Introduction to Endodontics

Dr. Feras Aalam

Outline

• What is Endodontics??• Indications • Contraindications• Steps• Instuments

Endodontic

• known as "root canal treatment”• "Endo" is the Greek word

="inside”• "odont" is Greek ="tooth"• Endodontic treatment =treats the

inside of the tooth

The pulp

• Inside the tooth, under enamel an dentin, is a soft tissue called the pulp

• Extends from the crown of the tooth to the tip of the roots where it connects to the tissues surrounding the root

• Contains blood vessels,nervesconnective tissue

The pulp

• Ccreates the surrounding hard tissues of the tooth during development

• The pulp is important during a tooth’s growth and development

• Once a tooth is fully mature it can survive without the pulp, because the tooth continues to be nourished by the tissues surrounding it

What is endodontics??

Endodontics is that branch of dentistry

concerned with the 1.Diagnosis2.Treatment3.Prognosis and 4.prevention of

diseases and injuries of the pulp and

periapical tissues

Objectives of Endodontic Treatment

• Relief of pain = symptom free• To render the affected tooth biologically

acceptable and functioning without a diagnosable pathosis

• Removal of pulp from root(s) of tooth• Disinfections of root and surrounding bone• Root canal treatment is an attempt to retain

a tooth which may otherwise require extraction.

Indications for Endodontic Therapy

• a-Teeth with pulpal and /or priapical pathosis.

• b-Teeth with no pulpal or periapical pathosis may need endodontic treatment due to:

1-The need for post and core construction to rebuild the missing coronal portion of the tooth

2-Traumatic pulp exposure due to dental

work or accidental fracture.

Indications

• 3-Incomplete calcification of the pulp chamber and root canals

• 4-Internal resorption.• 5-Over erupted and mesially drifted

teeth when crown reduction may cause pulp exposure.

• 6-Teeth retained in the mouth to support overlay denture

• 7-Esthetic requirement.

1-Teeth with insufficient periodontal support. 2-Teeth with vertical root fracture.3-Teeth with external root resorption.

Contraindications for Endodontic Therapy

4-Non restorable teeth which can not properly

function after endodontic treatment.

5-Non strategic teeth which can not serve in

occlusion or as abutments after endodontic

treatment.

6-Teeth with root canals not suitable for

instrumentation and /or periapical surgery such as calcified or severely curved canals.

7-Patients with systemic conditions contraindicates surgical

endodontics.

Phases of Endodontics treatment

• Diagnostic phase

• Preparatory phase (cleaning & shaping)

• Obturation phase

Diagnostic phase

During this phase the condition of the toothis determined and the plan of treatment isdeveloped.

Diagnostic phase

• Determine the condition of the tooth and the plan of treatment

• Clinical examinations– Percussion, pain– Deep caries

• Radiographic examinations- Periapical radiographs

• Vitality test

Clinical examinations

Radiographic examinations

Periapical radiographs

Vitality test

• Pulp test• Vitality pulp tests:

– Electric Pulp tester (EPT)– Thermal Tests:

• CO2 Ice• Cold water/Ice• Hot water• Cavity Test

• Compare the reading with the opposing or adjacent tooth

Preparatory phase(Cleaning & Shaping)

• During this phase the condition of the tooth is determined and the plan of treatment is developed.

• Instuments needed:– Handpeice low, high speed– Endo-files– Saline– Irrigation syringe– Paper points– Calcium hydroxide– Cotton pellets– Temporaty filling– Rubber dam

Rubber dam

Rubber dam

Rubbere dam over the area to isolate the tooth, keep it clean and free of saliva during the dental procedure

HAND PEICE

LOW SPEED HAND PEICE

HIGH SPEED HAND PEICE

Burs

Endo-files

Preparatory phase

Pulp chamber

Root canal

Preparatory phase

• Determine the working length

• Radiographs • Add radiograph

with the working lenght

RCT of tooth #44

RCT of tooth #35

Irrigation

Paper points

Dry the canals

Temporary filling

Obturation phase

During this phase the root canals are filled with an inert material to achieve a hermetic seal as close as possible to the anatomic apex.Instuments needed1.Gutta percha2.Paper points3.Spreader 4.Root canal sealer

Gutta percha

Spreader

                                                                                                          

Root canal sealer

Gutta perchaPaper points

Obturation phase

RCT of tooth #44

RCT of tooth #35

Gutta percha

Summary

Post and core

Cats post & core for tooth #35