Definition : Endodontics is the branch of
dentistry dealing with diseases of the
The number of canals in a tooth
correlates to the number of roots in a
The space inside the root canals is filled
with a highly vascularized and highly
innervated loose connective tissue,
called the dental pulp.
The pulp tissue is in communication
with the periodontium and the rest of
the body through the apical foramen.
Central region contains nerves and
Innermost layer, - contains fibroblasts
and undifferentiated mesenchymal cells.
Zone of Weil – This is a cell free zone,
rich in capillaries and nerve fibres.
Odontoblastic layer – outermost layer,
contains odontoblasts and is next to the
predetin and mature dentin.
Primary Function is to form Dentin
Nutritive – provides nutrients to the
Sensory – sensitive to temperature,
pressure or trauma
Protective – forms secondary dentin,
when under attack from bacteria.
Accessory canals are branches of the main
canal that form a communication between the
pulp and periodontum.
They also contain vessels and nerves, and can
be located anywhere between the level of
furcation to the apex.
30% of lower incisors have lingual and labial
85% of mesiobuccal roots contain two canals
(MB1 and MB2), in upper molar teeth.
The shape of the preparation is dictated
The shape of the pulp chamber
The morphology of the canals.
It is important that straight line access to
the apical foramen is created.
The access cavity is initiated in the
middle of the palatal side of the tooth.
Initial preparation should be at 90° to
the palatal aspect of the tooth.
Once dentine has been reached the
angulation of the bur is changed to
follow a long axis of the tooth using a
Initial preparation is made in the
middle of the fissure. The cavity is then
extended buccally and palatally.
NB : Marginal ridges must not be
involved in this presentation, as this
would compromise the integrity of the
Initial Preparation is done in the mesial
The cavity is then extended in the mesial
half of the tooth to include all canals.
The mesial marginal ridge must not be
damaged in upper molars as the cavity
should lay mesially to it.
However lower molar teeth, have a distal
canal, which is located just past the middle
of the tooth.
Irrigation in Endodontic treatment
serves the following purposes:
Dissolve the pulp remnants
Washing out debris created by canal
Kill/remove the bacteria/micro-
organisms in root canal
Clean the smear layer
Sodium Hypochlorite :Dissolves necrotic
tissue and kills bacteria quite effectively.
Kills bacteria quite effectively.
Chelators: Such as EDTA, remove the
Hydrogen Peroxide: Used to be used a lot,
however studies have shown it to be
Chlorhexidine: Has been shown to remove
significant number of bacteria.
ENDOVAC TECHNOLOGY – the use of
apical negative pressure irrigation,
significantly improves cleaning and
disinfection more closely to the apex.
ENDOACTIVATOR – Sonically driven
system, enables the irrigant to travel
deep into the pulpal system, enabling