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By Tung Bui, DDS, FICD

Artificial intelligence is no longer an abstract concept discussed in computer science seminars; it is a tool that is already changing how we teach and practice endodontics. When I mentor AEGD residents about evidence based practice, I often begin by showing how many papers are published each year and how little time we have between patients to review them. This flood of information is not a problem that better memory can solve. It requires technology that helps us find trustworthy evidence and presents it in a way that clinicians can use during a busy clinic session. OpenEvidence is one of the most interesting responses to that challenge. It is a platform built for clinicians, and it rewards the curiosity of educators and students who want to ground their teaching in current research.

What is OpenEvidence?

OpenEvidence is an artificial intelligence powered medical information platform that draws exclusively from peer reviewed medical literature. Instead of scraping the entire internet, the software indexes metadata from PubMed abstracts, full text journal articles, monographs and book chapters. When a user, who must be a verified healthcare professional, asks a clinical question, OpenEvidence identifies potentially relevant sources, selects the most authoritative papers based on relevance, publication date, journal impact factor and citation count, and then synthesizes a short answer with clickable citations. This output arrives within seconds, allowing a clinician to remain in the loop and dig deeper if needed. To limit hallucinations, the system abstains when evidence is inconclusive and always includes references.

The platform is intentionally restricted to healthcare professionals. Physicians, dentists, nurses and other clinicians verify their status by entering a National Provider Identifier or similar credentials. Medical and dental students can register by submitting proof of enrollment. Non-clinicians are permitted only two searches per day, and there is currently no way for the public to purchase unrestricted access. This gatekeeping maintains quality by ensuring that the user community understands the consequences of acting on clinical information. OpenEvidence complies with the Health Insurance Portability and Accountability Act (HIPAA) and will sign a Business Associate Agreement with covered entities, but it warns users not to enter protected health information.

Origin Story and Business Model

OpenEvidence was co founded by Daniel Nadler and Zachary Ziegler. Nadler is a Harvard trained economist and artificial intelligence entrepreneur who previously founded Kensho, a financial AI firm. During the COVID‑19 pandemic he observed that physicians were drowning in a fire hose of literature where medical knowledge doubles roughly every seventy three days. He assembled a team of researchers from Harvard and MIT, including Ziegler, to build smaller, highly specialized models trained solely on peer reviewed medical literature. The company launched in 2021 under the Mayo Clinic Platform Accelerate program and released its direct to clinician application in 2022.

The go to market strategy treats doctors like consumers rather than hospital administrators. OpenEvidence is free for United States clinicians and students and generates revenue through targeted advertising. The company has raised several rounds of funding: self financed in 2021, a friends and family round in 2023, a seventy five million dollar Series A led by Sequoia Capital in February 2025, and a two hundred and ten million dollar Series B co led by Google Ventures and Kleiner Perkins in July 2025, valuing the firm at 3.5 billion dollars. Those private investments mean there is no publicly traded stock; interested investors would need access to future private rounds, which are typically limited to accredited investors. The rapid adoption with over forty percent of U.S. physicians logging in daily, is proof that the free, advertising supported model can scale. Disclosure; I have been working patiently with my hedge fund manager to acquire private shares of OpenEvidence.

How does it work?  

OpenEvidence’s core function is known informally as Ask. Clinicians type or speak a question into a mobile or desktop interface, such as “write home care instructions for apical surgery” or “what is the dosing of Penicillin VK for a ten year old. The platform uses natural language processing to interpret the question and then searches its indexed corpus of more than thirty five million peer reviewed publications. It ranks the articles, extracts the relevant facts and composes a short answer with inline citations. The interface invites follow up questions and may suggest related queries to help refine the search. When viewing citations, clinicians can expand a details button to read a summary of each reference, rate the helpfulness of the response, copy a shareable link and see automatically generated follow on questions. The platform warns users to verify that citations actually answer the question, reinforcing healthy skepticism.

While the standard search is designed for rapid answers, some questions require deeper research. Deep Consult is an AI agent that autonomously reads hundreds of studies and produces a longer research brief. The service runs complex computations, more than a hundred times the compute of a standard search, but remains free for verified clinicians. Deep Consult is useful when preparing literature reviews or when dealing with complex medical histories. For example, when a patient presents to the clinic with a complex medical history, we can request a Deep Consult on the list of conditions and receive a summary of all available evidence, including randomized controlled trials and systematic reviews.

Visits is a digital clinical assistant introduced in 2025. It acts like a medical scribe: recording patient encounters, drafting notes and enriching the assessment and plan with guidelines and current research. Visits allows clinicians to ask questions using the patient’s full history and documentation, organizes patient files into a searchable repository and generates polished notes that can be pasted into the electronic health record. For dental educators supervising residents, this module can lighten the administrative load and model best practice documentation.

The Dialer module provides a HIPAA secure phone line with unlimited minutes and smart caller ID. When calling a patient after hours, the clinician’s personal number is masked, and the call can be recorded or linked to a Visit. The application also offers clinical trial matching so providers can identify active trials for conditions like cemental tears, external invasive cervical resorption, or regenerative endodontics procedures. Inbox, a secure messaging centre, allows clinicians to manage queries and results from the platform, while Discover curates featured stories and recent advances from journals such as The New England Journal of Medicine and JAMA. Looking into the future, one could customize the feed to focus on relevant endodontic topics. These feeds transform idle scrolling into a learning opportunity.

Accessing the service

Downloading OpenEvidence is straightforward: search for the name in the Apple App Store or Google Play, or use the web version (https://www.openevidence.com). After installation, users must create an account. Physicians, dentists and allied providers verify their identity by entering an NPI; dental students and endodontic residents upload proof of enrollment. The platform is free for verified professionals, but non clinicians are limited to two searches per day. Institutions seeking to integrate Visits or store protected health information must sign a Business Associate Agreement [4]. The platform’s terms permit the company to collect usage data and sell anonymized, non personal information for commercial purposes, so educators should remind residents not to enter identifiable patient data.

How OpenEvidence benefits dental educators and residents

The everyday functions of Ask, Deep Consult and Visits make OpenEvidence a natural companion for endodontic education. Residents often struggle to connect pathophysiology with evidence based management. With Ask, a resident confronted with burning mouth syndrome in an endodontic residency program can pose a question like “what are the etiologic factors and management options for burning mouth syndrome” and receive a concise summary with citations that they can read before presenting the case to faculty. When our residents debated whether every patient needs a pre-operative cone beam computed tomography scan, Deep Consult produced a structured report summarizing guidelines, systematic reviews and cost effectiveness analyses. That report grounded our discussion in evidence rather than anecdotes and allowed us to model critical appraisal skills.

OpenEvidence also shines when we evaluate new technology. Sales representatives often pitch devices like GentleWave with claims of superior cleaning and less postoperative pain. By asking the platform for a Deep Consult on the device, we quickly learn whether independent trials support those claims. If the evidence is weak or only animal studies exist, we can protect our budgets and our patients. Similarly, when a patient asks whether a muscle relaxant we plan to prescribe interacts with their antiretroviral medications, the platform surfaces drug monographs and interaction studies. Instead of relying on memory or generic interaction checkers, we see the primary literature.

Educators can integrate OpenEvidence into lesson plans. Assign students to craft endodontic questions and evaluate the AI’s responses. Users can filter searches by All, Guidelines and Standard of Care or Clinical Evidence, with results that are tagged as Highly Relevant, Leading Journal or New Research. Those tags help students judge the strength of evidence and understand that not all papers are equal. Encourage residents to follow the citations, read the original articles and consider the applicability to endodontic practice.  Remind them that OpenEvidence is an experimental tool and does not replace critical thinking.

Why use a purpose built platform instead of general large language models?

General purpose large language models such as ChatGPT are trained on vast swaths of the internet, including blogs, social media and satirical sites.  Daniel Nadler argues that “an index of websites is not an index of facts”. Because mainstream models do not differentiate between high quality medical research and unreliable sources, they are prone to error and hallucinations. In contrast, OpenEvidence is trained on peer reviewed publications and selects citations based on relevance and impact. The platform abstains when evidence is insufficient, and it displays citations so clinicians can verify the information. The general public without an NPI is limited to two searches per day; this gatekeeping reduces misuse and encourages proper clinical oversight. In other words, the platform is designed not just to answer questions but to foster evidence based reasoning.

Looking ahead

OpenEvidence’s vision extends beyond answering questions. The company plans to expand globally and develop advanced AI models capable of sophisticated diagnostic reasoning and personalized treatment recommendations. Future modules may integrate with electronic health records to surface evidence during charting and provide application programming interfaces for third party applications. The platform already offers clinical trial matching and is experimenting with ways to help clinicians draft prior authorization letters and patient education handouts. These innovations suggest that artificial intelligence will become an ambient part of clinical workflows, not a separate destination.

A measured embrace of AI in endodontics

For endodontic educators, AI is not a replacement for mentorship but a catalyst for deeper learning. OpenEvidence demonstrates how a tool built on high quality data, designed for clinicians, can shrink the distance between the literature and the operatory. Whether we are confronting an unusual neuropathic pain condition, debating imaging protocols or evaluating a flashy new device, we can turn to a platform that delivers rapid, referenced answers and encourages us to read the source material. By integrating these tools into our teaching, we prepare residents for a future in which evidence is at their fingertips and critical appraisal is more important than memorization. Artificial intelligence in education is not about abdicating judgement; it is about augmenting our ability to find and apply the best available evidence.

References

  1. FeldmanA, Shrivastava R. This AI founder became a billionaire by building ChatGPT for doctors. Forbes. July 15, 2025. https://www.forbes.com/sites/amyfeldman/2025/07/15/this-ai-founder-became-a-billionaire-by-building-chatgpt-for-doctors/
  2. OpenEvidence, the fastest‑growing application for physicians in history, announces $210 million round at $3.5 billion valuation.PR Newswire. July 15, 2025. https://www.prnewswire.com/news-releases/openevidence-the-fastest-growing-application-for-physicians-in-history-announces-210-million-round-at-3-5-billion-valuation-302505806.html
  3. Jiang Y. OpenEvidence and the future of AI medical assistants. VerticalAI Newsletter. 2025. https://www.newsletter.lukesophinos.com/p/135-openevidence-vertical-ai-for

The Wisconsin Dentistry Examining Board proposed revisions to Chapter DE 6 that would allow general dentists to advertise as specialists even without completing a Commission on Dental Accreditation–accredited residency program. This change would open the door to unrecognized credentials, short-term coursework, and non-CODA training programs being presented to the public as legitimate specialty qualifications. The potential consequences are significant: patient confusion, diminished standards of care, and erosion of the specialist designation our members earn through rigorous education and experience. 

In response, the AAE submitted strong formal opposition to the board. We emphasized that specialty recognition and advertising must remain tied to CODA-accredited education or National Commission on Recognition of Dental Specialties and Certifying Boards–approved programs. This framework protects the public from misleading claims and ensures consistency, safety, and competency in the delivery of dental specialty care. Weakening these standards would jeopardize patient safety and undermine the board’s core mission of safeguarding public health. 

Our advocacy also underscored the expectations of the public. Research published in the Journal of Dental Education shows that patients overwhelmingly believe that anyone advertising as a specialist has completed an accredited residency, and many would reconsider seeking care from someone without that level of training. In short, the public already trusts that the title “specialist” conveys meaningful, rigorous preparation. It is our shared responsibility—along with state regulators—to ensure that this trust is upheld. 

Our message to the Wisconsin Dentistry Examining Board was clear: the AAE stands firm against efforts that threaten the integrity of our specialty. Through direct engagement, evidence-based advocacy, and unwavering commitment to public safety, we continue to protect your ability to practice as true specialists. This action reflects the AAE’s ongoing work to uphold the high standards of endodontics and support the professionals who advance patient care every day. 

By Dr. Kayla Tavares Tio, D.D.S., M.D.S.

Insurance carrier misalignment and improper claims processing have become increasingly common sources of strain within endodontic practices. Many providers find themselves caught in cycles of delays, repeated resubmissions and inconsistent information. My practice recently confronted such a challenge when Carrier A and Carrier B failed to honor our timely Carrier A network opt-out and continued to process claims under the incorrect fee schedule.

After months of unsuccessful attempts at internal resolution, the matter was finally corrected—swiftly and decisively—once the Texas Department of Insurance (TDI) became involved. Within days, all claims were reprocessed correctly.

This experience highlights a clear pathway for other endodontists facing similar obstacles: a structured advocacy model grounded in documentation, professionalism and strategic escalation.

The Problem: A Timely Opt-Out Ignored

In January, our practice submitted the required Carrier A opt-out documentation. Despite completing the process, claims continued to return under the Carrier A/Sun Life fee schedule instead of our specially contracted fees. We contacted both Carrier A and Carrier B repeatedly, resending documentation multiple times. Each interaction produced shifting timelines—first 30 business days, then 60, then 90 and eventually 120. Throughout this period, Carrier B maintained that no opt-out was on file.

The issue persisted for months without progress, significantly increasing our administrative burden. Each attempt to correct the problem was met with vague assurances, inconsistent explanations or new waiting periods. Meanwhile, claims continued to process incorrectly.

The Turning Point: Regulatory Oversight

After exhausting all internal channels, our practice submitted a formal complaint to the Texas Department of Insurance. Once TDI reviewed our documentation and contacted Carrier A, the issue turned around almost immediately. Carrier A updated our network status, acknowledged the opt-out and reprocessed all affected claims—something customer service could not resolve over nearly half a year.

This rapid correction underscores the impact of regulatory involvement. Insurance carriers often respond quickly when contacted by state oversight agencies, and regulators take network accuracy and claim integrity seriously.

Conclusion

Advocacy is not only necessary—it works. By following a structured model supported by proper documentation, persistence, professional collaboration and regulatory oversight when warranted, endodontists can overcome carrier barriers and ensure accurate claim processing. This experience stands as a practical and repeatable model for our specialty.

A Structured Model for Endodontists

This experience revealed several steps that may serve other endodontists well.

  1. Build a strong documentation foundation.
    Every form submitted, every EOB received, every call made and every email exchanged should be recorded and organized. Accurate CDT code definitions, specialty standards of care and clinically detailed narratives reinforce code appropriateness and reduce ambiguity.
  2. Communicate clearly and consistently.
    Carrier communication should be factual and firm. Clearly state what treatment was performed, why the CDT code is correct and what action is required. Request written confirmation, not verbal assurances.
  3. Leverage professional organizations.
    When routine channels stall, the AAE and ADA provide valuable support. Their guidance reinforces correct coding and strengthens the provider’s position.
  4. Escalate when necessary.
    If an insurer remains unresponsive—even when provided with correct documentation and explanations—the next step is escalation to the state insurance commissioner. This formal, consumer-protected pathway exists specifically for situations where insurers improperly process claims or fail to act. Regulators can intervene, compel corrective action and ensure carriers follow contractual and statutory obligations.

Documentation Tips That Strengthen Your Position

Strong documentation plays a decisive role in successful dispute resolution. Endodontists should:

  • Keep detailed records of all calls, including dates, times, representatives and promised follow-up steps.
  • Maintain concise, clinically accurate narratives aligned with specialty standards.
  • Retain copies of all claim submissions, EOBs and network correspondence—both electronic and scanned—to create a traceable paper trail.

When preparing a regulatory complaint, clarity is essential. Summaries should outline the issue, timeline, attempts at resolution and the specific action requested. Providing well-organized evidence enables regulators to intervene efficiently and confidently.

 

The American Association of Endodontists (AAE) is proud to support Michigan House Bills 4593 and 4594, companion measures that strengthen the integrity of dental specialty licensure and protect endodontists ability to provide care. Introduced by Representatives Martus, Bierlein, Rheingans, Rogers, Neyer, Kunse, Schmaltz, and Roth, these bills uphold professional standards while protecting Michigan patients from being treated by specialists with misleading claims of dental expertise. 

HB 4593 authorizes the Michigan Board of Dentistry to issue health profession specialty licenses to dentists who complete advanced training and demonstrate competency in approved specialty areas. Beginning January 1, 2026, only those holding these specialty field licenses may represent themselves as “dental specialists” or claim specialization in any area of dentistry. Endodontists who have completed a CODA-accredited program would continue being able to advertise their services as “dental specialists” while those who obtained credentials derived from short-term courses that do not meet the educational standards necessary for competent specialty practice would no longer be able to advertise themselves as “dental specialists”. 

HB 4594 complements this by amending the Public Health Code (MCL 333.16605) to formally restrict the use of certain professional dental titles—specifically including “dental specialist”—to individuals recognized under Michigan law. Together, these bills safeguard the dental profession’s credibility, ensuring that patients can confidently identify and seek care from qualified, licensed specialists. 

Endodontists know firsthand how critical it is for patients to trust the expertise of their dental providers. Misrepresentation of specialty credentials not only undermines public confidence but can also result in delayed or inappropriate care. By advancing HB 4593 and HB 4594, Michigan lawmakers are helping to preserve that trust—ensuring patients receive safe, high-quality, and accurately represented dental care. 

The AAE applauds the Michigan Legislature for taking action to protect patients and reinforce professional integrity in dentistry. Supporting HB 4593 and HB 4594 means standing for honesty, transparency, and the highest standards of oral health care—principles that define endodontists and the specialty at large. 

AAE’s advocacy efforts in 2025 demonstrated the power of strategic planning, strong partnerships, and member engagement. Throughout the year, AAE advanced impactful initiatives that protected the specialty, strengthened practice sustainability, reinforced public health, and elevated the voice of endodontists in state and national policy conversations. Our progress reflects the combined strength of dedicated members, thoughtful leadership, and a clear vision for the future of endodontics. 

Defending Specialty Recognition 

Protecting the integrity of accredited specialty training remained one of the most urgent advocacy efforts. When the Ohio State Dental Board considered weakening the definition of endodontists, AAE acted swiftly in collaboration with the Ohio Association of Endodontists, ADA, and other partners. Through coordinated letters, testimony, and member mobilization, AAE helped prevent the proposal from moving forward, preserving both patient safety and the clarity of specialist qualifications. 

Supporting Student Loan Reform and Workforce Sustainability 

AAE remained committed to supporting the next generation of endodontists by advancing policies that reduce financial barriers to specialty training. AAE strongly advocated for the REDI Act, which would pause student loan interest during residency, easing the financial burden on future specialists. AAE also worked closely with the Organized Dentistry Coalition to protect Graduate PLUS Loans, maintain Public Service Loan Forgiveness eligibility, and oppose restrictive caps on federal education financing. These efforts reinforce the importance of accessible, equitable pathways into the specialty. 

Advancing Dental Benefits Reform 

Reforming dental plan systems continued to be a major focus in 2025, as AAE worked to ensure greater transparency, fairness, and accountability in dental plan structures. A key part of this effort included strengthening the Transparency in Dental Benefits Contracting Model Act to promote clearer and more equitable contracting standards for specialists. AAE also continued its advocacy around Dental Loss Ratio (DLR) policies, supporting efforts in multiple states to require insurers to spend a minimum percentage of premiums on actual patient care. This position reinforces AAE’s commitment to ensuring that dental benefit dollars go directly to treatment—not administrative overhead. In addition to advocating for stronger DLR protections, AAE addressed administrative challenges such as virtual credit card transaction fees, unclear payment protocols, and burdensome billing processes. By pursuing these reforms, AAE sought to reduce unnecessary obstacles that complicate practice operations and to help endodontists focus on delivering high-quality patient care rather than navigating opaque insurance systems. 

Mobilizing Grassroots Advocacy 

AAE’s grassroots advocacy efforts reached new levels of engagement in 2025, demonstrating the remarkable influence that unified, coordinated member action can have on key policy outcomes. When proposals emerged that posed significant risks to practice sustainability and patient access—most notably the threat to eliminate the Pass-Through Entity Tax (PTET) deduction—AAE members responded with unprecedented mobilization. Endodontists across the country advocated through coordinated email campaigns, personalized outreach to lawmakers, and rapid engagement with AAE’s Action Center. This collective response represented the largest grassroots advocacy effort in AAE’s history and played a decisive role in persuading Congress to preserve the PTET deduction. 

Protecting Public Health and Promoting Awareness 

AAE’s commitment to public health remained a driving force throughout 2025, with the association taking a proactive and science-centered stance on issues that directly affect community wellness, patient safety, and long-term oral health outcomes. As multiple states introduced proposals to restrict or eliminate community water fluoridation, one of the most proven, cost-effective public health measures of the past century—AAE responded decisively by submitting formal opposition, collaborating with public health partners, and educating policymakers about the extensive body of evidence supporting fluoridation’s safety and effectiveness. AAE also endorsed the bipartisan TEETH Act, reinforcing that any changes to federal fluoridation regulations must undergo rigorous scientific review and uphold safeguards that protect decades of public health progress. Beyond these policy battles, AAE significantly expanded public awareness of the value of endodontic care by securing 19 gubernatorial, legislative, and mayoral proclamations recognizing Save Your Tooth Month, elevating conversations about natural tooth preservation and the critical role of endodontists in maintaining oral health. In parallel, AAE strengthened the specialty’s visibility on the national stage through active participation in key policy forums, including the American Association of Dental Consultants Meeting, where AAE representatives engaged directly with dental plan leaders and benefit administrators to advocate for fair coverage, equitable reimbursement, and recognition of the specialty’s expertise. Combined, these efforts demonstrated AAE’s unwavering dedication to protecting evidence-based public health measures while simultaneously raising the profile of endodontic care across the country, ensuring that both policymakers and the public understand the essential contributions endodontists make to overall health and patient-centered dentistry. 

Looking Ahead 

As AAE reflects on the achievements of 2025, it is clear that the progress made this year lays a strong foundation for the work that lies ahead, positioning the association to navigate an increasingly complex policy landscape with confidence, clarity, and momentum. The challenges facing the specialty—ranging from evolving dental benefit structures and emerging public health threats to ongoing attempts to dilute specialty recognition and redefine scopes of practice—will require continued vigilance, strategic coordination, and rapid mobilization. AAE enters 2026 prepared to meet these demands, supported by engaged members, committed leadership, and a strengthened advocacy framework that has proven capable of driving meaningful change at both the state and national levels. The association’s focus will remain on championing fair dental benefits, protecting evidence-based public health measures, advancing workforce sustainability, and defending the integrity of accredited specialty training, all while expanding its grassroots capacity and deepening partnerships across organized dentistry and the broader healthcare community. With renewed energy, a clear policy agenda, and the demonstrated power of unified action, AAE looks forward to entering the 2026 legislative session strong, focused, and ready to build on the significant progress achieved together in 2025. 

As we approach the end of the year, I’ve been reflecting on my first eight months as your AAE President. All I can say is WOW!  Time has moved quickly and taken me to places I never expected. The year began in New York City with my first satellite media tour and will end in Cairo, Egypt, where I will represent the AAE at the PAN Endo/APEC Conference.

In between, I’ve had the privilege of visiting Columbus, Morgantown, Charleston, Montreal, Denver, New Orleans, Prince Edward Island, Paris, Las Vegas, Savannah, Brazil, Washington, D.C., Palm Springs, Toronto, and Chicago… five times.

Our Marketing & Communications team tells me that our media presence this year has reached over 1.3 billion impressions. I’ve completed more than 25 interviews, including two at WGN in Chicago and two in my hometown of Cleveland. I’ve written for Good Housekeeping, Travel & Leisure, The Washington Post, Deseret News, Yahoo, and KevinMD.com. Some articles were endodontics-focused, some weren’t, but each one mentioned the AAE and underscored the value of our specialty. I’ve also recorded three podcasts, continuing to raise awareness of who we are and what we do.

Raising the Bar

When I think about what makes me most proud, my mind goes straight to the work happening at the Board of Directors level. One of the most significant accomplishments has been the update and approval of the joint AAE–AAOMR position statement on the use of CBCT in endodontics. A project begun under the leadership of Dr. Natasha Flake.

The updated statement has been approved and will be published in the JOE in January. This document will not only guide best practices for our specialty but will serve as a long-awaited reference for all of dentistry. We are recognized as the leaders in dental imaging, and we will continue to live up to that expectation.

In addition, your Board approved a new policy that elevates our specialty, clarifies how we partner with outside organizations, and reinforces the excellence expected when representing the AAE globally. There is no compromise when it comes to the standard of practice in endodontics.

We also initiated a forward-looking project on the use of Augmented Intelligence (AI) in endodontics. A dedicated think tank has been created to explore what many experts regard as one of the most transformative developments in human history, compared by Lee Rainey of Elon University to the discovery of fire and the invention of the printing press. The AAE intends to be at the forefront of understanding and guiding AI’s impact within our specialty.

Advocacy in Action

Our advocacy department has been exceptionally active this year. The AAE led the mobilization of endodontists and other specialists in Ohio to protect our right to advertise as specialists.

We have also signed on to legislation across numerous states and at the federal level addressing fluoride access, veterans’ benefits, insurance reform, specialty advertising, and tax policy.

With several dedicated AAE members, I testified at the ADA reference committee hearings and House of Delegates meetings. We faced issues that could have negatively affected our specialty, our autonomy, and our patients. I’m proud to report that every endodontic issue of consequence was resolved in our favor.

And just this past month, the AGD and AAE released a special edition of AGD Impact highlighting the value of endodontics and the strong relationship between endodontists and general dentists, a project more than two and a half years in the making.

Not Done Yet

With a little over four months until AAE26 in Salt Lake City, I’m far from finished. In recent weeks, we have pitched new media stories and responded to requests for additional national features. We also have a second satellite media tour tentatively scheduled for January. The momentum continues.

This is also an important moment to highlight how the AAE is proactively countering online mis  and disinformation about endodontic therapy. Through our expanding influencer partnerships, strengthened social media presence, and the continued rollout of our Misinformation Toolkit, we are reaching new audiences with clear, evidence-based messages about the safety and benefits of endodontic care. These efforts are especially timely as a new study in the Journal of Translational Medicine indicates that root canal treatment may be associated with positive improvements in glucose metabolism, lipid profiles, and systemic inflammation — findings that reinforce what endodontists have long known about the broader health implications of treating dental infection at its source. With that Satellite Media Tour scheduled for January, we will have a major opportunity to amplify this story, address longstanding myths, and ensure that accurate, patient-centered information rises above the noise.

Looking Ahead

Serving as your President over these first eight months has been one of the most meaningful and energizing experiences of my career. The travel, the media outreach, the policy work, the board initiatives, the advocacy efforts—none of it matters without the people behind it. Every accomplishment this year has been possible because of the dedication of our members, the passion of our volunteers, the expertise of our educators and clinicians, and the steadfast commitment of our exceptional AAE staff, who work tirelessly behind the scenes to support our mission and elevate our specialty.

Thank you for your trust, your encouragement, and the many ways you continue to strengthen our specialty. I am grateful every day for the privilege of representing the AAE, and I look forward to everything we will achieve together as we head toward AAE26 in Salt Lake City and beyond.

Wishing all of you a happy and healthy holiday season and an excellent New Year!

Nominations for a new slate of leadership to take office in 2026 have been proposed by the AAE, the Foundation for Endodontics and ABE Nominating Committees. AAE Nominating Committee members, Drs. Stefan I. Zweig, past president; Craig S. Hirschberg, past president; Natasha M. Flake, immediate past president, together with District Directors Fiza Singh and Harold J. Martinez, met to recommend new Officers for the AAE and Trustees for the Foundation for Endodontics. The ABE Board of Directors and Foundation for Endodontics Board of Trustees also met to recommend new leadership for their respective organizations.

Nominees for terms beginning in 2026 are listed below.

The 2026 General Assembly will vote to approve nominees for AAE Officers and Directors, Foundation Trustees and Public Sector Representatives, and ABE Directors. Officers of the Foundation for Endodontics and American Board of Endodontics are elected by their respective Boards.

Additional nominations for AAE Officers, Foundation for Endodontics Trustees and Public Sector Representatives, or ABE Directors may be made in writing by Active, Educator and Life members. Such nominations much be accompanied by a petition that includes the printed names and signatures of 50 voting members, and must be received by AAE Secretary, Mark B. Desrosiers, care of AAE Headquarters, no later than March 18, 2026.

AAE Executive Committee
President Dr. W. Craig Noblett*
President-Elect Dr. Elizabeth Shin Perry*
Vice President Dr. Bradley H. Gettleman
Secretary Dr. Kenneth Tittle
Treasurer Dr. Mark B. Desrosiers
Immediate Past President Dr. Steven J. Katz*
*Automatic, the president-elect automatically succeeds to president and the vice president to president-elect.

Foundation for Endodontics Board of Trustees
Trustees
Dr. Hossein Moosavi
New Practitioner Trustee
Dr. Morgan Celistan
Trustees, Public Sector
Mr. Jack Burlison
Ms. Amy Warren-Kimbro
Ms. Judith Forsythe

American Board of Endodontics
Directors
Dr. Emanouela Carlson
Dr. Qian Xie

In addition, the following members were nominated by their respective districts to serve on the AAE Board of Directors for three-year terms beginning in 2026. The period in which a petition may be submitted to nominate an alternate candidate for District Director positions expired as of October 15, 2025.

District I
Nominee: Dr. Tadros M. Tadros, Hudson, New Hampshire
Nominating Committee Chair: Dr. Garry L. Myers, Midlothian, Virginia
District II
Nominees: Dr. Adrienne Korkosz, Schenectady, New York
Nominating Committee Chair: Dr. Lorel E. Burns, New York, New York
District III
Nominee: Dr. Christopher Walker Cain, Nashville, Tennessee
Nominating Committee Chair: Dr. Robert W. Heydrich, Spring Hill, Florida
District VI
Nominee: Dr. Callee Clark, Grand Junction, Colorado
Nominating Committee Chair: Dr. Alejandro Aguirre, Plymouth, Minnesota
District VII
Nominee: Dr. Mike Sabeti, Irvine, California
Nominating Committee Chair: Dr. Yaara Berdan, Calabasas, California

The AAE thanks the following directors who are completing their terms on the Board of Directors in April 2026: Drs. Harold J. Martinez, District I; Lorel E. Burns, District II; Robert Heydrich, District III; Lauren E. Jensen, District VI; and Bryan F. Mansour, District VII.

Members will approve the nominees by casting their votes at the General Assembly in Salt Lake City, Utah on April 17, 2026.

AAE strives to develop position statements that present a comprehensive viewpoint on medical or scientific issues. These statements are developed through a consensus-building approach involving subject matter experts. We make it a point to review and revise them every five years, ensuring they stay up-to-date and relevant. After careful consideration, the members of our Practice Affairs Committee reached a consensus to sunset the following position statements due to their overlapping content with other position statements, outdated information and relevance to the specialty. This proposal was subsequently approved by the Board of Directors in October 2025.

AAE Guidance on Antibiotic Prophylaxis for Patients at Risk of Systemic Disease
Antibiotic Prophylaxis 2017 Update – Quick Reference Guide
Art and Science of New Materials in Endodontics
Paraformaldehyde-Containing Endodontic Filling and Sealing Materials

By Badr Hefnawi, Raju Gandhi, and Xiaofei Zhu

Many clinicians have ventured into the realm of regenerative procedures, often presenting radiographic evidence of apical closure and canal wall thickening. These observations frequently lead to assertions of successful regeneration. However, it is vital to acknowledge that relying solely on radiographic assessments cannot definitively distinguish between repair and regeneration (Figure 1). A deeper dive must be taken into the histological outcomes of regenerative procedures to attain a better understanding of its success.

Many prospective animal studies have been conducted to examine the histological outcomes to various treatment methods, however results from animal studies may not always be extrapolated to human situations.1,2,3 This is due to variations in pathophysiology, and also different study protocol conditions that can take place in animal versus human studies. Due to ethical reasons, no randomized control trial has been conducted in humans on histological outcomes. This limits the current review to focus on human histological observational studies as opposed to interventional. Although the number of reports on in vivo teeth that have undergone REP followed by histological analysis is scarce, and the details of each treatment may vary, it does not take away from the importance of evaluating this body of literature.

Literature Search

A comprehensive literature search was conducted across PubMed, Embase, and Web of Science for studies published between 2001 and 2023. Inclusion criteria required that each study report a completed regenerative endodontic procedure with histological evaluation—either of the entire tooth or a relevant section. Out of 389 initially identified papers, 17 human case studies were ultimately included, representing 22 teeth subjected to histological analysis.

Pre-Treatment Diagnoses and Patient Demographics

Of the 22 teeth reviewed, 18 were immature teeth, most diagnosed with pulp necrosis and apical pathology such as acute or chronic apical abscesses, symptomatic or asymptomatic apical periodontitis. These align with the classic indications for REP, where continued root development is desired.4-20

Two cases involved mature teeth with pulpal necrosis—an area of increasing interest in regenerative endodontics. Notably, two additional cases featured vital, healthy teeth undergoing REP strictly for research purposes before scheduled orthodontic extraction, providing rare control-like conditions.

Clinical Outcomes

Thermal or electric pulp testing was included as part of the evaluations in 19 of the 22 cases reviewed. Five of these teeth recorded a positive reaction to either thermal or electric pulp testing. Notably, two of these teeth cases were mature teeth that belonged to the only case report involving mature teeth with histologic examination. These teeth lasted 3.5 years before requiring extraction due to horizontal crown fractures. These cases demonstrate the potential of regenerative procedures to induce a positive sensibility response in mature teeth, even in necrotic cases.

Percussion testing was reported in 20 of the 22 cases reviewed, with five teeth showing a positive response. Three of these teeth also showed a response to either thermal or electric pulp testing. The remaining two teeth that tested positive to percussion were associated with persistent infection, demonstrated by an acute apical abscess in one case and symptomatic apical periodontitis in the other.

Figure 1: Histological spectrum of outcomes following regenerative endodontic procedures. Regenerative response showing formation of tubular dentin structures and odontoblast-like cells, indicative of true pulp–dentin complex regeneration. Reparative response characterized by cementum-, bone-, and periodontal ligament (PDL)-like tissues containing cementocyte, osteocyte, and osteoblast-like cells. Inflammatory response demonstrating mononuclear cell infiltration with fibrotic or granular tissue formation, reflecting an unfavorable healing outcome.

Histological findings

The distribution of tissue responses following regenerative procedures varied according to the underlying etiology (Figure 2). Reparative outcomes were the most frequently observed across all categories, with caries and crown fractures demonstrating the highest number of cases. Dens evaginatus, however, showed a broader spectrum of outcomes, including combined reparative–regenerative and reparative–inflammatory responses, highlighting the complexity of tissue reactions in this condition. In contrast, purely regenerative or inflammatory responses were relatively uncommon overall.

While these findings may, in part, reflect the bacterial nature of certain etiologies, definitive conclusions cannot be drawn due to variability in protocols, including differences in materials, intracanal medicaments, and treatment time frames.

Figure 2: Distribution of regenerative, reparative, and inflammatory histological findings across human teeth subjected to regenerative procedures, categorized by etiology.

Comparing Immature and Mature Teeth

Although most studies involved immature teeth, the mature tooth cases may be the most groundbreaking.4,5 Histological analysis of these teeth (combined with clinical testing) demonstrates true regeneration may be possible even without a natural apical blood supply or native stem cells. This could represent a shift in the field’s understanding and a call to expand REP indications, particularly as tissue engineering advances, including the use of platelet-rich/fibrin matrices and allogenic stem cells, continue to emerge.

Conclusion: Regeneration or Repair?

This review provides a nuanced look into the biological realities of regenerative endodontic procedures in humans. While true pulp regeneration remains elusive, the formation of vascularized, functional tissue in some cases, especially in mature teeth, marks an encouraging evolution in endodontic care. As protocols are refined and regenerative materials evolve, a future where true pulp regeneration is routine may not be far off. Until then, continuing to integrate histological insights into clinical decision-making will be key in ensuring REP fulfills its promise.

References

  1. Altaii M, Richards L, Rossi-Fedele G. 2017. Histological assessment of regenerative endodontic treatment in animal studies with different scaffolds: A systematic review. Dent Traumatol. 33(4):235-244.
  2. Torabinejad M, Faras H, Corr R, Wright KR, Shabahang S. 2014. Histologic examinations of teeth treated with 2 scaffolds: A pilot animal investigation. J Endod. 40(4):515-520.
  3. Yamauchi N, Yamauchi S, Nagaoka H, Duggan D, Zhong S, Lee SM, Teixeira FB, Yamauchi M. 2011. Tissue engineering strategies for immature teeth with apical periodontitis. J Endod. 37(3):390-397.
  4. Adhikari HD, Gupta A. 2018. Report of a case of platelet-rich fibrin-mediated revascularization of immature 12 with histopathological evaluation. J Conserv Dent. 21(6):691-695.
  5. Arslan H, Şahin Y, Topçuoğlu HS, Gündoğdu B. 2019. Histologic evaluation of regenerated tissues in the pulp spaces of teeth with mature roots at the time of the regenerative endodontic procedures. J Endod. 45(11):1384-1389.
  6. Austah O, Joon R, Fath WM, Chrepa V, Diogenes A, Ezeldeen M, Couve E, Ruparel NB. 2018. Comprehensive characterization of 2 immature teeth treated with regenerative endodontic procedures. J Endod. 44(12):1802-1811.
  7. Becerra P, Ricucci D, Loghin S, Gibbs JL, Lin LM. 2014. Histologic study of a human immature permanent premolar with chronic apical abscess after revascularization/revitalization. J Endod. 40(1):133-139.
  8. Kwon SK, Kyeong M, Adasooriya D, Cho SW, Jung IY. 2023. Histologic and electron microscopic characterization of a human immature permanent premolar with chronic apical abscess 16 years after regenerative endodontic procedures. J Endod. 49(8):1051-1057.
  9. Lei L, Chen Y, Zhou R, Huang X, Cai Z. 2015. Histologic and immunohistochemical findings of a human immature permanent tooth with apical periodontitis after regenerative endodontic treatment. J Endod. 41(7):1172-1179.
  10. Lin LM, Shimizu E, Gibbs JL, Loghin S, Ricucci D. 2014. Histologic and histobacteriologic observations of failed revascularization/revitalization therapy: A case report. J Endod. 40(2):291-295.
  11. Lui JN, Lim WY, Ricucci D. 2020. An immunofluorescence study to analyze wound healing outcomes of regenerative endodontics in an immature premolar with chronic apical abscess. J Endod. 46(5):627-640.
  12. Martin G, Ricucci D, Gibbs JL, Lin LM. 2013. Histological findings of revascularized/revitalized immature permanent molar with apical periodontitis using platelet-rich plasma. J Endod. 39(1):138-144.
  13. Meschi N, Hilkens P, Van Gorp G, Strijbos O, Mavridou A, Cadenas de Llano Perula M, Lambrichts I, Verbeken E, Lambrechts P. 2019. Regenerative endodontic procedures posttrauma: Immunohistologic analysis of a retrospective series of failed cases. J Endod. 45(4):427-434.
  14. Nosrat A, Kolahdouzan A, Hosseini F, Mehrizi EA, Verma P, Torabinejad M. 2015. Histologic outcomes of uninfected human immature teeth treated with regenerative endodontics: 2 case reports. J Endod. 41(10):1725-1729.
  15. Palma PJ, Martins J, Diogo P, Sequeira D, Ramos JC, Diogenes A, Santos JM. 2019. Does apical papilla survive and develop in apical periodontitis presence after regenerative endodontic procedures? Appl Sci. 9(19):3942.
  16. Peng C, Zhao Y, Wang W, Yang Y, Qin M, Ge L. 2017. Histologic findings of a human immature revascularized/regenerated tooth with symptomatic irreversible pulpitis. J Endod. 43(6):905-909.
  17. Shetty H, Shetty S, Kakade A, Desai R, Zhang CF, Neelakantan P. 2018. Cone-beam computed tomographic and histological investigation of regenerative endodontic procedure in an immature mandibular second premolar with chronic apical abscess. J Investig Clin Dent. 9(4):e12352.
  18. Shimizu E, Jong G, Partridge N, Rosenberg PA, Lin LM. 2012. Histologic observation of a human immature permanent tooth with irreversible pulpitis after revascularization/regeneration procedure. J Endod. 38(9):1293-1297.
  19. Shimizu E, Ricucci D, Albert J, Alobaid AS, Gibbs JL, Huang GT, Lin LM. 2013. Clinical, radiographic, and histological observation of a human immature permanent tooth with chronic apical abscess after revitalization treatment. J Endod. 39(8):1078-1083.
  20. Torabinejad M, Turman M. 2011. Revitalization of tooth with necrotic pulp and open apex by using platelet-rich plasma: A case report. J Endod. 37(2):265-268.

Badr Hefnawi, Raju Gandhi, and Xiaofei Zhu are with the Department of Endodontics, Boston University Henry M. Goldman School of Dental Medicine.

By Dr. Keriann Jimenez

‘Tis the season to put down the handpiece, relax and lean into a different kind of comfort.

One dish worth the pause is the lovely Sweet Potato Casserole with Marshmallows & Pecans from House of Nash Eats. It’s not about complicated technique or memorizing lit—just wholesome ingredients, simple steps, and the kind of warmth that helps you reset for a new year of seeing patients.

Why It Matters

  • For you, the resident: You’ve spent the day navigating difficult canals, interpreting CBCTs, collaborating with faculty, and balancing clinic hours with study time. Your holiday moment is not about adding one more “to-do,” but about stepping out of that cycle for a few deep, restorative breaths.
  • For the family table: The recipe leans into classic holiday flavors—sweet potato, cinnamon, brown sugar, marshmallows, pecans—and invites a communal vibe. It’s less about perfection and more about presence.

Recipe

For the mashed sweet potatoes

▢ 3 pounds sweet potatoes cleaned (about 3-4 sweet potatoes)

▢ 4 tablespoons salted butter melted

▢ 1/3 cup milk

▢ 1/2 cup brown sugar

▢ 1 teaspoon cinnamon

▢ 2 large eggs lightly beaten

▢ 1 teaspoon vanilla extract

▢ 1/2 teaspoon table salt

For the topping

▢ 1/2 cup brown sugar

▢ 1/2 cup all-purpose flour

▢ 1/2 teaspoon cinnamon

▢ Pinch of salt

▢ 6 tablespoons salted butter melted

▢ 1 1/4 cups chopped pecans

▢ 2 cups miniature marshmallows

 

  1. Cook the sweet potatoes by roasting or boiling. To roast: Preheat the oven to 350°F. Prick the sweet potatoes all over with a fork, then place them on a baking sheet lined with foil and sprayed with cooking spray. Roast for 45-60mins, until soft. Larger sweet potatoes may take longer to cook. To boil: Peel the sweet potatoes and cut them into chunks, then boil them in a large pot with enough water to cover them for 10 minutes until fork tender. Drain well, then proceed as directed in the recipe.
  2. If you have roasted the potatoes, let them cool and scoop out the insides into a large bowl. Alternatively, transfer boiled potatoes straight to a large bowl and gently mash. Add the butter, milk, brown sugar, cinnamon, eggs, vanilla, and salt, and mash with a potato masher or beat using a hand mixer until smooth.
  3. Spray a 9×13 baking dish with cooking spray, then transfer the mashed sweet potatoes and smooth them out evenly with a rubber spatula
  4. In a separate bowl, combine the brown sugar, flour, cinnamon, salt, melted butter, and chopped pecans. Mix them together with a fork or whisk, then sprinkle evenly on top of the mashed sweet potatoes.
  5. Increase the oven temperature to 375°F. Bake the sweet potato casserole for 25-30 minutes, until heated all the way through and the topping begins to brown.
  6. Remove the sweet potato casserole from the oven and sprinkle with the marshmallows. Set the oven to broil, then return the casserole to the oven and cook just long enough for the marshmallows to toast on top. This happens quickly so make sure to watch carefully during this part.
  7. Serve immediately (base can be assembled up to 3 days ahead in the fridge, or frozen up to 3 months)

How to Squeeze This into a Busy Residency Schedule

  • Prep one afternoon: Roast or boil the sweet potatoes, mash and mix with the filling ingredients, and layer the streusel topping. Cover and refrigerate.
  • When clinic ends: Drop the dish in the oven for ~25-30 minutes at 375 °F, then add marshmallows and broil until browned (watching carefully!). This gives you a warm homecoming ritual.
  • Invite conversation: As you pull the casserole out of the oven, pause to share how the day went. You don’t need to talk shop unless you want to—just the rhythm of coming together counts.
  • Use leftovers wisely: If there’s scooping at midnight or reheating the next day, you’ve earned it. Let the simple sweetness carry you through.

A Final Note

You dedicate long hours to mastering root morphology and patient comfort. In this moment, set the scene with a festive Thanksgiving table instead of a microscope and cassette, because the best part of the holiday is just showing up for the people who show up for you

Dr. Keriann Jimenez is a member of the AAE’s Resident & New Practitioner Committee.