The document discusses various clinical factors that can affect the outcome of endodontic treatment. It covers historical concepts of endodontic success and failure. Key factors that influence treatment outcomes include thorough debridement and disinfection of the root canal, obtaining an adequate apical seal, clinical signs and symptoms, radiographic findings, root canal anatomy, systemic health status, and the clinician's skill level. The document also provides guidance on assessing case difficulty and determining whether a case should be treated or referred.
This document discusses factors to consider for case selection in endodontic treatment. Proper case selection is important to ensure successful treatment outcomes and avoid pitfalls. Key factors include those related to the tooth itself like root canal anatomy, restorability, and periodontal support. Patient health factors like medical history and physical status must also be evaluated. The clinician's skill and ability to handle different cases is another important consideration. Careful evaluation of all relevant factors helps determine if endodontic therapy is appropriate and predicts the difficulty level of the case.
This document discusses endodontic retreatment. It defines retreatment as removing root canal filling materials from a tooth to clean, shape, and re-obturate the canals. Reasons for retreatment include persistent or reinroduced intraradicular microorganisms, extraradicular infection, foreign body reaction, or true cysts. Evaluation involves clinical examination, radiographs, and assessing for symptoms like pain, swelling or sinus tracts. Success is defined as resolution of symptoms and periapical radiolucency, while failure is persistence or worsening of these signs.
This document discusses the process and effects of intracoronal bleaching. It involves placing bleaching agents such as superoxol and sodium perborate into the tooth chamber. The bleaching solution is then heated using a bleaching stick or light curing unit and repeated until the desired color is achieved. Some potential side effects include tooth sensitivity, effects on enamel and the pulp, decreased bond strength of composites, and toxicity from ingesting high concentrations of hydrogen peroxide.
Veneers are a conservative treatment to improve the appearance of teeth. They involve bonding thin facings of tooth-colored material to the front of teeth. Veneers can be made of composite resin, porcelain, or other ceramic materials. They are either bonded directly during a single appointment or indirectly with impressions taken and veneers fabricated by a dental laboratory over two appointments. Veneers can repair damage, close gaps, change the shape or length of teeth, or improve discoloration while minimizing the removal of tooth structure. The choice of material and technique depends on the specific needs and preferences of the patient.
This document provides an overview of endodontic surgery. It begins with a brief history of endodontic surgery dating back over 1500 years. It then discusses the definition, rationale, objectives, and indications for endodontic surgery. The document outlines the classification of endodontic surgery and describes various surgical procedures like periradicular surgery, root-end resection, and root-end filling. It provides details on surgical instruments, treatment planning considerations, and techniques for achieving profound local anesthesia. In summary, the document provides a comprehensive review of the principles and procedures involved in endodontic surgery.
This document discusses root resorption, including its history, types, causes, pathogenesis, classification, and treatment. It describes internal resorption in detail, noting that it begins with a breach in the dentin layer that allows resorption to spread towards the cementum. Internal resorption can be inflammatory or replacement, and treatment involves root canal therapy to remove pulpal tissue and arrest resorption, as well as disinfecting and sealing the root canal system. For large defects, biocompatible materials like MTA or Biodentine may be used to fill the area.
Recent concepts in post endodontic restorationshemam22
This document discusses recent concepts in post endodontic restorations. It notes that with advances in adhesive dentistry, there are now multiple treatment options for restoring endodontically treated teeth. However, determining whether cuspal coverage is needed and selecting the appropriate treatment can be challenging. There has been a paradigm shift from relying on mechanical retention to using adhesion. The document discusses several key concepts including the importance of preserving remaining tooth structure and establishing a ferrule effect to strengthen the restoration and resist forces.
This document discusses factors to consider for case selection in endodontic treatment. Proper case selection is important to ensure successful treatment outcomes and avoid pitfalls. Key factors include those related to the tooth itself like root canal anatomy, restorability, and periodontal support. Patient health factors like medical history and physical status must also be evaluated. The clinician's skill and ability to handle different cases is another important consideration. Careful evaluation of all relevant factors helps determine if endodontic therapy is appropriate and predicts the difficulty level of the case.
This document discusses endodontic retreatment. It defines retreatment as removing root canal filling materials from a tooth to clean, shape, and re-obturate the canals. Reasons for retreatment include persistent or reinroduced intraradicular microorganisms, extraradicular infection, foreign body reaction, or true cysts. Evaluation involves clinical examination, radiographs, and assessing for symptoms like pain, swelling or sinus tracts. Success is defined as resolution of symptoms and periapical radiolucency, while failure is persistence or worsening of these signs.
This document discusses the process and effects of intracoronal bleaching. It involves placing bleaching agents such as superoxol and sodium perborate into the tooth chamber. The bleaching solution is then heated using a bleaching stick or light curing unit and repeated until the desired color is achieved. Some potential side effects include tooth sensitivity, effects on enamel and the pulp, decreased bond strength of composites, and toxicity from ingesting high concentrations of hydrogen peroxide.
Veneers are a conservative treatment to improve the appearance of teeth. They involve bonding thin facings of tooth-colored material to the front of teeth. Veneers can be made of composite resin, porcelain, or other ceramic materials. They are either bonded directly during a single appointment or indirectly with impressions taken and veneers fabricated by a dental laboratory over two appointments. Veneers can repair damage, close gaps, change the shape or length of teeth, or improve discoloration while minimizing the removal of tooth structure. The choice of material and technique depends on the specific needs and preferences of the patient.
This document provides an overview of endodontic surgery. It begins with a brief history of endodontic surgery dating back over 1500 years. It then discusses the definition, rationale, objectives, and indications for endodontic surgery. The document outlines the classification of endodontic surgery and describes various surgical procedures like periradicular surgery, root-end resection, and root-end filling. It provides details on surgical instruments, treatment planning considerations, and techniques for achieving profound local anesthesia. In summary, the document provides a comprehensive review of the principles and procedures involved in endodontic surgery.
This document discusses root resorption, including its history, types, causes, pathogenesis, classification, and treatment. It describes internal resorption in detail, noting that it begins with a breach in the dentin layer that allows resorption to spread towards the cementum. Internal resorption can be inflammatory or replacement, and treatment involves root canal therapy to remove pulpal tissue and arrest resorption, as well as disinfecting and sealing the root canal system. For large defects, biocompatible materials like MTA or Biodentine may be used to fill the area.
Recent concepts in post endodontic restorationshemam22
This document discusses recent concepts in post endodontic restorations. It notes that with advances in adhesive dentistry, there are now multiple treatment options for restoring endodontically treated teeth. However, determining whether cuspal coverage is needed and selecting the appropriate treatment can be challenging. There has been a paradigm shift from relying on mechanical retention to using adhesion. The document discusses several key concepts including the importance of preserving remaining tooth structure and establishing a ferrule effect to strengthen the restoration and resist forces.
An altered cast procedure to improve tissue supportCPGIDSH
The document discusses an altered cast technique for removable partial dentures. The technique involves making an impression of the edentulous ridge after the metal framework is cast. This refined impression is used to alter the edentulous areas of the master cast, accurately reproducing the supporting tissues. This provides correct denture base extension and favorable physiologic support when seated. The technique offers benefits like reducing adjustments and preserving residual ridges by improving stress distribution. Two case examples demonstrate using the altered cast technique for mandibular and maxillary removable partial dentures.
Minimally invasive dentistry aims to control dental disease through early detection and least invasive treatment methods. It focuses on remineralizing early lesions and performing minimal surgical procedures. Recent advances include new cavity classification systems, preparation techniques like tunnels and slots, and caries removal methods like air abrasion, sonoabrasion, and chemomechanical removal. The Atraumatic Restorative Technique and Interim Therapeutic Restoration were developed to provide basic dental care using only hand instruments and restorative materials like glass ionomer cement. Lasers can also be used for caries prevention, removal and cavity preparation with minimal thermal damage to surrounding tooth structure.
Restoration of endodontically treated teethNivedha Tina
This document discusses various methods for restoring endodontically treated teeth. It covers the history of restoring pulpless teeth dating back to 1747. Key factors in selecting a restorative approach include the amount of residual root and crown structure remaining as well as the tooth's function and position. Methods discussed include direct composite restorations, indirect restorations, fiber posts, cast posts, and full crowns. The document also addresses the vulnerability of root filled teeth to fracture and emphasizes the importance of preserving tooth structure.
Working length is the distance from a coronal reference point to the point where canal preparation and obturation should terminate. It is important to determine working length precisely using radiographs or electronic apex locators. The radiographic method involves measuring the total length of the tooth on preoperative radiographs, subtracting 1mm as a safety factor, and confirming length under radiograph after instrumentation. Electronic apex locators use electric current to detect the apical foramen. Tactile methods are unreliable due to risk of over-instrumentation or under-instrumentation.
This document compares and contrasts microabrasion and macroabrasion techniques for treating tooth discoloration. Microabrasion involves using a paste of hydrochloric acid and pumice or silicon carbide to dissolve and abrade the enamel surface. It is a conservative treatment that removes only superficial stains. Macroabrasion uses diamond or carbide burs to remove defects at a faster rate but with less control than microabrasion. Both techniques can improve the appearance of teeth affected by conditions like fluorosis but microabrasion allows for better control and more conservative removal of tooth structure.
Ultrasonics have various applications in endodontics. They can be used to refine root canal access and remove calcified deposits, detached pulp stones, and intracanal obstructions like broken instruments. Ultrasonics increase the flushing action of irrigants by generating acoustic streaming that more effectively cleans root canal walls and difficult anatomical features. They also aid in removing posts and silver points with minimal damage to tooth structure. Overall, ultrasonics provide a safe and effective method for various challenges in endodontic treatment.
1. Success rates for initial endodontic treatment range from 54-95% depending on studies and definitions of success.
2. Factors affecting success or failure include diagnosis, root canal anatomy, debridement, quality of filling, and systemic health.
3. Causes of endodontic failure include residual bacteria, incomplete debridement, hemorrhage, iatrogenic errors, and systemic factors.
4. Retreatment involves removing previous fillings and obstructions, regaining patency, and thoroughly cleaning and refilling canals. Outcomes depend on regaining patency and quality of
This document discusses irrigation techniques and solutions used in endodontics. It states that irrigation is necessary to clean areas that instruments cannot reach, like fins and anastomoses. The ideal irrigant has antimicrobial properties, tissues dissolving ability, lubrication, and can remove the smear layer while being non-toxic. Commonly used irrigants include sodium hypochlorite, chlorhexidine, hydrogen peroxide, EDTA, and MTAD. Proper irrigation requires needles inserted to the full working length and solutions delivered slowly and passively.
Smear layer is a controversial topic in the field of operative dentistry and endodontics. This presentation includes composition, concepts, structure, advantages, disadvantages, and removal methods of smear layer.
This document discusses the cleaning and shaping of root canals. It defines cleaning as the removal of pathogenic contents from the root canal and shaping as creating a 3D tapered shape that is widest coronally and narrowest apically. The objectives of shaping are outlined as both mechanical and biological to remove debris without forcing it periapically and create sufficient space for obturation. Various techniques are described such as step-back, crown-down, and hybrid techniques. Considerations like instrument movements, irrigation methods, and the goals of apical enlargement are also covered.
This document discusses early diagnosis of dental caries. It defines dental caries and outlines various diagnostic methods including visual and tactile inspection, caries detection dyes, radiography, fiber optic transillumination, and digital methods. Radiography provides additional information compared to visual examination alone but has limitations in detecting enamel lesions. Digital radiography and subtraction techniques allow comparisons over time. Overall, early and accurate diagnosis is important for determining treatment and prognosis.
This document provides information on root canal obturation including the purpose, materials, techniques, and potential causes of failure. It discusses criteria for obturation such as absence of symptoms. Common obturation materials include gutta-percha, resins, and silver points used with sealers like zinc oxide-eugenol, calcium hydroxide, and epoxy resin. Techniques covered are cold lateral condensation, warm lateral/vertical condensation, thermocompaction, and others. Potential causes of failure include inadequate apical, coronal, or lateral seals and over/under filling.
This document discusses various aspects of vital pulp therapy (VPT), including indirect pulp capping (IPC), direct pulp capping (DPC), and pulpotomy procedures. It provides the history and objectives of these procedures, as well as guidelines for when each is appropriate based on factors like the size of a pulp exposure and presence of symptoms. Materials commonly used for VPT are also reviewed, including calcium hydroxide, MTA, and others. Success rates from studies on IPC and factors influencing the outcome of VPT are presented.
This document discusses vertical root fractures, including their definition, classification, etiology, clinical presentation, diagnosis, and prevalence. A vertical root fracture is a longitudinally oriented complete or incomplete fracture that originates in the root. Premolars are the most susceptible teeth. Risk factors include endodontic treatment, posts, and excessive forces from trauma or heavy chewing. Clinically, a vertical root fracture may cause vague pain, a sinus tract, or a narrow isolated periodontal pocket. Radiographs may reveal a J-shaped radiolucency or separated root segments. Diagnosis is based on clinical history and examination, as well as radiographic findings. Vertical root fractures account for 3-20% of extracted teeth.
Temporization refers to provisional restorations used to establish esthetics, function, and occlusion prior to definitive treatment. Provisional restorations protect the pulp and support periodontal health during treatment. They also allow evaluation of esthetics, occlusion, and patient acceptance of the planned treatment outcome. Common materials for provisional restorations include polymethyl methacrylate resin and various composite resins. Provisionals must meet biological, mechanical, and esthetic requirements and be cemented securely yet removable when treatment is complete.
Pulpotomy is the removal of the coronal portion of the pulp while preserving the radicular pulp. It is indicated for cariously exposed primary teeth when extraction is less advantageous than retention. There are various techniques for pulpotomy including devitalization with formocresol or other chemicals to fix the pulp, preservation techniques using less harmful chemicals to maintain pulp vitality, and regeneration techniques aiming to stimulate reparative dentin formation. The goal of pulpotomy is to disinfect the exposed pulp, maintain pulp vitality, and avoid periapical issues.
This document discusses newer methods for removing dental caries. It begins by classifying techniques as mechanical, chemomechanical, or thermal. Mechanical techniques include non-rotary methods like air abrasion and air polishing, as well as sonic and ultrasonic instrumentation. Chemomechanical caries removal uses chemical agents like carisolv or enzymes to dissolve carious dentin which is then removed. Thermal techniques include lasers. The document then discusses several methods in more detail, including controlled rotary excavation techniques like the endostepper and smart prep burs, as well as air abrasion, air polishing, sonoabrasion, and chemomechanical caries removal.
Dr. Rahul VC Tiwari - Fellowship In Orthognathic Surgery - Jubilee Mission Medical College Hospital and Research Center, Thrissur, Kerala - 31st publication IJAR 1st name
This document provides information on diagnosis and treatment planning for complete dentures. It discusses examining the patient's medical history, dental history, psychological evaluation, and conducting an extraoral and intraoral clinical examination. The extraoral exam evaluates features like facial form, symmetry, and muscle tone. The intraoral exam assesses the arch size and form, ridge anatomy, interarch space, and other anatomical landmarks. Taking a thorough patient history and clinical exam is important for diagnosis and developing a proper treatment plan for complete dentures.
An altered cast procedure to improve tissue supportCPGIDSH
The document discusses an altered cast technique for removable partial dentures. The technique involves making an impression of the edentulous ridge after the metal framework is cast. This refined impression is used to alter the edentulous areas of the master cast, accurately reproducing the supporting tissues. This provides correct denture base extension and favorable physiologic support when seated. The technique offers benefits like reducing adjustments and preserving residual ridges by improving stress distribution. Two case examples demonstrate using the altered cast technique for mandibular and maxillary removable partial dentures.
Minimally invasive dentistry aims to control dental disease through early detection and least invasive treatment methods. It focuses on remineralizing early lesions and performing minimal surgical procedures. Recent advances include new cavity classification systems, preparation techniques like tunnels and slots, and caries removal methods like air abrasion, sonoabrasion, and chemomechanical removal. The Atraumatic Restorative Technique and Interim Therapeutic Restoration were developed to provide basic dental care using only hand instruments and restorative materials like glass ionomer cement. Lasers can also be used for caries prevention, removal and cavity preparation with minimal thermal damage to surrounding tooth structure.
Restoration of endodontically treated teethNivedha Tina
This document discusses various methods for restoring endodontically treated teeth. It covers the history of restoring pulpless teeth dating back to 1747. Key factors in selecting a restorative approach include the amount of residual root and crown structure remaining as well as the tooth's function and position. Methods discussed include direct composite restorations, indirect restorations, fiber posts, cast posts, and full crowns. The document also addresses the vulnerability of root filled teeth to fracture and emphasizes the importance of preserving tooth structure.
Working length is the distance from a coronal reference point to the point where canal preparation and obturation should terminate. It is important to determine working length precisely using radiographs or electronic apex locators. The radiographic method involves measuring the total length of the tooth on preoperative radiographs, subtracting 1mm as a safety factor, and confirming length under radiograph after instrumentation. Electronic apex locators use electric current to detect the apical foramen. Tactile methods are unreliable due to risk of over-instrumentation or under-instrumentation.
This document compares and contrasts microabrasion and macroabrasion techniques for treating tooth discoloration. Microabrasion involves using a paste of hydrochloric acid and pumice or silicon carbide to dissolve and abrade the enamel surface. It is a conservative treatment that removes only superficial stains. Macroabrasion uses diamond or carbide burs to remove defects at a faster rate but with less control than microabrasion. Both techniques can improve the appearance of teeth affected by conditions like fluorosis but microabrasion allows for better control and more conservative removal of tooth structure.
Ultrasonics have various applications in endodontics. They can be used to refine root canal access and remove calcified deposits, detached pulp stones, and intracanal obstructions like broken instruments. Ultrasonics increase the flushing action of irrigants by generating acoustic streaming that more effectively cleans root canal walls and difficult anatomical features. They also aid in removing posts and silver points with minimal damage to tooth structure. Overall, ultrasonics provide a safe and effective method for various challenges in endodontic treatment.
1. Success rates for initial endodontic treatment range from 54-95% depending on studies and definitions of success.
2. Factors affecting success or failure include diagnosis, root canal anatomy, debridement, quality of filling, and systemic health.
3. Causes of endodontic failure include residual bacteria, incomplete debridement, hemorrhage, iatrogenic errors, and systemic factors.
4. Retreatment involves removing previous fillings and obstructions, regaining patency, and thoroughly cleaning and refilling canals. Outcomes depend on regaining patency and quality of
This document discusses irrigation techniques and solutions used in endodontics. It states that irrigation is necessary to clean areas that instruments cannot reach, like fins and anastomoses. The ideal irrigant has antimicrobial properties, tissues dissolving ability, lubrication, and can remove the smear layer while being non-toxic. Commonly used irrigants include sodium hypochlorite, chlorhexidine, hydrogen peroxide, EDTA, and MTAD. Proper irrigation requires needles inserted to the full working length and solutions delivered slowly and passively.
Smear layer is a controversial topic in the field of operative dentistry and endodontics. This presentation includes composition, concepts, structure, advantages, disadvantages, and removal methods of smear layer.
This document discusses the cleaning and shaping of root canals. It defines cleaning as the removal of pathogenic contents from the root canal and shaping as creating a 3D tapered shape that is widest coronally and narrowest apically. The objectives of shaping are outlined as both mechanical and biological to remove debris without forcing it periapically and create sufficient space for obturation. Various techniques are described such as step-back, crown-down, and hybrid techniques. Considerations like instrument movements, irrigation methods, and the goals of apical enlargement are also covered.
This document discusses early diagnosis of dental caries. It defines dental caries and outlines various diagnostic methods including visual and tactile inspection, caries detection dyes, radiography, fiber optic transillumination, and digital methods. Radiography provides additional information compared to visual examination alone but has limitations in detecting enamel lesions. Digital radiography and subtraction techniques allow comparisons over time. Overall, early and accurate diagnosis is important for determining treatment and prognosis.
This document provides information on root canal obturation including the purpose, materials, techniques, and potential causes of failure. It discusses criteria for obturation such as absence of symptoms. Common obturation materials include gutta-percha, resins, and silver points used with sealers like zinc oxide-eugenol, calcium hydroxide, and epoxy resin. Techniques covered are cold lateral condensation, warm lateral/vertical condensation, thermocompaction, and others. Potential causes of failure include inadequate apical, coronal, or lateral seals and over/under filling.
This document discusses various aspects of vital pulp therapy (VPT), including indirect pulp capping (IPC), direct pulp capping (DPC), and pulpotomy procedures. It provides the history and objectives of these procedures, as well as guidelines for when each is appropriate based on factors like the size of a pulp exposure and presence of symptoms. Materials commonly used for VPT are also reviewed, including calcium hydroxide, MTA, and others. Success rates from studies on IPC and factors influencing the outcome of VPT are presented.
This document discusses vertical root fractures, including their definition, classification, etiology, clinical presentation, diagnosis, and prevalence. A vertical root fracture is a longitudinally oriented complete or incomplete fracture that originates in the root. Premolars are the most susceptible teeth. Risk factors include endodontic treatment, posts, and excessive forces from trauma or heavy chewing. Clinically, a vertical root fracture may cause vague pain, a sinus tract, or a narrow isolated periodontal pocket. Radiographs may reveal a J-shaped radiolucency or separated root segments. Diagnosis is based on clinical history and examination, as well as radiographic findings. Vertical root fractures account for 3-20% of extracted teeth.
Temporization refers to provisional restorations used to establish esthetics, function, and occlusion prior to definitive treatment. Provisional restorations protect the pulp and support periodontal health during treatment. They also allow evaluation of esthetics, occlusion, and patient acceptance of the planned treatment outcome. Common materials for provisional restorations include polymethyl methacrylate resin and various composite resins. Provisionals must meet biological, mechanical, and esthetic requirements and be cemented securely yet removable when treatment is complete.
Pulpotomy is the removal of the coronal portion of the pulp while preserving the radicular pulp. It is indicated for cariously exposed primary teeth when extraction is less advantageous than retention. There are various techniques for pulpotomy including devitalization with formocresol or other chemicals to fix the pulp, preservation techniques using less harmful chemicals to maintain pulp vitality, and regeneration techniques aiming to stimulate reparative dentin formation. The goal of pulpotomy is to disinfect the exposed pulp, maintain pulp vitality, and avoid periapical issues.
This document discusses newer methods for removing dental caries. It begins by classifying techniques as mechanical, chemomechanical, or thermal. Mechanical techniques include non-rotary methods like air abrasion and air polishing, as well as sonic and ultrasonic instrumentation. Chemomechanical caries removal uses chemical agents like carisolv or enzymes to dissolve carious dentin which is then removed. Thermal techniques include lasers. The document then discusses several methods in more detail, including controlled rotary excavation techniques like the endostepper and smart prep burs, as well as air abrasion, air polishing, sonoabrasion, and chemomechanical caries removal.
Dr. Rahul VC Tiwari - Fellowship In Orthognathic Surgery - Jubilee Mission Medical College Hospital and Research Center, Thrissur, Kerala - 31st publication IJAR 1st name
This document provides information on diagnosis and treatment planning for complete dentures. It discusses examining the patient's medical history, dental history, psychological evaluation, and conducting an extraoral and intraoral clinical examination. The extraoral exam evaluates features like facial form, symmetry, and muscle tone. The intraoral exam assesses the arch size and form, ridge anatomy, interarch space, and other anatomical landmarks. Taking a thorough patient history and clinical exam is important for diagnosis and developing a proper treatment plan for complete dentures.
Diagnosis and treament planning in fixed partial denturesSoumyadev Satpathy
The document provides guidance on diagnosis and treatment planning for prosthodontic cases. It discusses collecting a thorough patient history, performing extraoral and intraoral examinations, taking diagnostic casts and radiographs, and developing a treatment plan. The diagnostic process aims to determine the nature of the patient's dental needs and establish a logical sequence of procedures to address identified issues before undertaking fixed prosthodontic treatment. Developing an accurate diagnosis and treatment plan requires a systematic, multidisciplinary approach.
Correlation of the interdental and the interradicular bone lossDr Gauri Kapila
This document discusses a study that aimed to correlate interdental and interradicular bone loss in patients with chronic periodontitis. The study used digital radiography to measure bone loss levels between teeth and between roots in 50 patients. It found a significant correlation between higher levels of interdental bone loss and interradicular bone loss. Specifically, interradicular bone loss of 0.8mm or more was only seen when interdental bone loss was 3.7mm or greater. The study concludes that assessing interdental bone loss could serve as a screening tool to detect early furcation involvement and guide more in-depth examination.
Diagnosis and treatment planning of Removable Partial Denture dwijk
This document discusses the process of examining a patient and developing a treatment plan for a removable partial denture. It covers organizing the initial examination, evaluating medical and dental history, performing diagnostic tests and impressions, and analyzing the data to formulate a treatment plan. The goal is to thoroughly understand the patient's condition and needs to develop a successful treatment.
This document outlines the process and factors involved in diagnosing and determining the prognosis of periodontal diseases. Diagnosis involves a thorough medical and dental history, clinical examination including probing, radiographs, and other tests to determine the type, extent, severity and cause of periodontal disease present. The prognosis takes into account disease severity and extent, oral hygiene ability, systemic factors like smoking, genetic risks, and anatomic and restorative challenges that could impact treatment outcomes. Prognosis can range from excellent to hopeless depending on these various clinical factors.
A 70-year-old retired teacher is referred for comprehensive dental treatment after losing his front bridge due to decay. His dental history includes missing and extracted teeth as well as root canals and ill-fitting bridges. A dental exam finds gingivitis, possible pulpal problems, attrition, and improper bridges. The treatment plan includes cleaning, evaluating abutment teeth, possible root canals or extractions, and temporization followed by replacing the missing teeth and ill-fitting bridges to restore function and aesthetics.
This document discusses radiographic aids in diagnosing periodontal disease. It describes the normal appearance of interdental septa on radiographs and how periodontal disease appears radiographically. Periodontal disease is seen as fuzziness or breaks in the lamina dura, wedge-shaped radiolucencies across the crest, and progressively reduced height of the interdental septum. The document also discusses how different radiographic techniques can distort images and the limitations of radiography for assessing internal morphology, depth of bone destruction, or abscesses in soft tissue.
Diagnosis and treatment planning in removable partial dentureVinay Kadavakolanu
The document discusses the process of treatment planning for removable partial dentures (RPDs). It begins by outlining the steps of patient interview, clinical examination, and treatment planning. Key aspects of the clinical examination are described, including medical history, oral examination, and diagnostic models and radiographs. Factors considered in treatment planning include classification of the edentulism, abutment conditions, occlusion, and residual ridge. Treatment options and their indications are also summarized. The treatment planning process aims to address the patient's unique dental needs and desires through shared decision making.
The document discusses risk assessment for dental implant treatment. It finds that poor oral hygiene, a history of periodontitis, and cigarette smoking are strong risk indicators for peri-implant disease based on evidence from experimental and clinical studies. Future prospective studies are still needed to confirm these factors as true risk factors. The review also identifies that probing depth, bleeding on probing, and suppuration should be regularly assessed to diagnose peri-implant diseases, and radiographs are required to evaluate bone levels around implants.
This document discusses the importance of developing a thorough treatment plan for patients. It outlines the key steps in treatment planning which include taking a dental and medical history, performing a clinical examination, taking radiographs and diagnostic impressions, creating diagnostic casts and wax-ups. The treatment plan should be developed in phases to address disease control, restorative work, and long-term maintenance. Factors like the patient's needs, expectations, and medical conditions must be considered when formulating the optimal treatment.
1. The document discusses the process of diagnosis and treatment planning for complete dentures, including patient evaluation, history taking, examination, and developing a treatment plan.
2. It emphasizes the importance of a thorough patient assessment, including medical history, chief complaints, and lifestyle factors, to understand the patient's physical and psychological condition and ensure functional complete dentures.
3. Key parts of the examination are assessing factors like nutrition, habits, systemic diseases, jaw range of motion, and mental attitude to determine their implications for denture design and prognosis.
NON SURGICAL MANAGEMENT OF RADICULAR CYST.pptxAshokKp4
This document describes the non-surgical management of a radicular cyst in a 15-year-old male patient. Clinical examination and investigations including an OPG revealed a radicular cyst associated with teeth 31, 32, 33, 41, 42, 43. The treatment plan involved root canal treatment of these teeth with calcium hydroxide dressing and triple antibiotic paste. After 1 month of treatment, the canals were obturated. Follow-up OPG showed reduction in size of the cyst. Non-surgical management of radicular cysts is an efficient alternative to surgery and can help recover esthetics and function in growing patients.
This study examines complications arising from squamosal chronic suppurative otitis media (CSOM) at a tertiary hospital in India. 22 CSOM patients with complications were reviewed. Complications were classified as extracranial (e.g. subperiosteal abscess) or intracranial (e.g. pyogenic meningitis, temporal lobe abscess). Common pathogens included Staph aureus and Pseudomonas. Treatment involved antibiotics and surgery such as mastoidectomy. While complications have declined with new drugs and techniques, life-threatening issues persist, emphasizing the need for standardized management protocols.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
The document provides an introduction to the department of oral and maxillofacial surgery at Um Al Qura University. It discusses the aims of the course, which covers medical and surgical management of diseases affecting the oro-facial region. It then outlines some key topics that will be covered, including basic oral surgery, pain management techniques, dental implants, maxillofacial trauma management, tumors of the head and neck, and teaching/assessment strategies.
This document discusses diagnosis and treatment planning for removable partial dentures. It begins by defining key terms like diagnosis, treatment planning, and removable partial denture. It emphasizes the importance of a thorough patient interview and medical/dental history to accurately diagnose issues and develop a treatment plan. The document outlines factors to consider in the patient interview and examining the patient's mouth, teeth and bone. It discusses how various medical conditions and medications can impact treatment and the need to consult physicians in some cases.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
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4. Radiographic features affecting treatment
outcome
Assessment of patient’s systemic status
Role of radiographs
Case difficulty assessment form
Levels of difficulty
2
5. Factors affecting healing after endodontic
treatment
Endodontic treatment plan
Indications for extraction
3
6. Single visit / mulitiple visit
Periodontal considerations
Surgical considerations
Restorative and prosthetic considerations
Conclusion
4
9. Proper selection of cases avoids pitfalls
during treatment and helps to ensure
success
22%of failures – errors in case selection
The Washington Study
Ingle & Beveridge
7
15. Hunter’s Focal infection theory
Rosenow’s Elective localization
Rickert & Dixon Hollow tube theory
13
16. Factors to be considered
Sterilization – purest form, impossible
Theories – highly speculative
Hollow tube theory- disproved 1960
Dye leakage studies-static evaluation
14
17. 1950-1960- lack of apical seal
Contemporary studies – root canal
fillings leak over time
Bacterial etiology together with
inflammatory reactions
15
19. Factors – may influence the
treatment outcome
Pulpal status
Procedural accidents
Crown/root fractures
Periodontal status
Occlusal discrepancies
Size of periradicular rarefaction
17
20. Pain threshold
Level of canal obturation
Time of post treatment evaluation
Degree of canal calcification
Accessory communications
Presence of root resorption
18
21. Factors – definitely influence
the outcome
r/g interpretation
Periradicular pathosis
Root canal anatomy
Thorough debridement
Apical seal
Disinfection and asepsis
Systemic status
Clinician’s skill
19
22. Treatment outcome based on clinical
features
Acceptable
No tenderness
Normal mobility
No sinus tract, assc periodontal disease
No swelling
No subjective discomfort
20
23. Uncertain
Sporadic vague symptoms
Pressure sensation
Low grade discomfort
Discomfort when pressure applied by tongue
Superimposed sinusitis
Analgesics to relieve pain
21
25. Treatment outcome based on r/g features
Acceptable
Normal, slight thickened pdl space
Elimination of previous r/l
Normal lamina dura
No evidence of resorption
3-D obturation of canal space
23
26. Uncertain
Increased pdl space
r/l of similar size, slight repair
Irregularly thickened lamina dura
Evidence of progressive resorption
Voids in canal obturation
overfilling
24
27. Unacceptable
Increased width of PDL space >2mm
Lack of osseous repair/ size of lesion
Lack of new ld formation
New osseous r/l
Visible patent canal space
Excessive overextension , voids in the apical
area
Definite progressive resorption
25
34. Pregnancy
X ray exposure
Antibiotics if any- penicillins,
cephalosporins, macrolides – first line
NSAIDs – not preferred
Second trimester – safest for dental
care
32
36. Oral infections and potential problems should be
addressed before initiating radiation
Rx of Symptomatic non vital teeth – 1 week before
chemo/radiation
Asymptomatic - delayed
34
37. Medication related osteonecrosis of the
jaws(MRONJ)
AAOMS
1. Current/ previous Rx with antiresorptive drug
2. Exposed necrotic bone in MF region
3. No h/o radiation therapy to jaws
35
38. Recommendations prior to endodontic
treatment
1 min mouth rinse with CHX
Avoid LA with vasoconstrictors
Asepsis
Avoid gingival damage
Maintain apical patency
Prevent overfilling
Aggressive use of antibiotics - infection
36
39. HIV
long term prognosis on endodontic
therapy- unknown
Minimize the possibility of transmission of
infection – strict adherence to universal
precautions
37
40. CD4+ cell count
>350/mm3 – receive all indicated dental
treatments
<200/mm3- opportunistic infections ,
medicated with prophylatic drugs
38
47. Case selection – dictated by what is seen in the
radiograph
Extent of caries
Periapical lesion
Resorption
Anatomy of root canal
Fracture of tooth
45
54. Use of case difficulty assessment form
Items in minimal difficulty – point 1
Moderate – point 2
High- point value – 5
53
55. Decision to treat or refer
< 20 points – dental student may treat under
facult’s supervision
20-40 points – experienced n skilled dental
student , with close supervision by faculty
> 40 merits - case not treated by predoctural
student
54
67. 6
Management of periodontally compromised mandibular molar with
Hemisectioning: A case report
Bandu Napte, Srinidhi Surya Raghavendra
Department of Conservative Dentistry and Endodontics,
28-Oct-2014
77. 6Restor Dent Endod.
2013 May;38(2):59-64
Sin-Yeon Cho and Euiseong Kim
6-year follow up case of horizontal root fracture.
(a) Horizontal root fractures were found on teeth #11 and #21
at the first visit in 2006; (b) The tooth #11 became necrotic and
Received non-surgical root canal therapy in 2007;
(c) 3-year follow up radiograph in 2009; (d) 6-year follow up radiograph in 2012.
78. 6
Figure 1: (a) The initial radiograph was showing the horizontal root
fracture.
(b)The periapical radiograph of the teeth was taken 3 months later.
(c) Six month follow-up radiograph.
(d) One-year follow-up radiograph. (e) Two-year follow-up
radiograph
Year : 2013 | Volume : 1 |
Issue : 1 | Page : 19-23
Treatments of
horizontal
root fractures:
Four case reports
Ebru Kucukyilmaz,
Murat Selim Botsali
Journal of Pediatric
dentistry
79. 6
Figure 4a. Schematic of class III fracture:
incomplete vertical fracture
involving the attachment apparatus.
Figure 4b. Pretreatment radiograph
of mandibular first molar
demonstrating a class III fracture.
Figure 4c. The mesial root has been
amputated and the fracture is observed.
Figure 4d. A 10-year recall of
hemisection and restoration.
Courtesy: Dentistry Today
80. 6
No treatment – the gingival tissue
can be retracted during crown preparation
Gingivectomy using electrosurgery
- Crown lengthening including osseous recontouring
Sub-epithelial connective tissue graft
Mesial root amputation ??
Reattachment with RMGIC followed by
crown placement / extraction ??
91. Reasons for extraction
Symptomatic tooth with non negotiable
canals/ iatrogenic errors whose surgical
management – not possible
Failed rct not amenable to
retreatment
58
93. Single visit vs multiple visit Rx
6
No:of
roots,
time
Severity
of pt’s
symptoms
Clinician’s
skill
94. 61
Single visit vs multiple
visit Rx
Post treatment obturation
discomfort
Post treatment flare up
Radiologic success
Healing rate
JOE 2008 Figini, Lodi, et al
IEJ 2008, Sathorn et al
JOE 2008 , Figini
et al
JOE 2011 , Su, Wang et al
98. Surgical considerations
Lesions – non odontogenic
Biopsy – definitive means , osseous pathosis
Retreatment - approach ?
Apical surgery – failed nsrct
Cause should be corrected first
64
99. Endodontic surgery – primary procedure
- Non surgical
treatment is
not possible
65
100. Pts with preoperative pain – lower
healing rate // pts without pain
Periodontal condition – interproximal
bone levels, marginal bone loss
Isolated endodontic lesion – better
prognosis than endoperio lesion
66
101. Advent of microscope, endoscope ,
ultrasonics, retrograde filling instruments
–improved surgery
CBCT – 3-D image of tooth , pathosis,
localizing mandibular canal, maxillary
sinus
67
103. Reduced coronal tooth structure beneath a
full crown – difficult access & lack of idea
about pulp chamber
When possible , remove restorations before
starting endodontic Rx
Quality of coronal restoration – imp as the
root filling
69
104. Conclusion
Thus, according to Torabinejad and Goodacre,
the decision to retain or remove teeth should
be based on
Thorough assessment of risk factors affecting
long term prognosis of endodontic treatment
70
105. The clinician should consider
Patient related factors
Tooth and periodontium related factors
Treatment related factors
71
106. The use of rotary instruments, ultrasonics,
microscopy as well as new materials
Made it possible to predictably reatin teeth
that previously would have been extracted
72
107. In addition, even teeth
that have failed following
nsrct can often be
retreated using
non surgical or
surgical approach.
73