endodontics

Endodontics

Endodontology is derived from the Greek language and translated as ‘the knowledge of what is inside the tooth’

Definition

Endodontics: The branch of dentistry concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice the basic and clinical sciences including the biology of the normal pulp and the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.

Scope

Differential diagnosis and treatment of oral pains of pulpal and/or periapical origin. Vital pulp therapy such as pulp capping and pulpotomy. Nonsurgical treatment of root canal systems. Selective surgical removal of pathological tissues resulting from pulpal pathosis Surgical removal of tooth structure such as in root-end resection, hemisection and root resection.

Intentional replantation and replantation of avulsed teeth. Bleaching of discolored dentin and enamel. Retreatment of teeth previously treated endodontically. Treatment procedures related to coronal restorations by means of post and/or cores.

Indications

Pathologically involved pulp: Irreversible pulpitis. Pulp necrosis.


Intentional endodontics: When a tooth can not be restored properly without performing root canal therapy on a vital pulp. Hypererupted teeth. Drifted teeth. Teeth needing post and core restorations.

Overdenture abutment: To preserve the alveolar ridge bone.

Overdenture

Trauma: Pulp necrosis Ankylosis Resorption Calcification

Contraindications
From an endodontic point of view there are no absolute contraindications for performing root canal treatment . Calcifications. Dilacerations. Resorptive defects.

Calcification

Severe dilaceration of MB root

Curvature is not apparent in Buccolingual aspect

Bayonet- shaped canal

Internal

External

Contraindications

Restorative considerations: Subosseous caries. Poor crown/root ratio. Misalignment. Badly fractured tooth.

Contraindications

Periodontal considerations: Extensive periodontal defect that can not be maintained.

Prognosis

Success rate is high, around 90% Teeth without periradicualr radiolucency have better prognosis than teeth with periradicular radiolucency (up to 20% difference)

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