Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long...

42
Endodontics Endodontics I. I. Morphology Morphology Pulp Pulp disease disease Indication Indication Contraindiction Contraindiction Instrumentarium Instrumentarium

Transcript of Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long...

Page 1: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

EndodonticsEndodontics I.I.

MorphologyMorphologyPulp Pulp diseasedisease

IndicationIndicationContraindictionContraindictionInstrumentariumInstrumentarium

Page 2: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

EndodonticsEndodontics

Pulp Pulp andand

periodontalperiodontal

diseasesdiseases

––diagnosisdiagnosis, , therapytherapy, , preventionprevention

Page 3: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

EndodoncieEndodoncie I.I.

MorphologyMorphology

OnemocnOnemocněěnníí

zubnzubníí

ddřřeneněě

Indikace a kontraindikace Indikace a kontraindikace endodontickendodontickééhoho

ooššetetřřeneníí

InstrumentariumInstrumentarium

Page 4: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

Morphology

Enamel

Dentin

Cementum

Periodontium

Pulp

Page 5: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

Meyer 1962

Page 6: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

3D3D

Page 7: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

MeyersMeyers conclusionsconclusionsTheThe rootroot canalcanal isis not not roundround butbut oval (oval (longlongaxisaxis mesiodistalmesiodistal))

TheThe rootroot canalcanal doesdoes not not gogo straightstraight butbut ititdeflectsdeflects distaldistal

TheThe outfalloutfall isis not on not on thethe top top ofof thethe rootroot butbutbelowbelow ((distaldistal oror distooraldistooral))

Page 8: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

MeyerMeyer´́s s conclusionsconclusionsTheThe formform ofof thethe outfalloutfall isis funnelfunnel -- shapedshaped

TheThe rootroot canalcanal systemsystem has has usuallyusually more more outfallsoutfalls((ramificationsramifications))

TheThe ramificationsramifications are are situatedsituated mostlymostly in in apicalapicalarea (area (firstfirst apicalapical mm)mm)

AllAll outfallsoutfalls are are situatedsituated in in cementumcementum

Page 9: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

Basic Basic formsforms ofof

thethe rootroot

canalcanal systsystéém (m (WeineWeine))

Page 10: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

Apical

morphology

1.

X –

ray

apex2.

Foramen

apicale

3.

Apical

constrictionA4.

Periodontal

ligament

5.

Root

cementum6.

Dentin

Acc. to Guldener a Langeland

Page 11: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

CanalCanal shapingshaping terminatesterminates in in apicalapical constrictionconstrictionSmallSmall communicationcommunication

LessLess risk risk ofof periodontalperiodontal damagedamagePreventionPrevention ofof overfillingoverfillingPreventionPrevention ofof apicalapical transport transport ofof infectiousinfectiousmaterialmaterialPossibilityPossibility ofof goodgood bacterialbacterial decontaminationdecontaminationPossibilityPossibility ofof goodgood condensationcondensation ofof thethe rootroot fillingfilling

Page 12: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

MacrocanalMacrocanal systemsystem

MicrocanalMicrocanal systemsystem

Page 13: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

Endodont: dentin

and

pulp (morphological

and

functional

unit)

Page 14: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

OdontoblastsPredentinDentin

Dental pulp

Page 15: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

Defense Defense mechanismsmechanisms ofof

thethe pulppulp

SclerosisSclerosis

TertiarTertiar dentindentin

DentinDentin bridgebridge

Page 16: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

Pulpodentinální

orgán -

endodont

Page 17: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

Pulp Pulp diseasesdiseases

InflammationInflammation

--

pulpitispulpitis

ConsequencesConsequences--

NecrosisNecrosis

--

GangraenaGangraena--

ApicalApical

periodontitisperiodontitis

Page 18: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

ReasonsReasons

BacteriaBacteria

MechanicalMechanical irritantsirritants ((overinstrumentationoverinstrumentation, , trauma)trauma)

ChemicalChemical irritationirritation((espesp. . phenolicphenolic basedbasedintracanalintracanal medicamentsmedicaments,,overfillingoverfilling,,irrigantsirrigants))

Page 19: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

ClassificationClassification ofof

pulp pulp diseasesdiseases

HistopatologicalHistopatologicalHyperemiaHyperemia

pulpaepulpae

PulpitisPulpitis

acutaacuta

serosa serosa partialispartialistotalistotalis

PulpitisPulpitis

acutaacuta

purulentapurulenta

partialispartialistotalistotalis

Page 20: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

ClassificationClassification ofof

pulp pulp diseasesdiseases

HistopatologicalHistopatologicalPulpitisPulpitis

chronicachronica

clausaclausaapertaaperta

ulcerosaulcerosapolyposapolyposa

Page 21: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

ClassificationClassification ofof

pulp pulp diseasesdiseases

ClinicalClinical

ReversibleReversible

pulpitispulpitis

PainPain doesdoes not not lingerlinger afterafter stimulus stimulus isis removedremoved

PainPain isis difficultdifficult to to localizelocalize

NormalNormal periradicularperiradicular appearanceappearance

TeethTeeth are not tender to are not tender to percussionpercussion

Page 22: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

ClassificationClassification ofof

pulp pulp diseasesdiseases

ClinicalClinical

IrreversibleIrreversible

pulpitispulpitisPainPain maymay developdevelop spontaneouslyspontaneously oror fromfromstimulistimuliIn In laterlater stagesstages heatheat isis more more significantsignificantResponse Response lastslasts fromfrom minutesminutes to to hourshoursWhenWhen thethe periodontalperiodontal ligamentligament isis involvedinvolved, , thethe painpainisis localizedlocalized

A A widenedwidened periodontalperiodontal ligamentligament maymay bebe seenseen in in laterlater stagesstages

Page 23: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

DiagnosisDiagnosisHistoryHistory

PresentingPresenting

complaintcomplaintMedicalMedical

historyhistory

Dental Dental historyhistoryPainPain

historyhistory

LocationLocationType Type andand intensity intensity ofof painpainDurationDurationStimulusStimulusReliefRelief ((analgeticsanalgetics, , antibioticsantibiotics, , sippingsipping coldcold drinksdrinks) )

Page 24: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

DiagnosisDiagnosis

ClinicalClinical examinationexamination

ExtraoralExtraoral

((swellingswelling, , rednessredness, , extraoralextraoral

sinusessinuses, , lymphlymph

nodesnodes, , degreedegree

ofof

mouthmouth

openingopening))

IntraoralIntraoral

examinationexamination

SwellingSwelling, , rednessredness,,palpationpalpation, , percussionpercussion, sinus, sinus

tracttract

examinationexamination, , teethteeth

mobility,mobility,pocketspockets

Page 25: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

DiagnosisDiagnosis

ClinicalClinical

examinationexamination

Pulp sensitivity Pulp sensitivity teststests, , radiographicradiographic

examinationexamination, , transilluminationtransillumination..

Page 26: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

Ca (OH)2

Disociation

–

strong

alcality

Low

solubility

Suspension

Page 27: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

SuspensionsCementsSubbaseTemporary root canal filling- Short term- Middle term- Long term

Antiphlogitic

Improves dentinogenesis

Antimicrobial effect

Page 28: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

Indirect

pulp capping

Page 29: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

IndirectIndirect pulp pulp cappingcapping

Suspension

Cement

Page 30: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

IntermitentIntermitent excavationexcavation

Page 31: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

DirectDirect pulp pulp cappingcapping

NecrosisReparative inflammationDentin bridge

Page 32: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

DirectDirect pulp pulp cappingcapping

Small perforation surrounded with healthy dentin, immediately.

Page 33: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

Pulpotomy

Page 34: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

Indikace a Indikace a kontraindokacekontraindokace endodontickendodontickééhoho

ooššetetřřeneníí

HlediskoHledisko

MMíístnstnííRegionRegionáálnlnííCelkovCelkovéé

Page 35: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

Indikace a Indikace a kontraindokacekontraindokace endodontickendodontickééhoho

ooššetetřřeneníí

HlediskoHledisko

MMíístnstníí--

Stav Stav parodontuparodontu

--

AnatomickAnatomickéé

pompoměěry kory kořřenových kanenových kanáálklkůů

Page 36: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾
Page 37: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

IndicationsIndications andand

contraindicationscontraindications ofof

thethe endodontic endodontic treatmenttreatment

Point Point ofof viewview

LocalLocal

––

morphologymorphology

ofof

thethe

toothtooth

((numbernumber

ofofrootsroots, , configurationconfiguration

ofof

thethe

rootroot

canalscanals,,

destructiondestruction

ofof

thethe

clinicalclinical

crowncrown).).

Page 38: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

IndicationsIndications andand

contraindicationscontraindications ofof

thethe endodontic endodontic treatmenttreatment

Point Point ofof viewview

RegionalRegionalImportanceImportance

ofof

thethe

toothtooth

Page 39: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

Indikace a Indikace a kontraindokacekontraindokace endodontickendodontickééhoho

ooššetetřřeneníí

Point Point ofof viewview

SystemicSystemicHealthyHealthy

statusstatus

AbilityAbility

ofof

cooperationcooperation

Page 40: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

PrePre--requisitesrequisites forfor successucces

Right indicationElimination of infection

Canal shapingCanal cleaning

Hermetic root canal fillingAdequate reaction of thepatient

Page 41: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

PhasesPhases ofof thethe endodontic endodontic treatmenttreatment

DiagnosisDiagnosis ((historyhistory, , investigationinvestigation, x, x--rayray))

DecisionDecision

LocalLocal anaesthesiaanaesthesia

RemovalRemoval ofof oldold fillingsfillings, dental , dental cariescaries, , reconstuctionreconstuction ofof thethe clinicalclinical crowncrown ififnecessarynecessary, , rubberrubber damdam

Access to Access to thethe pulp pulp chamberchamber

Page 42: Endodontics I. - is.muni.cz · Meyers conclusions ¾ The root canal is not round but oval (long axis mesiodistal) ¾ The root canal does not go straight but it deflects distal ¾

PhasesPhases ofof thethe endodontic endodontic treatmenttreatmentOpeningOpening ofof rootroot canalcanal orificesorificesCathetrizationCathetrization, , removingremoving ofof thethe contentcontent ofof thethe rootroot canalcanal, , initialinitial shapingshaping –– safe safe lengthlengthNegotiationNegotiation ofof hehe workingworking lengthlengthRootRoot canalcanal shapingshaping andand irrigationirrigationRecapitulationRecapitulationDryingDryingRootRoot canalcanal fillingfillingXX-- rayrayTemporaryTemporary fillingfillingPostendodonticPostendodontic treatmenttreatment


The Endodontics Root Canals Instrumentation & Irrigation ...root canal preparation and elimination of infection and the canal can be dried. It ... Instrumentation • Root canal debridement

The Endodontics Root Canals Instrumentation & Irrigation ...root canal preparation and elimination of infection and the canal can be dried. It ... Instrumentation • Root canal debridement

Root Canal Sealers - Seminar

Root Canal Sealers - Seminar

Histologic Evaluation of Canal and Isthmus Debridement ... · system design on canal/isthmus debridement efficacy. In other studies, the criteria for mesiodistal isthmus width selection

Histologic Evaluation of Canal and Isthmus Debridement ... · system design on canal/isthmus debridement efficacy. In other studies, the criteria for mesiodistal isthmus width selection

Monster Root Canal Doctor

Monster Root Canal Doctor

ROOT CANAL REPAIR MATERIAL - Dentsplydentsplymea.com/sites/default/files/Brochure_ProRoot_MTA.gb_.pdf · ROOT CANAL REPAIR MATERIAL ... • Repair of root resorption Internal root

ROOT CANAL REPAIR MATERIAL - Dentsplydentsplymea.com/sites/default/files/Brochure_ProRoot_MTA.gb_.pdf · ROOT CANAL REPAIR MATERIAL ... • Repair of root resorption Internal root

lenin-root canal sealers

lenin-root canal sealers

Root Canal Morphology

Root Canal Morphology

Root Canal Filling Materials

Root Canal Filling Materials

Root canal filling techniques

Root canal filling techniques

Root Canal Preparation Simplified

Root Canal Preparation Simplified

Root Canal Desoto 

Root Canal Desoto 

Root canal filling materials. Root filling techniques.

Root canal filling materials. Root filling techniques.

Root canal filling

Root canal filling

Root Canal Treatment Michigan

Root Canal Treatment Michigan

Root canal treatment

Root canal treatment

Improve Your Root Canal Preparations with Adaptive Motion ... adaptive... · Improve Your Root Canal Preparations with Adaptive Motion Technology ... the root canal to the apical

Improve Your Root Canal Preparations with Adaptive Motion ... adaptive... · Improve Your Root Canal Preparations with Adaptive Motion Technology ... the root canal to the apical

Root Canal Preparation & Obturation - Henry Schein · 2019-05-22 · root canal system using HyFlex rotary NiTi instrumentation Three dimensional root canal obturation Wed 10 July

Root Canal Preparation & Obturation - Henry Schein · 2019-05-22 · root canal system using HyFlex rotary NiTi instrumentation Three dimensional root canal obturation Wed 10 July

Root Canal Filing Materials

Root Canal Filing Materials

ROOT CANAL COVER UP

ROOT CANAL COVER UP

Root Canal Sealing Material

Root Canal Sealing Material