Download - Introduction to endodontics2009(new)
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