Dr. Clifford J Ruddle DDS, FACD, FICDDr. Terry  Pannkuk DDS, MScD

Endodontic Surgery Live Stream: Drs. Ruddle and Pannkuk

Saturday, September 7, 2019 | Time: 10:00AM - 12:00PM PDT
CDE Credits: 2.00 Teaching Methods: Lecture; Live Online or Self-Instructional Video Length: 2 hours
PDL is an ADA CERP recognized provider. PDL designates this activity for 2.00 hours continuing dental education credit.
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  • Webinar Title: Endodontic Surgery Live Stream: Drs. Ruddle and Pannkuk
  • Presenters: Dr. Clifford Ruddle and Dr. Terry Pannkuk
  • Date Recorded: September 7th, 2019
  • Duration: 2 hours
  • CDE Credits: 2 CDE credits will be issued by Pure Dental Learning



Dr. Pannkuk will perform a live apicoectomy with reverse-filling with a play-by-play narrative by Dr. Cliff Ruddle. A pre-surgical presentation will be given highlighting surgical principles and the plan for the specific patient being treated live. This will be a wonderful opportunity for online and live participants to ask real-time questions of both Drs. Ruddle and Pannkuk about the details of the procedure and the specific clinical events (unplanned and planned) as they unfold. A unique feature of PDL events is the uncensored expectation that participants will ask critical questions that require thoughtful and honest answers by the presenters and demonstrating live-stream clinicians.

Course Outline

  1. Preplanning session: details of the patient discussed including medical history, dental history, clinical findings, diagnosis, prognosis, and treatment plan The CBCT scan will be shown with dynamic slicing considering surgical access and the location of vital structures. Radiographs and microphotos of the case will be highlighted and discussed.

  2. Surgical Endodontic Theory: Technqiue, Principles and Goals

  3. Live Demonstration

  4. Post-surgical discussion with review of the treated case. This will discuss a plan for follow-up


The participant will learn:

  1. Surgical planning and how to access a case that is appropriate

  2. To identify and locate vital structures to be avoided during the surgery

  3. To understand flap design and the plan for bone entry

  4. How to bevel a root and prepare it to receive a root filling

  5. How to suture and follow-up healing

Course Evaluation

See Below

Resources and References

See Below

Supplementary Material

If provided, available when logged in.


Dr. Clifford Ruddle has no relevant commercial relationships.

Dr. Terry Pannkuk has no relevant commercial relationships.

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Dr. Clifford J Ruddle DDS, FACD, FICD

Dr. Clifford Ruddle

[javascript protected email address]
122 S. Patterson Ave, Ste. 206
Santa Barbara, CA 93111


Internationally recognized as a leading expert in all aspects of clinical endodontics, Dr. Ruddle is acclaimed for providing superb endodontic education through his teachings, clinical articles, training manuals and multimedia products. He is the founder and director of Advanced EndodonticsĀ®, an international educational source in Santa Barbara, California. Dr. Ruddle created the world's first private microendodontic simulation training center in 1989 and has trained several thousand dentists microscope-assisted endodontic techniques. He is well-known for his ability to empower colleagues and motivate clinicians towards their full potential. Additionally, Dr. Ruddle maintains a private practice limited to endodontics in Santa Barbara.

Dr. Ruddle received his dental degree from University of the Pacific, School of Dentistry, San Francisco, California, in 1974. In 1976, he completed his postgraduate work in endodontics at Harvard School of Dental Medicine, Boston, Massachusetts.

Dr. Terry  Pannkuk DDS, MScD

Dr. Terry Pannkuk

[javascript protected email address]
9 E Pedregosa Street, Suite B
Santa Barbara, CA 93101
United States


Dr. Terry Pannkuk, a native of California, graduated from University of California at Los Angeles with a degree in Biology, Georgetown Dental School with a D.D.S., and Boston University with an M.Sc.D. in Endodontics. He is a Diplomate of the American Board of Endodontics, former editor and publisher of The Endodontic Report, former president of the Boston University Endodontic Alumni Association, current reviewer for the Journal of Endodontics (official journal of the American Association of Endodontists), Past President of the Academy of Microscope Enhanced Dentistry, President and Founder of the Schilder Institute for the Advancement of Endodontics, Editor and Publisher of PDL (Pure Dental Learning), Volunteer Clinical Professor at the University of California at San Francisco, and international lecturer-author of topics relating to clinical endodontics.

He lives and practices in Santa Barbara, California.

Resources and References

Click on a photo to view the larger version.

Patient: 49 year-old female with a history of fibromyalgia and chronic fatigue syndrome, controlled hypertension
Pulp Diagnosis: Previous Root Filling
Periapical Diagnosis: Asymptomatic Periapical Abscess
Periodontal Findings: WNL
Percussion: WNL

The patient presented on 10/14/2009 with slight percussion sensitivity, moderate palpation sensitivity, and severe gingival inflammation with normal sulcular probing depths (associated with a mesial bridge abutment, the mandibular left first bicuspid). Radiographic findings revealed a lateral and a periapical radiolucency. The patient reported that root canal treatment had been performed in Russia a few years earlier. Root canal retreatment was performed and a Thermafil obturator was removed. A second root canal system was found that had been previously missed. Retreatment was performed in two steps with intracanal calcium hydroxide placed for one month before obturation via the vertical compaction of warmed gutta percha technique. The patient returned on routine recall examination prior to having the bridge removed in preparation for an implant treatment plan (4/2/2012). Marked osseous regeneration was noted on the radiograph and the patient was asymptomatic at this time. The patient returned for a recall examination on 1/14/2014 absent of symptoms and normal radiographic findings suggesting complete osseous regeneration. The patient returned for a third recall visit on 3/6/2019 with a periapical radiolucency confirmed on traditional and a CBCT scan. She was without symptoms but ready to have implants placed.

Surgical retreatment of the mandibular left first bicuspid was recommended.


Original Release Date: September 7, 2019
Review Date: TBD
*Expiration Date: September 7, 2022

*Self-instructional activities are reviewed at least once every three years, or more frequently if indicated by new scientific developments, to ensure that content is current and accurate.

CDE Credits

PDL is an ADA CERP recognized provider
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