THE COMPLETE 4ROD PROTOCOL IS NOW PUBLISHED

I am pleased to announce the publication of the final article in our four-part interview series:

Write your awesome label here.
The 4R Operational Diagnosis Protocol: Part 4—R4: Restorative and Tooth Structure Assessment
R4 addresses a frequently overlooked reality: endodontic diagnosis cannot be completed by evaluating only the pulp and periapical tissues.
The clinician must also assess the existing restorations and the remaining tooth structure—including restorative quality, cracks, discoloration, tooth wear, developmental anomalies, alignment, and occlusion. These findings may explain the origin of disease, influence treatment decisions, and determine the tooth’s long-term prognosis.
With the publication of R4, the complete 4ROD framework is now available to the dental profession:
R1—Patient Report and Rapport
R2—Radiographic Interpretation
R3—Response Testing
R4—Restorative and Tooth Structure Assessment
Together, the 4Rs provide a structured, evidence-based approach that moves diagnosis beyond the traditional pulpal and periapical labels toward comprehensive, patient-centered decision-making.
My sincere appreciation to Deeraj Sharma and the Journal of Oral Health and Dentistry Research for providing the opportunity to present this complete diagnostic philosophy to the profession.
Diagnosis is not the collection of isolated findings. It is the disciplined integration of evidence.

Our Courses

Created with