figure-of-eight 4-0 vicryl suture and two 4-0 vicryl interrupted sutures were used to stabilize the transplanted tooth into place (Figures 8 – 11). Five minutes of pressure with moist gauze was applied to #17 and 18 area to achieve hemostasis. The transplanted tooth was verified not to be in hyperocclusion. The patient was instructed to follow a soft food diet and chew primarily on the right side for two weeks.

A four-month recall was obtained, in which the patient expressed only occasional minor biting sensitivity. A clinical and radiographic exam revealed that the transplanted tooth had a class I mobility, adequate osseous repair, and root length appeared to be developing (Figures 12 – 16). The patient will continue to be monitored at routine recall intervals.

Submit your Crazy Case to for a chance to be featured in an upcoming issue of The Paper Point!


Residency Program Profile

In an attempt to acquaint residents with their peers across the nation, the Resident and New Practitioner Committee presents the Residency Program Profile. In each issue, a resident shares details of his or her personal experience at an endodontic program.

University of Iowa College of Dentistry

Resident Interviewed: Dr. Mark P. Sullivan, D.D.S.

Q. How many residents are in the endodontic program?

Eight. Currently six are certificate track and two are Master’s.

Q. How many different places in the country are represented by residents in your program?  

Colorado, Illinois, Iowa, Michigan, Nevada, Utah and Wisconsin

Q. Where is your program located?

Iowa City, Iowa

Q. On average, how many hours a week do you spend in the clinic?

We are in the clinic approximately 20 hours per week during the academic year. During the summer, between the first and second year, clinic time goes up to around 32 hours per week.

Q. What is your favorite thing about endo residency at University of Iowa?

The friendships and camaraderie that develop in the resident room among the eight residents over the course of the program.

Q. Are you given hands-on experience with new endodontic technology?

Our clinic is only three years old. In addition to nine student operatories, we have six faculty/grad ops that are equipped with ASI carts and Zeiss microscopes. Two Global microscopes are also available in the student ops. Additionally, we have a Carestream 7000 CBCT dedicated to our department.

Q. What is something unique about your program that no one else would know?

Four Iowa graduates have been AAE presidents, including the first AAE president, W. Clyde Davis, a 1891 graduate and founder of the University of Nebraska Medical Center College of Dentistry. Along with Louis Grossman and John Hospers, Dr. Davis organized the AAE in 1943.

The department has produced eight directors of the ABE.

The graduate program was to be closed in 1979 due to a lack of faculty. Dean Jim McLeran mandated it stay open. There were three applicants in April of 1979, two were accepted; both became AAE presidents.

Q. Is there anything else you would like to add about the program?

Iowa offers the option of a two-year certificate or a three-year Master’s program. The department has five full-time faculty who work with all the residents in varying capacities. In addition, residents can collaborate with other research-focused faculty within the College when conducting their research projects. Starting at the end of the first year, residents begin teaching second-year dental students in the preclinical endo course and continue working with the students throughout the following year in the student clinics. The program offers a great balance of clinical, didactic, teaching and research components.

American Association of Endodontists
211 E. Chicago Ave., Suite 1100
Chicago, IL 60611-2691
Phone: 800/872-3636 (U.S., Canada, Mexico) or 312/266-7255
Fax: 866/451-9020 (U.S., Canada, Mexico) or 312/266-9867


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