Welcome to Scribd, the world's digital library. Read, publish, and share books and documents. See more
Download
Standard view
Full view
of .
Look up keyword
Like this
1Activity
0 of .
Results for:
No results containing your search query
P. 1
Endodontics Final Reviewer

Endodontics Final Reviewer

Ratings: (0)|Views: 74 |Likes:
Published by Rosette Go
Endodontics Reviewer 3
Endodontics Reviewer 3

More info:

Categories:Topics
Published by: Rosette Go on Sep 27, 2013
Copyright:Attribution Non-commercial

Availability:

Read on Scribd mobile: iPhone, iPad and Android.
download as DOC, PDF, TXT or read online from Scribd
See more
See less

04/10/2014

pdf

text

original

 
ENDODONTICS FINAL REVIEWERENDODONTICS
Branch of dentistry concerned with the :
o
Morphology –
shape of the pulp cavity
o
Physiology –
reversible or irreversible state
o
Pathology
of the human dental pulp andperiradicular tissues
Its study and practice encompass the basic andclinical sciences including the biology of the normalpulp and the etiology, diagnosis, prevention and thetreatment of diseases and injuries of the pulp andassociated periradicular conditions
REVERSIBLE PULPITIS –
diagnosis of class 1 to 5 restoration
IRREVERSIBLE PULPITIS
do root canal therapy
SCOPE OF ENDODONTICS
1.Differential diagnosis2.Treatment of oral pains of pulpal and/or periapicalorigin (orthograde/conventional RCT)3.Vital pulp therapya.Pulp cappingb.Pulpotomy4.Non-surgical treatment of root canal systems with orwithout periradicular pathosis of pulpal origin5.Selective surgical removal of pathological tissuesresulting from pulpal pathosis (e.g. cyst)6.Intentional replantation and replantation of avulsedteeth7.Surgical removal of tooth structurea.Root-end rsectionb.
Bicuspidization –
cut molar to form 2bicuspidsc.
Hemisection -
1 root only for RCTd.
Apicoectomy
(retrograde/conventionalendodontics)8.Bleaching of discolored dentin9.Retreatment of teeth10.Treatment procedures related to coronal restorations
OBJECTIVES
1.To be able to retain a tooth inside the oral cavitywhich may otherwise require extraction (ex. Forextraction: no bone support anymore; horizontalfracture or root fracture)2.Relief of pain, if present3.Removal of pulp from root/s of tooth4.Disinfection of root and surrounding bone bycleaning and shaping of the root canal walls (use of irrigate
sodium hypochlorite
)5.Complete filling of root canal
(obturation)
6.Placement of final restoration (if not restorable,extract)7.Main contraindication: non-restorable tooth
HISTORY (1977 to PRESENT)
Improved visibility is now available with the adventof the endodontic microscope
 The single visit endodontic therapy globally acceptedby all school taught
Newer and better
BASIC PRINCIPLES1.Chain of asepsis
a.
Paper points =
5 secs in glass beadsb.
Gutta percha =
1 min in chloroxc.
Rubber dam =
alcohold.
Instruments =
sterilize (autoclave)e.
Files =
autoclave or glass beads
2.Correct diagnosis and treatment planning3.Atraumatic holding of tissues
4.
Cleaning of the canal –
debridement and removalof biofilm sticking on the canal walls
5.Shaping of the canal6.Complete obturation7.Restoration8.RecallRATIONALE
1.Saving the natural teeth to health2.Restore efficient mastication3.Control pain and swelling
1
 
4.Speech and phonation5.Preserved occlusion6.Esthetics
BASIC CONCEPT OF ROOT CANAL THERAPY 
If bacteria and byproduct of pulpal inflammation hasbeen reduced to a non-critical level of infection, it willeffect a cure allowing resolution and repair of damaged depends on the virulence
APPLIED ANATOMY OF THE ROOT CANAL SYSTEM1.ROOT CANAL SYSTEM2.SIGNIFICANCE OF STUDYING THE ROOT CANALSYSTEM3.FACTORS AFFECTING ROOT CANALMORPHOLOGY SPECIFIC OBJECTIVES
1.To review the individual root canal morphology of human teeth and relate it to endodontic treatment2.To know the factors that alter root canal morphology3.To understand the effect of root canal systemcomplexities to endodontic treatment4.To be familiar with other variations in the canalsystems5.To recognize the relationship of internal anatomy toendodontic procedures
Maxillary molar
3 roots (MB, DB and palatal)
4 canals (MB, DB, MP and palatal)ROOT CANAL MORPHOLOGY AND ITS SIGNIFICANCE
1.
DIAGNOSIS –
to know indication and case selectionfor root canal2.
TREATMENT –
to guide us in all treatmentprocedures3.
PROGNOSIS –
to predict the outcome of thetreatment
ROOT CANAL SYSTEM
Pulp is located and found at the center of the tooth
Unique for every tooth and is highly variable
SCHEMATIC SECTION (CROSS SECTION) OF THE TEETH
 The shape of the pulp chamber and the outline of thecanals are a reflection of the outline of the surface of the crown and root
DIFFERENCE BETWEEN ROOF AND FLOORROOFFLOORLOCATION
C3rd of crownC3rd of root
COLOR
 YellowishDarker
DENTINAL MAP
AbsentPresent
TEXTURE
Rough; no definiteshapeSmooth; convex
DENTINAL MAP –
line that connects the orifice of the canal
METHODS OF STUDYING THE ANATOMY OF THE ROOTCANAL
1.Ground section (cross or lingual)2.Histologic3.Radiograph4.Clearing technique5.Acrylic cast6.Silicone injection
FACTORS AFFECTING ROOT CANAL MORPHOLOGY 
1.Age2.Caries3.Developmental anomaliesa.Dilacerations – severe bend or distortion 45- 90°b.Taurodontism – bull or prism teethc.Dens en dented.Microdontiae.Macrodontia4.Irritatnts – pulp stones, internal resorption5.Attrition6.Abrasion7.Erosiona.Internal resorption (thermoplastic guttapercha)b.External resorption8.Trauma9.Clinical procedures
2
 
ROOT CANAL CONFIGURATIONTYPECONFIGURATIONI
1-1
II
2-1
III
1-2-1
IV
2-2
V
1-2
VI
2-1-2
VII
1-2-1-2
VIII
3-3
Maxillary Second Premolar
 The only tooth that showed all 8 possibleconfigurations
ACCESS CAVITY PREPRARATION
Cavity prepared on crown of teeth fro endodonticinstruments and materials to gain direct pathtowards the apex for biomechanical preparation andobturation
OBJECTIVES
1.To create a smooth, straight line path to the canalsystem up to the apex2.To remove caries and debris from the chamber3.To allow for complete irrigation4.To establish maximum visibility to gain access up tothe end of the canal (apical foramen)
IDEAL ACCESS RESULTS IN
1.Straight entry into the canal orifices, with the lineangles forming a funnel drops smoothly into thecanal or canals2.Quality endodontic result
“Variation of rooth canal anatomy is more of a rulerather than an exception.”
ANATOMY OF THE TEETH
Center (x-ray)
Create imaginary line to know how many orifice arethere
Maxillary second premolar
o
1 root = 1 canal
(canal is at the center)
o
Variations:
2 roots = 2 canals
3 roots = 3 canals
Maxillary first molar
o
3 roots = 4 canals (MB, DB, MP and P)
Mandibular incisors
o
2 canals
Mandibular second molar
o
2 roots = 3 canals (Distal, MLi andMBu)
o
C-shaped canal
Fusion of MB and Distal canals
2 canals
WAYS OF GAINING ACCESS
ANTERIOR – LINGUAL
POSTERIOR OCCLUSAL
Enamel =
size2 round bur
Dentin =
size 1 or 2 round bur
Roof =
size of bur depends on the size of roof andpulp chamber
o
has reddish color if it is vital but it is whitishcolor if it is non-vital because there is nomore or there is little space
if access is small:
o
you cannot locate all of the canals
o
incomplete cleaning because apical end canbe inaccessible
faulty canal access = infection
o
perforations = man-made canals
o
ledges –
step being created
o
strip side of danger zone
o
zipping of the apical end
o
opening of the apical end
o
formation of an elbow
STEPS IN ACCESS1.Study pre-operative radiograph
 To know how big the chamber is
 To know which bur to use in gaining access
3

You're Reading a Free Preview

Download
scribd
/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->