introductiontoendodontics2009new-101110042845-phpapp01

8/11/2019 introductiontoendodontics2009new-101110042845-phpapp01

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Introduction to Endodontics

Dr. Feras Aalam


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Endodontic

known as "root canal treatment

"Endo" is the Greek word ="inside

"odont" is Greek ="tooth"

Endodontic treatment =treats the insideof the tooth


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The pulp

Inside the tooth, underenamel an dentin, is a softtissue called the pulp

Extends from the crown ofthe tooth to the tip of theroots where it connects tothe tissues surrounding theroot

Containsblood vessels,

nerves

connective tissue


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The pulp

Ccreates the surroundinghard tissues of the toothduring development

The pulp is important duringa tooths growth anddevelopment

Once a tooth is fully matureit can survive without the

pulp, because the toothcontinues to be nourished bythe tissues surrounding it


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What is endodontics??

Endodontics is that branch of dentistry

concerned with the

1.Diagnosis2.Treatment

3.Prognosis and

4.prevention of

diseases and injuries

of the pulp andperiapical tissues


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Objectives of Endodontic Treatment

Relief of pain = symptom free

To render the affected tooth biologicallyacceptable and functioning without adiagnosable 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.


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Indications for Endodontic

Therapy a-Teeth with pulpal and /or priapical

pathosis.

b-Teeth with no pulpal or periapicalpathosis may need endodontictreatment due to:

1-The need for post and coreconstruction to rebuild the missingcoronal portion of the tooth

2-Traumatic pulp exposure due to dental

work or accidental fracture.


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Indications

3-Incomplete calcification of the pulpchamber 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 tosupport overlay denture

7-Esthetic requirement.


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1-Teeth with insufficient

periodontal support.2-Teeth with vertical rootfracture.3-Teeth with external rootresorption.

Contraindications for

Endodontic Therapy


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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.


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6-Teeth with root canals not suitable for

instrumentation and /or periapicalsurgery such as calcified or severelycurved canals.

7-Patients with systemic conditions

contraindicates surgical endodontics.


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Phases of Endodontics

treatment Diagnostic phase

Preparatory phase

(cleaning & shaping)

Obturation phase


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Diagnostic phase

During this phase the condition of the tooth

is determined and the plan of treatment is

developed.


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Diagnostic phase

Determine the condition of the toothand the plan of treatment

Clinical examinations Percussion, pain

Deep caries

Radiographic examinations- Periapical radiographs

Vitality test


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Clinical examinations


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Radiographic examinations

Periapical radiographs


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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 adjacenttooth


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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


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Rubber dam


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Rubber dam

Rubbere dam over the area to isolate the tooth, keep it

clean and free of saliva during the dental procedure


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HAND PEICE

LOW SPEED HAND PEICE

HIGH SPEED HAND PEICE


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Burs


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Endo-files


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Preparatory phase

Pulp chamber

Root canal


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Preparatory phase

Determine theworking length

Radiographs Add radiograph with

the working lenght


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44RCT of tooth #


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35RCT of tooth #


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Irrigation


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Paper points

Dry the canals


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Temporary filling


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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 anatomicapex.

Instuments needed

1.Gutta percha

2.Paper points

3.Spreader

4.Root canal sealer


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Gutta percha


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Spreader


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Root canal sealer


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Gutta perchaPaper points


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Obturation phase


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35RCT of tooth #


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Gutta percha


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Summary


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Post and core


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35Cats post & core for tooth #


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