Introduction To Endodontics

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LAM KIM TRIEN DDS
Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

This Document has been modified with Flexcil app (Android) https://www.fexcil.com
Questions
1. What is Endodontics? 7. How many visits will it Take
2. Who Performs an to Complete this Treatment?
Endodontic Therapy? 8. Will I have a Dead Tooth
3. How does Pulp become after Root Canal Therapy?
Damaged? 9. Will they feel Pain during or
4. Why do we need Root after Treatment?
Canal Therapy? 10. Will the Tooth need any
5. What is Root Canal Special Care or Additional
Procedure? Treatment after Endodontic
6. What are Risks and Treatment?
Complications? 11. Can all Teeth be Treated
Endodontically?
Endodontics
Endo = “Inside” (Greek)
Odont = “Tooth” (Greek)
Endodontic treatment deals inside of the
tooth.
Endodontics is associated with
1 •Prevention
2 •Diagnosis
3 •Treatment Kenneth M. H. et al. (2016), Cohen’s Pathways of the pulp, 11thed,
Mosby Elservier
pathosis of the dental pulp
and their sequelae
The main aim of the endodontic therapy

1. Maintain vitality of the pulp.
2. Preserve and restore the tooth with
damaged and necrotic pulp.
3. Preserve and restore the teeth
which have failed to the previous
endodontic therapy.
à The primary goal of endodontic therapy is to create an environment within

the root canal system which allows the healing and continued maintenance of
the health of the periradicular tissue.

What is the
difference
between
root canal The root canal
treatment is in fact The total care of the
just one part of
treatment endodontic
pulp is called
endodontics.
treatment.
and
endodontic
treatment?
A Brief History of Endodontics

Before
th
17 century

How to conserve the damaged

teeth?
1678–1761
Pierre Fauchard
founder of modern dentistry
Nisha
Flexcil - The Smart Study Garg
Toolkit & Annotate,
& PDF, Amit GargNote (2014), Textbook of ENDODONTICS
1725 1746
Lazare Rivere
Pierre Fauchard
Clove oil as = sedative The removal of pulp tissue
https://food.ndtv.com/food-drinks/14-amazing-benefits-of-clove-oil-1669499
Innovation era :
Prescience Dark age
1977 till date
The 1826–1876 1926–1976

evolution of 1776–1826 1876–1926 1977
endodontics
Age of discovery The renaissance

Prescience : 1776 - 1826

Thời kỳ tiền khoa học: 1776 -1826
Endodontic therapy was

concerned with the crude
modalities like abscesses were
being treated with poultices or
leeches and pulps were being
cauterized using hot instruments

Age of discovery : 1826 - 1876

Thời kỳ phát minh: 1826-1876 Anesthesia
The development of
anesthesia, gutta-percha and
barbed broaches happened.
The medications were created
for treating pulpal infections
and the cements and pastes
were discovered to fill them
https://www.woodlibrarymuseum.org/histor
y-of-anesthesia/

Age of discovery : 1826 to 1876
The development of
gutta-percha

The development of
and the cements and pastes barbed broaches
were discovered to fill them Trâm gai

The development of

Dark age: 1876 to 1926

Thời kỳ đen tối: 1876 - 1926
In spite of introduction of X-
rays and general anesthesia,
extraction of tooth was the
choice of treatment than
endodontics because theory of
the focal infection was main
concern at that time.

The renaissance: 1926 – 1976

Thời kỳ phục hưng : 1926-1976
Endodontics = science and therapy
The theory of focal infection was also
fading out à more of endodontics
being practiced.
The improvement in anesthesia and
radiographs for better treatment
results.
In 1943, because of growing interest
in endodontics, the AAE (American
Association of Endodontists) was
formed.

Innovation era: 1977 till date

Kỷ nguyên đổi mới: 1977 cho đến nay
The faster Tremendous advancements, the simpler, easier

and faster endodontics with more predictable results.
Also the concept of single visit endodontics is now globally
accepted in contrast to multiple visits.

Modern Dentistry
In the past two decades, extensive studies have been done on
microbial flora of pulp and the periapical tissue. The biological
changes, role of innate and acquired immunological factors are being
investigated in dental pulp after it gets infected, healing of the
periapical tissue after undergoing root canal therapy is also being
investigated.
Trong hai thập kỷ qua, các nghiên cứu sâu rộng đã được thực hiện trên hệ vi sinh
vật của mô tủy và mô quanh chóp. Trong các biến đổi sinh học, vai trò của các
yếu tố miễn dịch bẩm sinh và mắc phải đang được nghiên cứu trong tủy răng sau
khi bị nhiễm trùng, sự lành thương của mô quanh chóp sau khi điều trị tủy răng
cũng đang được nghiên cứu.
RUBBER DAM
Now, placement of rubber dam is mandatory for endodontic procedure


Laser Doppler
flowmetry test
• Vascular supply is the most
accurate marker of pulp vitality



Modern Dentistry

Modern Dentistry
Gutta Percha Trám bít ống tủy

Lèn ngang nguội Lèn dọc nóng Đơn côn
nhiệt dẻo với các đợt nén liên tục
Nguồn:
Flexcil - The Smart Study Toolkit & PDF, Annotate, Note Nisha Garg và Amit Garg, 2014
1.What is
ENDODONTICS?

2. How does Pulp become Damaged?
Tooth decay
Periodontal diseases
Tooth injuries
Nisha Garg & Amit Garg (2014), Textbook of ENDODONTICS
Sâu răng
Bệnh lý mô nha chu
Chấn thương răng
2. How does Pulp become Damaged?

Tooth decay
Periodontal diseases
Tooth injuries
3. Why do I feel pain ?

3. Why do I
feel pain ?
When pulp become infected, it
causes increased blood flow
and cellular activity, and
pressure cannot be relieved
from inside the tooth

4. Why do I need Root Canal Therapy?
The tooth will not heal by itself,

the infection may spread around
the tissues causing destruction of
bone and supporting tissues.
à This may cause tooth to fall out

5. What is Root Canal Procedure?
1:00

1/ Chẩn đoán 2/ Lựa chọn BN và 3/ Cung cấp thông tin và

lập kế hoạch điều trị Xác nhận đồng ý của BN
Tủy không lộ và không có dấu hiện viêm tủy
không hồi phục: che tủy gián tiếp
Tủy lộ
Liệu pháp điều trị tủy sống 4/ Lập bệnh án nội nha: Thu
I. Che tủy trực tiếp thập thông tin trước điều trị
II. Lấy tủy
- Lấy tủy từng phần
- Lấy tủy toàn bộ
Điều trị lấy tủy chân răng = Lấy tủy toàn bộ
Răng chết tủy chưa đóng chóp 5/ Chuẩn bị trước điều trị:
Kỹ thuật gây đóng chóp - Bệnh nhân
Kỹ thuật tạo chóp - Dụng cụ
Nội nha tái sinh - Vật liệu
Điều trị chấn thương răng - Tái tạo răng bị mất chất
Điều trị răng tiêu ngót (nếu cần)
Nội nha lại
Điều trị sang thương nội nha – nha chu kết hợp Điều trị
Phẫu thuật nội nha Flexcil - The Smart Study Toolkit & PDF, Annotate, Note


6. What are Risks and Complications?
§ >95 % successful
§ 5% fail cause of canal malformations, instrument
errors,…
§ >95 % điều trị nội nha thành công

§ 5% thất bại do hệ thống ống tủy bất thường, lỗi ở dụng cụ,…

7. How many visits will it Take to Complete this

Treatment?
Newer researches, techniques and materials have helped us to
perform the endodontic therapy in better way with more
efficiency. Since introduction of rotary instruments and other
technologies reduce the treatment time, the concept of single
visit is gaining popularity nowadays. It has been shown that
success of endodontic therapy depends on the quality of root
canal treatment and not the number of visits. In the modern world
single visit endodontics is becoming quite popular.

8. Will It become a Dead Tooth after Root Canal Therapy?
No, since tooth is supplied by

blood vessels present in
periodontal ligament, it
continues to receive the
nutrition and remains healthy.

9. Will they feel Pain during

or after Treatment?
• Nowadays with better techniques,
and better understanding of
anesthesia most of the patients feel
comfortable during the treatment.
• But for first few days after therapy,

one might feel sensation especially
if pain and infection were present
prior to the procedure. This pain can
be relieved by medication

10. Will the Tooth need any

Special Care or Additional
Treatment after Endodontic
Treatment?
• Should not chew or bite on the treated
tooth until it has been restored.
• Restore the tooth structure after
Endodontic treatment
• Maintain good oral hygiene

11. Can all Teeth be Treated Endodontically?
Most of the teeth can be treated endodontically, except:

- Root canals are not accessible
- Root is severely fractured
- Tooth cannot be restored
- Tooth does not have sufficient bone support,
à It becomes difficult to treat the tooth endodontically.
Hầu hết các răng có thể được điều trị nội nha, ngoại trừ:
• Không tìm thấy đường vào ống tủy
• Chân răng bị gãy nghiêm trọng
• Răng không thể phục hồi
• Răng không có đủ xương nâng đỡ,
à Điều trị nội nha răng trở nên khó khăn.
THANKS
FOR YOUR ATTENTION

Introduction To Endodontics

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Introduction To Endodontics

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This Document has been modified with Flexcil app (Android) https://www.fexcil.

LAM KIM TRIEN DDS

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

The main aim of the endodontic therapy

à The primary goal of endodontic therapy is to create an environment within

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

A Brief History of Endodontics

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

How to conserve the damaged

The 1826–1876 1926–1976

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

Prescience : 1776 - 1826

Endodontic therapy was

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

Age of discovery : 1826 - 1876

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

Age of discovery : 1826 to 1876

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

Age of discovery : 1826 to 1876

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

Age of discovery : 1826 to 1876

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

Dark age: 1876 to 1926

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

The renaissance: 1926 – 1976

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

Innovation era: 1977 till date

The faster Tremendous advancements, the simpler, easier

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

Now, placement of rubber dam is mandatory for endodontic procedure

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

Gutta Percha Trám bít ống tủy

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

2. How does Pulp become Damaged?

Nisha Garg & Amit Garg (2014), Textbook of ENDODONTICS

2. How does Pulp become Damaged?

3. Why do I feel pain ?

Nisha Garg & Amit Garg (2014), Textbook of ENDODONTICS

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

4. Why do I need Root Canal Therapy?

The tooth will not heal by itself,

Nisha Garg & Amit Garg (2014), Textbook of ENDODONTICS

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

1/ Chẩn đoán 2/ Lựa chọn BN và 3/ Cung cấp thông tin và

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

6. What are Risks and Complications?

§ >95 % điều trị nội nha thành công

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

7. How many visits will it Take to Complete this

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

8. Will It become a Dead Tooth after Root Canal Therapy?

No, since tooth is supplied by

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note

9. Will they feel Pain during

• But for first few days after therapy,

Flexcil - The Smart Study Toolkit & PDF, Annotate, Note