O.C.P.Introduction to Endodontics

Alan H. Gluskin DDSAlan H. Gluskin DDS

Professor and Chair Professor and Chair

Department of EndodonticsDepartment of Endodontics

Treating Dental Problems

When Tooth Decay Attacks...

Endodontics is the branch of dentistry which is concerned with the morphology, physiology, and pathology of the human pulp and periadicular tissues.

What is Endodontic Therapy?

What Are The Benefits of Endodontic Therapy ?

Endodontic therapy saves teeth that would otherwise be extracted. Although the pulp is removed, the treated tooth remains alive, nourished by the surrounding gums and jaw. There is no real substitute for your own tooth which is more efficient in chewing and biting than an artificial one.

What Steps Are Involved in Endodontic Treatment?

The Endodontic Triad

Seal

Clean & Shape

Access Opening

Endodontic therapy removes infected or damaged tissue from inside a tooth. This tissue, called the pulp, contains nerves and blood vessels that help nourish the tooth. After the pulp is removed, the pulp chamber and root canals are cleaned, sterilized, filled and sealed.

What Caused the Problem With My Tooth?

The most common cause of pulp damage is severe decay or a fracture that exposes the pulp to bacteria that may cause infection. Other causes of pulp damage include traumatic injury, such as a blow to a tooth, a cracked or loose filling or repeated fillings in a tooth and occasionally periodontal or gum disease.

Who Performs Endodontic Therapy?

All dentists receive some training in endodontic therapy in dental school. Endodontists are specialists who limit their practices to root canal procedures. They have two years postgraduate training in addition to dental school, and/or have been certified by the American Board of Endodontics after passing a series of examinations.

Its study and practice encompasses the basic clinical sciences including biology of the normal pulp: the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp; and associated periradicular conditions.

What Does An Endodontist Do?

Diagnoses and Treats Pain. Oral pain often is difficult to pinpoint. Because of the vast network of nerves in the mouth, the pain of a damaged or diseased tooth often is felt in another tooth or in the head, neck or ear. An endodontist is a specialist in diagnosing and treating this type of pain.

Treats Traumatic Injuries. Pulp damage is sometimes caused by a blow to the mouth, and the endodontist treats these traumatic injuries. A blow to a child’s permanent tooth that is not fully formed can cause injury to the pulp and, ultimately the root may cease development.

Dental and Facial Trauma

ApexificationApexification

Performs Orthodontic Extrusion:

the lifting of a submerged root above the gum level for restoring, thus avoiding surgical crown lengthening.

Salvages Avulsed Tooth: the complete separation of a tooth from its alveolus by traumatic injury. Replantation and splinting of the tooth must precede any type of treatment.

Performs Intentional Replantation: the insertion of a tooth into its alveolus after the tooth has been extracted for the purpose of accomplishing root-end filling.

Bleaches Discolored Teeth: Discolored teeth can sometimes be restored to near-natural color with either vital or pulpless bleaching procedures.

Performs Surgery. Sometimes standard endodontic therapy is ineffective. The endodontist may then us an in-office surgical procedure to remove the damaged pulp and seal the root canals.

Performs Apicoectomy: a.k.a. root-end resection; the excision of the apex of the root and attached soft tissues.

Can All Teeth Be Treated Endodontically?

Occasionally a tooth can’t be saved. Endodontic therapy can be performed only if the root canals are accessible and can be adequately sterilized and sealed. The tooth also must have sufficient bone support.

Performs Hemisection: the surgical separation of a mandibular molar tooth, through the furcation in such a way that a root and / or the crown portion may be removed.

Places Post and/or Core Buildups:

The restoration of the coronal structures utilizing the root canal system for retention and support.

Places Endodontic Implants:

The cementation of a metallic post through the root canal into periapical tissue spaces to improve root length.

Treatment of Horizontal Fractures

Middle Third Fracture

Intraradicular Implant

Post-Op Radiograph

7 Year Post-Op Radiograph

Performs Endodontic Retreatment:The redoing of previous treatment that is unsuccessful; retrieval of canal obstructions and complete or partial disassembly of restorative materials are frequently required.

Performs Guided Tissue Regeneration:

GTR attempts to regenerate lost periodontal structures using barrier membrane techniques.

What Are The Alternatives To Endodontic Therapy?

Extraction is the only alternative.

And unless the tooth is replaced, adjoining teeth will shift, interfering with biting and chewing. Loss of a tooth can lead to periodontal disease and loss of additional teeth. Replacing a tooth with an artificial one often requires dental procedures on adjacent healthy teeth.

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Differential Diagnosis of Toothache