root canal treatment international standard protocol by dr. amit t. suryawanshi (mds)
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Dr. Amit T. Suryawanshi ’s Face Art International Dental, Facial
Cosmetic Super Speciality & Hair Transplant Centre,
Kolhapur , MH(India)Call us today +91 7758976097 /
9405622455
ROOT CANAL TREATMENTInternational Protocol
For International Calls Dial +91 9405622455
(MH, India)
Root Canal Treatment is one of the most common treatments in dentistry that manages the diagnosis, and treatment of the dental pulp and the periradicular tissues that surround the root of the tooth.
Introduction
Physical irritation • Most generally
brought on by extensive decay.
Trauma • Blow to a tooth
or the jaw.
Causes of Pulpal Nerve Damage
Pain when biting down. Pain when chewing. Sensitivity with hot or cold beverages. Facial swelling.
Signs and Symptoms of Pulpal Nerve Damage
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Subjective examination• Chief complaint • Character and duration of pain • Painful stimuli • Sensitivity to biting and pressure
Diagnosis
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Objective examination• Extent of decay • Periodontal conditions surrounding
the tooth in question • Presence of an extensive restoration • Tooth mobility • Swelling or discoloration • Pulp exposure
Diagnosis- cont’d
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Percussion tests • Used to determine whether the
inflammatory process has extended into the periapical tissues.
• Completed by the dentist tapping on the incisal or occlusal surface of the tooth in question with the end of the mouth mirror handle held parallel to the long axis of the tooth.
Diagnostic Testing
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Palpation tests• Used to determine whether the
inflammatory process has extended into the periapical tissues.
• The dentist applies firm pressure to the mucosa above the apex of the root.
Diagnostic Testing- cont’d
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Thermal sensitivity• Necrotic pulp will not respond to cold
or hot. Cold test
• Ice, dry ice, or ethyl chloride used to determine the response of a tooth to cold.
Heat test• Piece of gutta-percha or instrument
handle heated and applied to the facial surface of the tooth.
Diagnostic Testing- cont’d
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Electric pulp testing• Delivers a small electrical stimulus to
the pulp. Factors that may influence readings:
• Teeth with extensive restorations.• Teeth with more than one canal. • Failing pulp can produce a variety of
responses. • Control teeth may not respond as
anticipated. • Moisture on the tooth during testing.• Batteries in the tester may be weak.
Diagnostic Testing- cont’d
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Initial radiograph • Diagnosis.
Working length film • Used to determine the length of the
canal. Final instrumentation film
• Taken with the final size files in all canals.
Root canal completion film • Taken after the tooth as been
temporized. Recall films
• Taken at evaluations.
Radiographs in Endodontics
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Show 4-5 mm beyond the apex of the tooth and the surrounding bone or pathologic condition.
Present an accurate image of the tooth without elongation or fore-shortening.
Exhibit good contrast so all pertinent structures are readily identifiable.
Requirements of Endodontic Films
Normal pulp• There are no subjective symptoms or
objective signs. The tooth responds normally to sensory stimuli, and a healthy layer of dentin surrounds the pulp.
Diagnostic Conclusions
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Pulpitis • The pulp tissues have become inflamed.
Reversible pulpitis• The pulp is irritated, and the patient is
experiencing pain to thermal stimuli. Irreversible pulpitis
• The tooth will display symptoms of lingering pain.
Diagnostic Conclusions- cont’d
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Periradicular abscess• An inflammatory reaction to pulpal
infection that can be chronic or have rapid onset with pain, tenderness of the tooth to pressure, pus formation, and swelling of the tissues.
Diagnostic Conclusions- cont’d
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Periodontal abscess • An inflammatory reaction frequently
caused by bacteria entrapped in the periodontal sulcus. A patient will experience rapid onset, pain, tenderness of the tooth to pressure, pus formation, and swelling.
Diagnostic Conclusions- cont’d
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Periradicular cyst• A cyst that develops at or near the
root of a necrotic tooth. These types of cysts develop as an inflammatory response to pulpal infection and necrosis of the pulp.
Diagnostic Conclusions- cont’d
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Pulp fibrosis• The decrease of living cells within the
pulp causing fibrous tissue to take over the pulpal canal.
Diagnostic Conclusions- cont’d
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Necrotic tooth• Also referred to as nonvital. Used to
describe a tooth that does not respond to sensory stimulus.
Diagnostic Conclusions- cont’d
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Pulp capping• A covering of calcium hydroxide is
placed over an exposed or nearly exposed pulp to encourage the formation of irritated dentin at the site of injury.
Indirect pulp cap is indicated when a thin partition of dentin is still intact.
Direct pulp cap is indicated when the pulp has been slightly exposed.
Endodontic Procedures
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Pulpotomy • Involves the removal of the coronal
portion of an exposed vital pulp.• Completed to preserve the vitality of
the remaining portion of the pulp within the root of the tooth.
• This procedure is commonly indicated for vital primary teeth, teeth with deep carious lesions, and emergency situations.
Endodontic Procedures- cont’d
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Pulpectomy • Also referred to as root canal therapy;
procedure involves the complete removal of the dental pulp.
Endodontic Procedures- cont’d
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Endodontic explorer Endodontic spoon excavator Broaches Endodontic files
• K-type• Hedstrom
Instruments and Accessories for Endodontic Procedures
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Colors and Sizes of Endodontic Files
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Rubber stops Paper points Spreaders Pluggers Glick No. 1 Millimeter ruler
Instruments and Accessories for Endodontic Procedures- cont’d
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Rotary instruments • Gates-Glidden bur • Pesso reamer • Lentulo spiral
Instruments and Accessories for Endodontic Procedures- cont’d
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Irrigation solution • Sodium hypochlorite • Hydrogen peroxide • Parachlorophenol (PCP)
Medicaments and Dental Materials in Endodontics
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Gutta-percha points Formocresol Root canal sealer
Medicaments and Dental Materials in Endodontics- cont’d
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Anesthesia and pain control Isolation and disinfection of the site Access preparation Debridement and shaping the canal Obturation
Overview of Root Canal Therapy
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Indications for surgical intervention• Endodontic failure caused by
persistent infection, severely curved roots, perforation of the canal, fractured roots, extensive root resorption, pulp stones, or accessory canals that cannot be treated.
• Exploratory surgery to determine why healing has not occurred.
• Biopsy
Surgical Endodontics
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To surgically remove the apical portion of the root with the use of a high‑speed handpiece and bur.
To evaluate:• Inadequate sealing of
the canal. • Accessory canals. • Fractures of the root. • Pathological tissue
around the root apex.
Apicoectomy and Apical Curettage
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Completed when an apical seal is not adequate. A small class I preparation is made at the apex and sealed with filling materials such as gutta-percha, amalgam, or composite.
Retrograde Restoration
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Root amputation• A surgery performed
to remove one or more roots of a multirooted tooth without removing the crown.
Hemisection• A procedure in which
the root and the crown are cut lengthwise and removed.
Root Amputation and Hemisection
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Created & Presented by Dr. Amit T. Suryawanshi
(MDS) Facial Cosmetic SurgeonOral & Maxillofacial Surgeon
Dental Surgeon & ImplantologistHair Transplant Surgeon (Germany)
Consulting Surgeon in Kolhapur, Sangli, Pune & Mumbai (India)
&founder of
Face Art International Super specialityat Kolhapur
Follow us on SlideShare &Click here
www.faceart-clinic.com
For more Information & Treatment Call us today
Clinic phone +91 7758976097 / 9405622455
Click here www.faceart-clinic.com
Face Art International Super Speciality
Address : Face Art International "Renuka Sadan",First floor, Above Kallappanna Aawade Bank, Near Allen Solly Showroom, 6th lane
Rajarampuri, Kolhapur. 416 008
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