Download SCOPE OF ENDODONTICS

SCOPE
OF
ENDODONTICS
Ass. Prof. Dr.
Talal H. Al-Salman
2015-2016
Definition:
Endodontics as a speciality of dentistry
concerned with the diagnosis and treatment
of disease and injuries of the pulp and
periapical tissues.
Definition:
American association of endodontic define
(endodontics)as:
Branch of dentistry concerned with the
morphology, physiology, and pathology of
human dental pulp and periradicular tissues.
Scope of endodontics include the followings:
• Deferential diagnosis and treatment of oral
pains of pulp and / or periapical origion.
• Vital pulp therapy such as pulp capping and
pulptomy.
• Root canal therapy such as pulpectomy, non
surgical treatment of root canal system with
or without periapical pathosis of pulpal origin
and the obturation of these root canal
systems
Scope of endodontics include the followings:
• Selective surgical removal of pathological
tissues resulting from pulpal pathosis.
• Intentional replantation, and replantation of
avulsed tooth.
• Surgical removal of tooth structure as in
hemisection, and root amputation.
• Endodontic implants
Scope of endodontics include the followings:
• Bleaching of discolored teeth.
• Retreatment of teeth previously treated
endodontically.
• Treatment procedure related to coronal
restoration by means of post and core
involving root canal space.
Basic phases of endodontic therapy:
• Diagnosis phase: in which the cause of disease
is identified end the treatment plan is
pepared.
• Preparatory phase: in which, by cleaning and
shaping of the canal space, the root canal
contents are removed and the canal is shaped
to receive root filling.
• Obturation phase: in which the root canal is
filled three dimensionally to ensure tight seal.
Indications of endodontic therapy:
(All teeth can be treated endodontically successfully)
(In theory there are no contraindication of
endodontic therapy)
Especially if the tooth is periodontally sound or can
be cured.
And the apical foramen or foramenae can be sealed.
Contraindications of endodontic therapy:
An advanced and untreatable periodontal
diseases is an absolute contraindication of
endodontic therapy.
And there are some contraindication that can be
distinguish as true or false.
True contraindication of endodontic therapy:
- Insufficient periodontal support:
Periodontal or periapical disease → alveolar
bone loss →lack of periodontal support.
- Inadequate crown - root ratio.
- Caries of root and caries of bifurcation
- Internal resorption with perforation.
- Vertical root fracture.
False contraindication of endodontic therapy:
The following clinico-pathological situations can be
considered as indication for the endodontic surgery,
and contraindication for the conservative endodontic.
Really, before surgery is performed, the dentist should try
with conservative non surgical endodontic therapy.
In case of failure, the change to the surgical treatment
become mandetory and (the contraindication of non
surgical endodontic become indication of surgical
treatment )
False contraindication of endodontic therapy:
- Presence of broken instrument
False contraindication of endodontic therapy:
- presence of calcification
- Anatomical difficulties
- Difficulty of retreatment:
• Presence of silver cone within the canal.
• Presence of ceramic crown covering the crown
(to overcome these problems surgical
intervension is indicated or removal of the old
root canal filling)
- Size of the lesion:
Pulp pathosis→periapical lesion(abcess
→granuloma →cyst)
(The smaller the radiographic emage, the more
likely the diagnosis is granuloma is correct)
According to Lalonde:
0-1cm →70% granuloma-30% cyst.
1-2cm →40% granuloma-60% cyst.
↑2cm →100% cyst.
Tay etal demonstrated that the success of
conservative endodontic therapy deminished with
the increased size of the periapical lesion
Some factors that may affect on indications of
endodontic therapy:
• Age.
• General health status of the patient.
• Prgnency.