Introduction to endodontics2009(new)

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  • Pulp chamber
    Root canals
  • Introduction to endodontics2009(new)

    1. 1. Introduction to Endodontics Dr. Feras Aalam
    2. 2. Outline • What is Endodontics?? • Indications • Contraindications • Steps • Instuments
    3. 3. Endodontic • known as "root canal treatment” • "Endo" is the Greek word ="inside” • "odont" is Greek ="tooth" • Endodontic treatment =treats the inside of the tooth
    4. 4. The pulp • Inside the tooth, under enamel an dentin, is a soft tissue called the pulp • Extends from the crown of the tooth to the tip of the roots where it connects to the tissues surrounding the root • Contains blood vessels, nerves connective tissue
    5. 5. The pulp • Ccreates the surrounding hard tissues of the tooth during development • The pulp is important during a tooth’s growth and development • Once a tooth is fully mature it can survive without the pulp, because the tooth continues to be nourished by the tissues surrounding it
    6. 6. What is endodontics?? Endodontics is that branch of dentistry concerned with the 1.Diagnosis 2.Treatment 3.Prognosis and 4.prevention of diseases and injuries of the pulp and periapical tissues
    7. 7. Objectives of Endodontic Treatment • Relief of pain = symptom free • To render the affected tooth biologically acceptable and functioning without a diagnosable pathosis • Removal of pulp from root(s) of tooth • Disinfections of root and surrounding bone • Root canal treatment is an attempt to retain a tooth which may otherwise require extraction.
    8. 8. Indications for Endodontic Therapy • a-Teeth with pulpal and /or priapical pathosis. • b-Teeth with no pulpal or periapical pathosis may need endodontic treatment due to: 1-The need for post and core construction to rebuild the missing coronal portion of the tooth 2-Traumatic pulp exposure due to dental work or accidental fracture.
    9. 9. Indications • 3-Incomplete calcification of the pulp chamber and root canals • 4-Internal resorption. • 5-Over erupted and mesially drifted teeth when crown reduction may cause pulp exposure. • 6-Teeth retained in the mouth to support overlay denture • 7-Esthetic requirement.
    10. 10. 1-Teeth with insufficient periodontal support. 2-Teeth with vertical root fracture. 3-Teeth with external root resorption. Contraindications for Endodontic Therapy
    11. 11. 4-Non restorable teeth which can not properly function after endodontic treatment. 5-Non strategic teeth which can not serve in occlusion or as abutments after endodontic treatment.
    12. 12. 6-Teeth with root canals not suitable for instrumentation and /or periapical surgery such as calcified or severely curved canals. 7-Patients with systemic conditions contraindicates surgical endodontics.
    13. 13. Phases of Endodontics treatment • Diagnostic phase • Preparatory phase (cleaning & shaping) • Obturation phase
    14. 14. Diagnostic phase During this phase the condition of the tooth is determined and the plan of treatment is developed.
    15. 15. Diagnostic phase • Determine the condition of the tooth and the plan of treatment • Clinical examinations – Percussion, pain – Deep caries • Radiographic examinations - Periapical radiographs • Vitality test
    16. 16. Clinical examinations
    17. 17. Radiographic examinations Periapical radiographs
    18. 18. Vitality test • Pulp test • Vitality pulp tests: – Electric Pulp tester (EPT) – Thermal Tests: • CO2 Ice • Cold water/Ice • Hot water • Cavity Test • Compare the reading with the opposing or adjacent tooth
    19. 19. Preparatory phase (Cleaning & Shaping) • During this phase the condition of the tooth is determined and the plan of treatment is developed. • Instuments needed: – Handpeice low, high speed – Endo-files – Saline – Irrigation syringe – Paper points – Calcium hydroxide – Cotton pellets – Temporaty filling – Rubber dam
    20. 20. Rubber dam
    21. 21. Rubber dam Rubbere dam over the area to isolate the tooth, keep it clean and free of saliva during the dental procedure
    22. 22. HAND PEICE LOW SPEED HAND PEICE HIGH SPEED HAND PEICE
    23. 23. Burs
    24. 24. Endo-files
    25. 25. Preparatory phase Pulp chamber Root canal
    26. 26. Preparatory phase • Determine the working length • Radiographs • Add radiograph with the working lenght
    27. 27. RCT of tooth #44
    28. 28. RCT of tooth #35
    29. 29. Irrigation
    30. 30. Paper points Dry the canals
    31. 31. Temporary filling
    32. 32. Obturation phase During this phase the root canals are filled with an inert material to achieve a hermetic seal as close as possible to the anatomic apex. Instuments needed 1.Gutta percha 2.Paper points 3.Spreader 4.Root canal sealer
    33. 33. Gutta percha
    34. 34. Spreader
    35. 35. Root canal sealer
    36. 36. Gutta perchaPaper points
    37. 37. Obturation phase
    38. 38. RCT of tooth #44
    39. 39. RCT of tooth #35
    40. 40. Gutta percha
    41. 41. Summary
    42. 42. Post and core
    43. 43. Cats post & core for tooth #35

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