Restorative dentistry 4: endodontics

Endodontics is the study of the prevention and management of problems affecting the dentine, pulp, and periapical tissues. This chapter is a concise guide to the rationale behind root canal treatment, the instruments and materials available, and the modern techniques used. The chapter considers the anatomy of the root canal system including the average working lengths of pulp canals, the prevalence of lateral and accessory canals, and the location of the apical foramina. Alongside discussion of the indications and contraindications for root canal treatment, the aims and objectives of canal shaping, cleaning, and obturation are outlined. Detailed, step-by-step guidance is given for the root canal treatment procedure and common errors in canal preparation are highlighted. Management options are presented for some endodontic problems such as an acute periapical abscess and long-term possibilities for a definitive restoration are offered.

Author(s):  
David A. Mitchell ◽  
Laura Mitchell ◽  
Lorna McCaul

Contents. Preserving pulp vitality. The root canal system. Root canal treatment—rationale. Root canal treatment—instruments. Root canal treatment—materials. Root canal preparation—1. Root canal preparation—2. Common errors in canal preparation. Root canal obturation. Some endodontic problems and their management. Restoration of the root-treated tooth. Treatment outcomes.


Author(s):  
Necdet Adanir ◽  
Hassan Alkhalaf ◽  
Maram H. Alanazi ◽  
Asma S. Alghamdi ◽  
Abdullah A. Aljami ◽  
...  

Introduction: Bacteria play a crucial role in the pathogenesis of pulpal and periradicular pathoses. For example: Apical periodontitis is an inflammation of dental periapical tissues developed as a response to colonization of microorganisms in root canal system. The elimination of microbial species from the infected root canal system necessitates a strict aseptic condition for Instrumentation, disinfection and inter appointment medication. Enterococcus faecalis and Candida albicans had been commonly associated organisms in treatment-resistant infections. Methods: This was an observational cross-sectional study based on web-survey questionnaires developed by the authors with high confidence. The sample size was 304 estimated using the Qualtrics calculator with a confidence level of 95% and a margin of error of 5%. The questionnaire is divided into sections, regarding endodontic practice include endodontic education , years of experience , used of rubber dam or no and how to used irrigant solution whoever Sodium hypochlorite (NaOCl), Chlorhexidine, chelating agents (EDTA) or (MTAD) and reasons of every irrigant that prevents during root canal treatment. Data were collected using Google forms and prepared for analysis using Microsoft Excel. Statistical analysis was performed using the SPSS software. Results: A total of 304 participants responded, 44.1% dental interns, 39.5% General Dentist, 9.9% Endodontist, 6.3% other dental specialty. the Probable reasons that prevent them using rubber dam during root canal treatment are: 5.9% due to difficulty to apply, 9.2% due to lack of materials, 5.3% because it is a time-consuming, 1.6% said that other isolation methods are enough (partial isolation), 3.9% because of multiple reason combined together. 48.7% they always use rubber dam, so they did not choose any of the previous reasons. Conclusion: In conclusion, we identify and understand, most of the participants “always using rubber dam” during root canal treatment and the most common reasons was time consumption that prevented dentist from using rubber. In this study majority of participants preferred NaOCl 81.9% and 7.1% don’t use it.


2021 ◽  
Vol 67 (2) ◽  
pp. 101-106
Author(s):  
Sanziana Adina Scarlatescu ◽  
◽  
Irina Gheorghiu ◽  
George Nicola ◽  
Andrei O. Al Aloul ◽  
...  

The objectives of root canal treatment are to prevent the apical parodontitis, to heal the acute or cronic apical periodontits and to maintain the results, keeping the teeth on the arch in a functional stage. Thus, accuratelly elimination of soft and hard tissues (cleaning and shaping of the root canal system), disinfection and complete, homogeneous and tridimensional filling of the root canal system are very important to successful endodontic treatment. Modern concepts in endodontic treatment rely on technological progress and therefore many cases are successfully fulfilled, but the practitioner may be put in front of procedural erorrs both during and after endodontic treatment. Apical blockage, ledging, zipping, stripping, perforations in the floor of the pulp canal chamber or root canals perforations are the most common errors, but in many clinical situations they can be prevented and even surpassed once happened.


2020 ◽  
Vol 11 (SPL3) ◽  
pp. 1761-1765
Author(s):  
Preethi Mariona ◽  
Delphine Priscilla Antony S ◽  
Sreedevi Dharman

Some mishaps tend to occur during treatment in the root canal system, for example, file fractures. The challenge of the removal depends on the type of file fractured and the method which is used to remove it, generally it is decided based on the level of the fracture. Any file can fracture inside the root canal which is based on the curvature, anatomy. Specific techniques and measures have been employed to remove this file from the root canal system. The aim of the study is to find the association of file fracture with the method of removal. The details of all patients who underwent a root canal treatment where noted and the details of 16 patients with file fractures during the procedure were shortlisted. The type of file fractures was analyzed, such as K files, rotary files, H files, other instruments. The method of removal was usually ultrasonic, mechanical, manual or combination of any of the above. Excel tabulation was done and imported to SPSS for results. Chi-square test performed. The most common and used file to fracture in the root canal system was rotary files which had a fracture incidence of 31% and most common method used to retrieve was using ultrasonic of an incidence of 37.5. Chi-square test shows p>0.05, which is statistically not significant. The study concludes that rotary files fracture the most and the method used to retrieve them was mechanical, but as a whole, the most common method used was ultrasonic.


Dental Update ◽  
2021 ◽  
Vol 48 (1) ◽  
pp. 58-61
Author(s):  
Ajinkya M Pawar ◽  
Shishir Singh

In root canal treatment, the foundation on which all surgical procedures are performed is a thorough knowledge of the anatomy of the pulp chamber and the root canal system. The endodontic triad comprises biomechanical preparation, microbial control and complete obturation of the root canal space. Knowledge of the pulp chamber floor anatomy is important in locating the numbers and orifices of root canals present within the tooth being root canal treated. This is particularly important while treating teeth that are heavily restored, mal-positioned, or calcified. The current review attempts to explain the complex anatomy of the pulp chamber floor and its significance in root canal treatment. CPD/Clinical Relevance: To allow the location of all root canal orifices in the pulp chamber and to perform successful root canal treatment, knowledge of pulp chamber floor anatomy is essential. The clinician should consider that, as the external morphology of the tooth varies in individuals, so does the internal morphology.


Author(s):  
Dr. Anil K Tomer ◽  
Dr. Akankshita Behera ◽  
Dr. Mehak Dogra ◽  
Dr. Anila Krishna Saxena ◽  
Dr. Nitish Mittal ◽  
...  

The root canal system presents a complex anatomy. It is a myriad complex of canals and their various portals of exits. The maxillary first molar is an important tooth in the arch and is of prime functional importance. In maximum cases, the maxillary first molar shows presence of three canals viz. mesiobuccal, distobuccal and palatal canal. At times, there may be presence of four or five canals. These extra canals may be present as a second mesiobuccal canal, a second distobuccal canal or an extra canal in the palatal root. These canals are often missed by the clinician. Their identification has benefitted from technological innovations like microscopes and ultrasonics that have enabled easy identification of the orifices of these canals. This case report presents a case of root canal treatment of maxillary first molar with four canals.


Author(s):  
Pardeep Mahajan ◽  
Ruma Grover ◽  
Shikha Baghi Bhandari ◽  
Prashant Monga ◽  
Vanita Keshav

Successful outcome of endodontic treatment depends on the identification of all root canals which in turn guarantee complete extirpation of pulp tissue, proper chemo-mechanical cleaning and shaping and three dimensional obturation of the root canal system with an inert filling material. However endodontic treatment can fail for many reasons, such as diagnostic errors, persistence of the infection in the root canal system, errors in debridement and shaping of the root canal systems, instrument fractures, poor restorations and extra roots or canals if not detected are the reasons for failure. Undetected extra roots or root canals have been considered as a major reason for failure of root canal treatment. Many of the challenges faced during root canal treatment may be directly attributed to an inadequate understanding of the canal morphology of teeth. A broad knowledge of both the external and internal anatomy of teeth is of great importance for adequate endodontic treatment. We present a case report of 2 roots in mandibular lateral incisor.


2010 ◽  
Vol 1 (1) ◽  
pp. 21-29
Author(s):  
Francis W Allen

ABSTRACT Cleaning and shaping of root canal system forms the most important step in root canal root canal therapy. Unfortunately most of the instruments and techniques advocated are unable to remove residual debris and bacteria, ultimately resulting in pain and failure. To eliminate the causes of pain, and ensure success, we must use instruments and employ a technique that can best accomplish proper cleaning and shaping. Virtually all canals have parallel walls, and are curved and oval in shape. Hence tapered instruments are unable to clean the canal effectively and increase the chances of ledges and transportation and extrusion of debris beyond the apex. With the introduction of Light Speed technology primary goal of endodontics which includes removal of debris safely and effectively can be achieved. This article focuses on the use of Light Speed technology to overcome the difficulties posed by the other instrumentation and techniques to achieve debris and bacteria free canal system.


2013 ◽  
Vol 01 (03) ◽  
pp. 159-162
Author(s):  
Harleen Gill ◽  
Ajay Chhabra ◽  
Varun Jindal ◽  
Ankur Vats ◽  
Gurkirat Grewal

AbstractIn case of failed root canal treatment endodontic retreatment of the root canal system is necessary. The aim of the present study was to compare the gutta-percha removal with Protaper retreatment files (Dentsply Maillefer, Ballaigues, Switzerland), K3 (SybronEndo) and Hero Shapers (MicroMega, Besancon, France). Method: Thirty freshly extracted human single rooted teeth were prepared with ProTaper rotary instruments up to file F3 andfilled with 30 # GP cones and AH plus sealer. The teeth were then stored for 1 week. The teeth were divide into 3 retreatment groups (n=10). The gutta-percha was removed using Protaper retreatment files, K3 and Hero Shapers. Teeth were then evaluated using radiographs. Results: Comparing the ratio between clean canals Protaper and K3 showed better debris removal as compared to Hero shaper. But no significance difference was found.


2017 ◽  
Vol 7 (3) ◽  
pp. 221-223
Author(s):  
Umme Kulsum

Background: Root canal system, when becomes infected is managed by thorough debridement and specific shaping of the root canal. It is to be followed by a specific type of filling. The ultimate goal of these approaches is to create an environment in which the body’s immune system can produce healing of the apical periodontal attachment apparatus. Thorough debridement and shaping are carried out usually by biomechanical preparation of root canal system along with intracranial medicament. The use of intracanal medicaments is still debatable. This study was designed to evaluate the usefulness of root canal treatment without using any biomedical preparation.Methods: The study was carried out in the Department of Conservative Dentistry and Endodontics, BSMMU, Dhaka July 2003 ……to July 2004. In the present study, 36 cases of endodontically involved infected teeth were treated by conventional root canal treatment without using intracanal medicaments and patients were followed up at 6 and 12 months after root canal treatment.Results: At 6 and 12 months follow up, an overall treatment success was revealed in clinical and radiological findings.Conclusion: It is the biomechanical preparation of the canal which decides the success rate of root canal treatment of infected teeth, not the use or nonuse of intracanal medicament.Birdem Med J 2017; 7(3): 221-223


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