Endodontics

Dental Materials I

DH 113

AAE

• One of the nine dental specialties

• Over 6400 members in US, Canada & Internationally

• Certifying Board – American Board of Endodontics (ABE)

What is an Endodontist?

• Dentist who specializes in root canal (endodontic) treatment

• Removes damaged tissue from inside the root canals of a tooth

• Have advanced surgical and nonsurgical skills for complex cases

• 2-3 year post-graduate course work after dental school

Why Endo?

• Prolonged sensitivity to hot and/or cold

• Abcess – look for fistula

• Pain

• Irreversible Pulpitis– Deep Caries– Trauma (external)– From dental work (nerve dies)– Cracked or chipped tooth

http://www.dentalnews.at/en/dental-fistula/

Saving the Tooth

• Infected pulp is removed

• Pulp canals are cleaned and shaped, then filled

• Following RCT, tooth generally requires a crown – endo treated teeth may become brittle and are more prone to fracture

Alternatives

• Most often, extraction of the tooth is the only option

Cracked root

Trauma

Retreat

Endo Instruments

• Reamer, K File, Hedstrom File

Root Canal Anatomy

• Multiple Canals

• Accessory Canals

Accessory Canals

Lateral Canal

• Extrusion of gutta percha into lateral canal

The Root Canal

Step 1: Exam & diagnosis» X-Rays, Pulp testing

Step 2: Patient preparation» Local anesthetic, place rubber dam

Step 3: Open the toothStep 4: Clean & shape the Root Canal

» Endo files, laser, ultrasonic» Additional XR to ensure end of root reached

Step 5: Fill the canal» gutta percha and adhesive » glass ionomer-type cement» Calcium hydroxide» ZOE-type

Step 6: Make post space for restorativeStep 7: Temporary filling

Then: Refer back to dentist for permanent restoration

Re-evaluate in 6-9 months with follow-up XR

Root canal treatment

• Root canal treatment

Finding Correct Length

Upper right lateral Laterally condensed

with diagnostic point gutta percha

through apex

Apex locator

j. morita.com

Lower Molar

• C shaped canal• C shaped canals with diagnostic points• Gutta percha in place

When things go wrong…

Apicoectomy

Retrofill

Endo Lesion Amalgam fills apex

Other types of Endodontic surgeries

1) Curettage (removing inflamed tissue)

2) Root amputation (selected removal of

roots)

3) Hemisection (dividing the tooth in half)

4) Intentional Replantation (removing and

reinserting the tooth).

Autoclavable Kit

Irrigating the Canal

• Syringe

• Narrow tips

Paper Points

• Absorbant

Root Canal Sealer

• Calcium hydroxide/Eugenol sealer with Iodoform

Gutta Percha, Points & Fillers

Gutta Percha

• A rubbery substance derived from the latex of any of several tropical trees of the genera Palaquium and Payena, used as an electrical insulator, as a waterproofing compound, and in golf balls.

• Just a bit of trivia!

Endofil

• Endo filling material based on ZOE

ADA News: FDA clears laser root canal therapy (01/29/02)

• Enamel, dentin and pulp removal as well as shaping the root canal

• provides optical energy to water, and the water particles provide the cutting of dental hard tissue: Waterlase

• Postoperatively, it may reduce pain, discomfort, swelling and the need for antibiotics.• Laser energy kills viruses and bacteria

during debridement phase