The document discusses surgical endodontics, including indications for endodontic surgery such as treating failed root canal treatments or addressing procedural difficulties. Key procedures covered include incision and drainage for acute infections, apicectomy and retrograde filling to seal the canal system at the apical foramen, and surgical repair of defects. Techniques such as flap design, location of the apex, and curettage are also summarized. The goal of these surgical procedures is to eliminate bacteria and establish drainage and sealing of the root canal system to allow for periapical healing.
This document discusses different types of vital pulp therapy procedures used to maintain pulp vitality when it has been exposed or injured. It describes indirect pulp capping, direct pulp capping, pulpotomy, and apexification procedures. Key goals are to treat reversible pulpal injuries, neutralize contamination, and prevent further contamination. Materials used include calcium hydroxide and MTA, with advantages and disadvantages discussed for each. The ideal properties of pulp capping agents are also reviewed.
Regenerative endodontics aims to regenerate damaged pulp and root structures through biologically-based procedures. Historically, studies in the 1960s-70s showed blood clots could induce tissue formation in root canals. Current methods include placing stem cells on scaffolds with growth factors in the root canal to regenerate the pulp-dentin complex. Triple antibiotic paste, calcium hydroxide, and MTA are used as antimicrobial medicaments. The protocol involves inducing bleeding into the root canal to form a blood clot which triggers regeneration. The goal is periradicular health and evidence of vital regenerated tissue through radiographic and clinical measures.
Iatrogenic Perforation- A guide to fixing the hole in your patient's toothTaseef Hasan Farook
An overview of the possible types of perforation that may occur during endodontic treatment with their management. This slide presentation covers multiple management possibilities of said perforation proposed by various clinicians from around the world which can aid the readers in their treatment plan for the repair of a tooth perforation
The document discusses endodontic surgery, including:
- Indications for endodontic surgery when non-surgical retreatment has failed or is not feasible.
- Classification, armamentarium, treatment planning considerations, and stages of surgical endodontics including flap design, osteotomy, periradicular curettage, root-end resection, and root-end preparation and filling.
- Key aspects are proper anesthesia, hemostasis, management of soft and hard tissues to access the surgical site and root structure for periradicular procedures.
This document discusses strategies for minimally invasive endodontics. It emphasizes preserving tooth structure to maximize strength and longevity. Smaller access openings and conservative root canal shaping are recommended to avoid weakening tooth structure. Thorough disinfection can still be achieved with smaller canal preparations when combined with improved irrigation methods. Restorations should maintain coronal and peri-cervical tooth structure to reinforce the tooth through the "ferrule effect." The goal of minimally invasive endodontics is effective treatment while minimizing structural damage to teeth.
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.
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 different types of vital pulp therapy procedures used to maintain pulp vitality when it has been exposed or injured. It describes indirect pulp capping, direct pulp capping, pulpotomy, and apexification procedures. Key goals are to treat reversible pulpal injuries, neutralize contamination, and prevent further contamination. Materials used include calcium hydroxide and MTA, with advantages and disadvantages discussed for each. The ideal properties of pulp capping agents are also reviewed.
Regenerative endodontics aims to regenerate damaged pulp and root structures through biologically-based procedures. Historically, studies in the 1960s-70s showed blood clots could induce tissue formation in root canals. Current methods include placing stem cells on scaffolds with growth factors in the root canal to regenerate the pulp-dentin complex. Triple antibiotic paste, calcium hydroxide, and MTA are used as antimicrobial medicaments. The protocol involves inducing bleeding into the root canal to form a blood clot which triggers regeneration. The goal is periradicular health and evidence of vital regenerated tissue through radiographic and clinical measures.
Iatrogenic Perforation- A guide to fixing the hole in your patient's toothTaseef Hasan Farook
An overview of the possible types of perforation that may occur during endodontic treatment with their management. This slide presentation covers multiple management possibilities of said perforation proposed by various clinicians from around the world which can aid the readers in their treatment plan for the repair of a tooth perforation
The document discusses endodontic surgery, including:
- Indications for endodontic surgery when non-surgical retreatment has failed or is not feasible.
- Classification, armamentarium, treatment planning considerations, and stages of surgical endodontics including flap design, osteotomy, periradicular curettage, root-end resection, and root-end preparation and filling.
- Key aspects are proper anesthesia, hemostasis, management of soft and hard tissues to access the surgical site and root structure for periradicular procedures.
This document discusses strategies for minimally invasive endodontics. It emphasizes preserving tooth structure to maximize strength and longevity. Smaller access openings and conservative root canal shaping are recommended to avoid weakening tooth structure. Thorough disinfection can still be achieved with smaller canal preparations when combined with improved irrigation methods. Restorations should maintain coronal and peri-cervical tooth structure to reinforce the tooth through the "ferrule effect." The goal of minimally invasive endodontics is effective treatment while minimizing structural damage to teeth.
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.
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 calcific metamorphosis (CM), which is hard tissue deposition within the root canal space after traumatic dental injuries. CM is commonly seen in anterior teeth and can partially or fully obliterate the root canal space on radiographs. The document covers the definition, causes, incidence, radiographic appearance, histology, and proposed mechanisms of hard tissue formation in CM. It also discusses the controversy around treating teeth with CM, with most literature recommending observation unless symptoms appear. The document provides tips for locating and negotiating canals when CM is present, including using anatomical knowledge and correlating radiographs with tooth morphology.
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
Minimally invasive endodontics by Dr. JAGADEESH KODITYALAJagadeesh Kodityala
This document discusses principles of minimally invasive endodontics. It defines minimally invasive dentistry and lists the primary goals of endodontics as tooth retention and preventing/managing pulpal and periapical disease while preserving structural integrity. The document discusses strategies for minimally invasive access cavity preparation and shaping of the root canal space. It emphasizes the importance of conserving tooth structure, maintaining smaller canal sizes when possible, and avoiding excessive dentin removal to strengthen teeth and reduce fracture risks.
This document provides information on surgical endodontics procedures performed by Dr. Osama Mushtaq. It discusses the reasons for endodontic treatment failure and describes objectives and indications for endodontic surgery, including managing periapical disease and lesions that cannot be treated via nonsurgical root canal treatment. The document outlines the surgical procedure, covering topics like flap design, root resection, root-end filling materials, and postoperative care. It also discusses factors associated with success and failure of periapical surgery, and indications and contraindications for corrective endodontic surgery to repair procedural errors or resorptive defects.
Objectives and rationale
Indications
Contraindications
False indications
Treatment planning and presurgical notes
Classification
Gutmann’s
Kim’s
Steps in endosurgery
Treatment planning & Presurgical notes
Mandatory investigations
Premedication
Local anaesthesia and hemostasis
Flap
Requirements of an ideal flap
Flap design
Semilunar flap
Vertical flaps
Horizontal flap
Ochsenbein-Luebke flap
Two-step or filling first technique
Disinfection immediately prior to filling
Preparation of surgical site
Soft tissue management
Opening the flap
Flap elevation
Flap retraction
Hard tissue considerations
Locating root apex
Osteotomy
Apical curettage
Apical rood end resection
Surgery from palatal access
Post-resection filling
Root end preparation
Root end filling materials
Reverse filling
Surgery for root fractures
Surgical management of internal resorption
Radisectomy and hemisection
Intentional replantation
Closure of surgical area
Repositioning of flap and compression
Needle selection
Suturing
Post surgical care
This document provides an overview of regenerative endodontics, which aims to regenerate dental tissues through biologically-based procedures using stem cells, growth factors, and scaffolds. Key elements for pulp regeneration include reliable stem cell sources, such as dental pulp stem cells, growth factors to stimulate cell proliferation and differentiation, and appropriate scaffolds. Potential regenerative therapies include revascularization, stem cell therapy, scaffold implantation, and gene delivery. Measuring clinical outcomes and further applications are areas of future focus to develop regenerative endodontic therapies.
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.
Endodontic surgery is performed to address issues like failed root canal treatments, procedural errors, anatomical variations, and biopsies. It involves raising a surgical flap, resecting the root tip, preparing and filling the root end cavity. Potential complications include swelling, pain, nerve damage and infection. A variety of materials can be used for the root end filling including zinc oxide eugenol cements, MTA, composites and glass ionomer cements. The goal is to provide an apical seal to prevent reinfection from microbes remaining in the root canal system.
This document discusses root canal irrigation and intracanal medicaments. It outlines the objectives and characteristics of an ideal irrigation system, including removing debris, being bactericidal, and dissolving tissue. EDTA and sodium hypochlorite are described as common irrigation solutions used to remove the smear layer. Factors influencing irrigation efficacy and methods of irrigant delivery are covered. Potential complications of sodium hypochlorite accidents and their treatment are summarized. Finally, the document briefly discusses root canal medication and categories of intracanal medicaments.
A post and core restoration is used to build up tooth structure for a crown when there is not enough structure remaining. A post is placed in the root canal and a core is built up around the post to provide support and retention for the crown. Key factors in post and core design include post length and diameter, surface texture, and luting agents to provide retention, as well as post design and cement layer to provide resistance to stresses. Custom post and cores are made using direct or indirect techniques involving impression taking, while prefabricated posts are used for circular root canals.
Operative Dentistry Viva questions. To help you revise your syllabus for examination.
If you found it helpful, please leave a feedback.
Thank You,
Dr. Almas Muhammad Arshad
Dr. Muaaz Amjad
The document discusses the use of magnification in endodontics. It begins with a brief history of magnification tools used in dentistry, from early microscopes to modern dental operating microscopes (DOM). It then defines various optical terms and describes different magnification tools including loupes, DOM, and rod lens endoscopes. The bulk of the document focuses on DOM, outlining its components, how it works, proper positioning and use. It concludes that DOM provides significant benefits for endodontic procedures by enabling preservation of tooth structure, localization of anatomy, and detection of fractures or separated instruments.
1. Cleaning and shaping of the root canal is essential for root canal treatment success by removing all contents from the root canal system.
2. Various techniques have been developed over time for root canal instrumentation including step-back, crown-down, and balanced force techniques.
3. Contemporary techniques such as ProTaper Next and Self-Adjusting File use engine-driven files and continuous irrigation for more efficient cleaning and shaping of the complex root canal anatomy.
This document discusses the procedure of pulp revascularization to treat immature permanent teeth with necrotic pulps and open apices. It involves disinfecting the root canal with calcium hydroxide or triple antibiotic paste, inducing bleeding into the canal to form a blood clot, and placing MTA over the clot to allow new tissue and blood vessel formation. This results in continued root development, thickening of dentin walls, and closure of the root apex. Advantages include natural root maturation and vital tooth structure, while disadvantages can include discoloration or resistant bacterial infection.
This document discusses the process of a complete denture try-in. It begins by defining complete denture prosthetics and try-in. It then outlines the steps to check the mandibular denture alone, including the peripheral outline, stability, tongue space, and occlusal plane height. It describes similarly checking the maxillary denture alone and then both dentures together, evaluating the occlusion, vertical height, even occlusal pressure, and appearance. The goal of the try-in is to evaluate and adjust the dentures before processing to ensure proper fit and function.
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.
The document discusses various techniques for cleaning and shaping the root canal system during endodontic treatment. It describes the objectives and basic principles of root canal preparation, including removing debris and maintaining the original shape of the canal. Several techniques are summarized, such as step-back, crown-down, balanced force, and ultrasonic instrumentation. For each technique, the document outlines the steps and discusses advantages and disadvantages.
Endodontic Root Perforation: Causes, Identification, and Management PresentationIraqi Dental Academy
This lecture present to you the concept of root perforation and its complications in endodontic practice. Management of such situation is also presented briefly.
The document discusses various challenges that can arise during endodontic treatment and ways to address them. It notes that the pulp chamber and canals have complex anatomy, so problems should be expected. It emphasizes the importance of experience, skill, care, observation, patience and proper patient/tooth selection and treatment procedures to avoid issues. Specific potential problems discussed include ledges, zips, transportations, perforations in curved canals, under/over instrumentation, and tissue emphysema from excess irrigation. The document provides guidance on addressing any perforations or other procedural accidents that occur.
Dental hard tissues are resorbed by multinucleate cells called odontoclasts or dentinoclasts. They are classified as physiological or pathological, with pathological further divided into external root resorption due to trauma, pulp/apical pathology, or pressure and internal root resorption. A new clinical classification is based on injury to protective tissues by chemical or mechanical means and stimulation by infection or pressure. Odontoclasts/dentinoclasts resorb dental tissues through a process that begins with injury exposing mineralized tissue, followed by colonization and resorption stimulated continuously by pressure or infection.
This document discusses calcific metamorphosis (CM), which is hard tissue deposition within the root canal space after traumatic dental injuries. CM is commonly seen in anterior teeth and can partially or fully obliterate the root canal space on radiographs. The document covers the definition, causes, incidence, radiographic appearance, histology, and proposed mechanisms of hard tissue formation in CM. It also discusses the controversy around treating teeth with CM, with most literature recommending observation unless symptoms appear. The document provides tips for locating and negotiating canals when CM is present, including using anatomical knowledge and correlating radiographs with tooth morphology.
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
Minimally invasive endodontics by Dr. JAGADEESH KODITYALAJagadeesh Kodityala
This document discusses principles of minimally invasive endodontics. It defines minimally invasive dentistry and lists the primary goals of endodontics as tooth retention and preventing/managing pulpal and periapical disease while preserving structural integrity. The document discusses strategies for minimally invasive access cavity preparation and shaping of the root canal space. It emphasizes the importance of conserving tooth structure, maintaining smaller canal sizes when possible, and avoiding excessive dentin removal to strengthen teeth and reduce fracture risks.
This document provides information on surgical endodontics procedures performed by Dr. Osama Mushtaq. It discusses the reasons for endodontic treatment failure and describes objectives and indications for endodontic surgery, including managing periapical disease and lesions that cannot be treated via nonsurgical root canal treatment. The document outlines the surgical procedure, covering topics like flap design, root resection, root-end filling materials, and postoperative care. It also discusses factors associated with success and failure of periapical surgery, and indications and contraindications for corrective endodontic surgery to repair procedural errors or resorptive defects.
Objectives and rationale
Indications
Contraindications
False indications
Treatment planning and presurgical notes
Classification
Gutmann’s
Kim’s
Steps in endosurgery
Treatment planning & Presurgical notes
Mandatory investigations
Premedication
Local anaesthesia and hemostasis
Flap
Requirements of an ideal flap
Flap design
Semilunar flap
Vertical flaps
Horizontal flap
Ochsenbein-Luebke flap
Two-step or filling first technique
Disinfection immediately prior to filling
Preparation of surgical site
Soft tissue management
Opening the flap
Flap elevation
Flap retraction
Hard tissue considerations
Locating root apex
Osteotomy
Apical curettage
Apical rood end resection
Surgery from palatal access
Post-resection filling
Root end preparation
Root end filling materials
Reverse filling
Surgery for root fractures
Surgical management of internal resorption
Radisectomy and hemisection
Intentional replantation
Closure of surgical area
Repositioning of flap and compression
Needle selection
Suturing
Post surgical care
This document provides an overview of regenerative endodontics, which aims to regenerate dental tissues through biologically-based procedures using stem cells, growth factors, and scaffolds. Key elements for pulp regeneration include reliable stem cell sources, such as dental pulp stem cells, growth factors to stimulate cell proliferation and differentiation, and appropriate scaffolds. Potential regenerative therapies include revascularization, stem cell therapy, scaffold implantation, and gene delivery. Measuring clinical outcomes and further applications are areas of future focus to develop regenerative endodontic therapies.
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.
Endodontic surgery is performed to address issues like failed root canal treatments, procedural errors, anatomical variations, and biopsies. It involves raising a surgical flap, resecting the root tip, preparing and filling the root end cavity. Potential complications include swelling, pain, nerve damage and infection. A variety of materials can be used for the root end filling including zinc oxide eugenol cements, MTA, composites and glass ionomer cements. The goal is to provide an apical seal to prevent reinfection from microbes remaining in the root canal system.
This document discusses root canal irrigation and intracanal medicaments. It outlines the objectives and characteristics of an ideal irrigation system, including removing debris, being bactericidal, and dissolving tissue. EDTA and sodium hypochlorite are described as common irrigation solutions used to remove the smear layer. Factors influencing irrigation efficacy and methods of irrigant delivery are covered. Potential complications of sodium hypochlorite accidents and their treatment are summarized. Finally, the document briefly discusses root canal medication and categories of intracanal medicaments.
A post and core restoration is used to build up tooth structure for a crown when there is not enough structure remaining. A post is placed in the root canal and a core is built up around the post to provide support and retention for the crown. Key factors in post and core design include post length and diameter, surface texture, and luting agents to provide retention, as well as post design and cement layer to provide resistance to stresses. Custom post and cores are made using direct or indirect techniques involving impression taking, while prefabricated posts are used for circular root canals.
Operative Dentistry Viva questions. To help you revise your syllabus for examination.
If you found it helpful, please leave a feedback.
Thank You,
Dr. Almas Muhammad Arshad
Dr. Muaaz Amjad
The document discusses the use of magnification in endodontics. It begins with a brief history of magnification tools used in dentistry, from early microscopes to modern dental operating microscopes (DOM). It then defines various optical terms and describes different magnification tools including loupes, DOM, and rod lens endoscopes. The bulk of the document focuses on DOM, outlining its components, how it works, proper positioning and use. It concludes that DOM provides significant benefits for endodontic procedures by enabling preservation of tooth structure, localization of anatomy, and detection of fractures or separated instruments.
1. Cleaning and shaping of the root canal is essential for root canal treatment success by removing all contents from the root canal system.
2. Various techniques have been developed over time for root canal instrumentation including step-back, crown-down, and balanced force techniques.
3. Contemporary techniques such as ProTaper Next and Self-Adjusting File use engine-driven files and continuous irrigation for more efficient cleaning and shaping of the complex root canal anatomy.
This document discusses the procedure of pulp revascularization to treat immature permanent teeth with necrotic pulps and open apices. It involves disinfecting the root canal with calcium hydroxide or triple antibiotic paste, inducing bleeding into the canal to form a blood clot, and placing MTA over the clot to allow new tissue and blood vessel formation. This results in continued root development, thickening of dentin walls, and closure of the root apex. Advantages include natural root maturation and vital tooth structure, while disadvantages can include discoloration or resistant bacterial infection.
This document discusses the process of a complete denture try-in. It begins by defining complete denture prosthetics and try-in. It then outlines the steps to check the mandibular denture alone, including the peripheral outline, stability, tongue space, and occlusal plane height. It describes similarly checking the maxillary denture alone and then both dentures together, evaluating the occlusion, vertical height, even occlusal pressure, and appearance. The goal of the try-in is to evaluate and adjust the dentures before processing to ensure proper fit and function.
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.
The document discusses various techniques for cleaning and shaping the root canal system during endodontic treatment. It describes the objectives and basic principles of root canal preparation, including removing debris and maintaining the original shape of the canal. Several techniques are summarized, such as step-back, crown-down, balanced force, and ultrasonic instrumentation. For each technique, the document outlines the steps and discusses advantages and disadvantages.
Endodontic Root Perforation: Causes, Identification, and Management PresentationIraqi Dental Academy
This lecture present to you the concept of root perforation and its complications in endodontic practice. Management of such situation is also presented briefly.
The document discusses various challenges that can arise during endodontic treatment and ways to address them. It notes that the pulp chamber and canals have complex anatomy, so problems should be expected. It emphasizes the importance of experience, skill, care, observation, patience and proper patient/tooth selection and treatment procedures to avoid issues. Specific potential problems discussed include ledges, zips, transportations, perforations in curved canals, under/over instrumentation, and tissue emphysema from excess irrigation. The document provides guidance on addressing any perforations or other procedural accidents that occur.
Dental hard tissues are resorbed by multinucleate cells called odontoclasts or dentinoclasts. They are classified as physiological or pathological, with pathological further divided into external root resorption due to trauma, pulp/apical pathology, or pressure and internal root resorption. A new clinical classification is based on injury to protective tissues by chemical or mechanical means and stimulation by infection or pressure. Odontoclasts/dentinoclasts resorb dental tissues through a process that begins with injury exposing mineralized tissue, followed by colonization and resorption stimulated continuously by pressure or infection.
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.
Endodontic surgery is a surgical procedure to treat endodontic problems. There are several types of endodontic surgery procedures described in the document, including incision and drainage to drain pus from infected areas, periapical surgery such as apicoectomy to remove the infected root tip, and retrograde filling to seal the root canal. Postoperative evaluation methods like reimplantation of extracted teeth and use of endodontic implants are also discussed. Contraindications, surgical techniques, and prognosis factors are provided. The document provides an overview of different endodontic surgical procedures and their indications.
Complications of wisdo removal neurological mangment .pdfIslam Kassem
1. The document provides information about impacted wisdom teeth and their treatment, including alternatives to removal, principles of surgery, and complications.
2. Key points discussed include evaluation of impaction patterns, lingual splitting surgical technique, laser therapy benefits, and management of dry socket and nerve injuries.
3. Post-extraction healing processes and potential complications are outlined, along with prevention strategies and treatment approaches.
This document discusses various perio-endo lesions and their treatment. It covers topics like non-vital teeth with furcation involvement and lateral canals resolving after root canal treatment. It also discusses generalized poor periodontal conditions with deep pockets and abscesses resolving with treatment. The document contrasts clinical, radiological, and histological features of pulpal versus periodontal lesions and their different treatments. It presents various advanced treatment options for complex perio-endo cases like resection, implants, bone grafts, and guided tissue regeneration.
This document discusses the procedures for diagnosis and treatment planning in root canal therapy, including taking a patient history, performing clinical and radiographic examinations, assessing symptoms, and determining indications and contraindications for root canal treatment or retreatment. It provides details on examination techniques, tests, anatomical considerations, and factors that influence treatment selection and prognosis.
Endodontic surgery is a procedure performed to remove or correct causes of dental disease and restore tissues to health. It is often a last resort to save a tooth and requires great skill. Indications include inability to eliminate pathology with root canal treatment, inability to fully clean and fill the root canal, or iatrogenic problems like instrument breakage. Contraindications include resolved pathology, health issues, anatomic constraints, or periodontal disease. Preparation includes referral data, radiographs, diagnosis, and informed consent. Common flap designs are triangular, rectangular, or submarginal. Types of endodontic surgery include incision and drainage, trephination, periapical surgery like apicoectomy, repair of perforations,
This comprehensive Urdu lecture is about the Maxillofacial prosthesis (prostheses).
Lecture Video
https://www.youtube.com/watch?v=ljhHR3kTZ_w
This lecture has four portions, First one is about the basics and intro. The second one is about the obturator. The third one is about the splint while the fourth one has miscellaneous maxillofacial prostheses.
I have tried to use simple language with common examples to make the study easy and fun.
Feel free to ask questions.
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Endodontic surgery ppt dr. ahmed elfatoryaabdesalam
Endodontic surgery, also known as apicoectomy, involves surgically resecting the root tip and surrounding pathological tissues to resolve periapical lesions and restore tissue health. It is often performed when root canal treatment fails or has difficulties. The aim is to disinfect the pulp space and seal it to prevent reinfection. Periapical lesions are caused by microbial contamination reaching the apex via caries or trauma. Treatment options include extraction, retreatment, or surgery. Endodontic surgery requires resection of the apex and removal of pathological tissue. Care must be taken near anatomical structures like the maxillary sinus or mental foramen. Both conventional and retrograde approaches are used depending on the clinical situation.
This document discusses proptosis and exophthalmos. It defines proptosis as forward displacement of the eye of less than 18mm and exophthalmos as protrusion of more than 18mm. Proptosis can be caused by a decrease in orbital volume or increase in soft tissue volume. Clinical evaluation of proptosis involves inspection of the eyes and skull shape and palpation to check for retrodisplacement of the globe. Common causes of unilateral, bilateral, acute, intermittent and pulsatile proptosis are discussed.
This document provides an overview of periodontal flap surgery techniques. It defines a periodontal flap as incising the gingival tissues to control or eliminate periodontal disease by elevating the gingiva and oral mucosa from underlying tissues for improved accessibility and visibility of bone and roots. The document discusses the classification, indications, advantages, and types of incisions for various flap techniques used in pocket therapy, including modified Widman flap, undisplaced flap, apically displaced flap, and distal wedge procedure. Healing processes and outcomes for different flap techniques are also summarized.
1. Endodontics presents unique challenges as the clinician cannot directly visualize the root canal anatomy and relies heavily on tactile feedback.
2. Curved canals can lead to procedural errors like ledge formation, zipping, or perforations if not cleaned and shaped carefully.
3. Factors like root canal curvature, tooth type, and prior treatments can increase difficulty, requiring modified instrumentation techniques.
This document provides an overview of the history and techniques of endodontic surgery. It discusses how endodontic surgery was first recorded over 1500 years ago and has evolved since. The document then covers classifications of endodontic surgical techniques, anatomical considerations, preoperative preparation, armamentarium, surgical procedures like flap design and osteotomy, and advances in materials. It emphasizes that endodontic surgery should only be considered when conventional root canal treatment is not possible and outlines factors for a successful outcome.
The document discusses various types of traumatic injuries to teeth, including classifications and treatment approaches. It covers injuries such as enamel fractures, crown fractures with and without pulp exposure, crown-root fractures, root fractures, and vertical fractures. For each type of injury, the summary discusses typical clinical and radiographic findings and outlines treatment options such as pulpotomy, root canal treatment, splinting fractured segments, and orthodontic or surgical repositioning of fragments. The prognosis depends on factors like the distance between fractured segments and their immobilization after injury. Healing may involve calcified tissue, connective tissue, or granulation tissue formation between fragments.
Emergency Department presentation by Dr Conor Dalby. Signs and symptoms to be aware of when assessing a patient following facial injury. Common types of fractures and their management. UK.
This document provides information about artificial cornea or keratoprosthesis surgery. It discusses the history and indications for the procedure, describes common designs for artificial corneas including biointegrated and non-biointegrated options, and outlines some of the major keratoprosthesis designs including the Boston KPro, AlphaCor KPro, and modified osteo-odonto keratoprosthesis. It also covers the preoperative evaluation, surgical procedure, postoperative management, prognosis, and complications for keratoprosthesis surgery.
This document provides an overview of maxillary and midface osteotomies. It begins with an introduction discussing the history and goals of orthognathic surgery. It then covers various osteotomy techniques including single tooth, anterior maxillary, posterior maxillary, Lefort I, II, and III osteotomies. For each technique, it discusses the relevant history, indications, surgical approach, complications, and advances. It emphasizes the Lefort I osteotomy as the mainstay procedure, covering its evolution, blood supply considerations, rigid fixation approaches, and indications. In summary, the document comprehensively reviews different maxillary osteotomy techniques for orthognathic surgery.
The document discusses recent advances in prosthodontics presented by Dr. J. Koshy Joseph. It covers various topics including complete dentures, fixed partial dentures, removable partial dentures, maxillofacial prosthetics, implantology, materials and instrumentation. New techniques and materials discussed include the use of lasers in denture fabrication, CAD/CAM systems for complete dentures, magnets and denture liners in prosthodontics, and all-on implants. The document provides an overview of the latest developments across different areas of prosthodontics.
This document discusses fractures of the nasal bone, including common causes, symptoms, diagnosis, and management. Nasal fractures most often result from direct trauma to the face from activities like sports, fighting, or falls. Symptoms include nose pain, swelling, bleeding and deformity. Diagnosis involves examination for deformities and imaging like x-rays. Treatment is usually closed reduction to manipulate the bone fragments back into position without surgery, sometimes using nasal splints for immobilization. Complications can include bleeding, deformity and obstruction if not properly treated.
This document discusses various techniques for preserving vital primary and young permanent teeth, including indirect pulp therapy, direct pulp capping, pulpotomy, and pulpectomy. It provides details on the indications, contraindications, techniques, and success rates of each procedure. Formocresol pulpotomy continues to be widely used for treating carious exposures in primary teeth, though alternatives like glutaraldehyde are discussed. Successful endodontic treatment of primary teeth requires an understanding of their complex root canal anatomy and the effects of physiologic root resorption.
The document discusses techniques for shaping root canals including the foramen last technique, apical control zone, and apical gauging. It emphasizes cleaning the coronal 2/3 of canals before reaching the apical 1/3 to minimize complications. The apical control zone is described as an enhanced taper in the apical third that provides resistance against obturation. Literature references typical canal diameters of 1mm from the apex across different tooth types. Electric foramenal locators and establishing working length are also covered.
This document discusses endodontic diagnosis and treatment planning. It begins with an introduction to endodontics and causes of pulpitis. Signs and symptoms of pulpitis are then outlined. The diagnostic process involves subjective history, objective examination, and tests like percussion, palpation, thermal sensitivity, electric pulp testing, and radiographs. Based on the diagnosis, a treatment plan is formulated which may involve root canal treatment, referral, or extraction. The document provides details on diagnosing and treating different pulpal and periapical conditions like reversible/irreversible pulpitis, abscesses, cysts, and necrosis.
This document discusses management of local anaesthesia in endodontics. It summarizes reported rates of profound anaesthesia from various studies ranging from 38-92%. It discusses reasons for mandibular anaesthesia failure including anatomical variations, maximum safe doses of local anaesthetics, and how pulpal inflammation can complicate achieving anaesthesia. Adjunctive strategies to improve mandibular anaesthesia outcomes are also reviewed such as additional injections, periodontal ligament injections, intraosseous injections, and alternative techniques like Gow-Gates or Akinosi.
The document describes a panoramic anatomy presentation that identifies anatomical structures on panoramic radiographs. It includes slides labeling structures, describing different types of images (single real, double real, ghost), and providing an anatomical key. The slides provide examples of panoramic images labeling different structures and examples of positioning errors.
The document discusses strategies for restoring teeth that have undergone root canal treatment. It notes that while root canal treatment has high success rates, teeth remain vulnerable after treatment until permanently restored. Key points emphasized include minimizing removal of further tooth structure, avoiding stress-generating restorations, and providing ferrule protection of remaining tooth structure with crowns or onlays when possible. Strategies like custom posts, diaphragm cores, and conservative cavity preparations are also recommended to maximize tooth reinforcement and strength.
The document contains a record of endodontic treatment performed on September 16, 2009 using Protaper files. A total of 45 individual file insertions are listed, ranging from file size MS 4 to file size 45. The entire root canal treatment was completed with Protaper files on this single date.
The goals of endodontic access cavity preparation are to remove all debris and microorganisms from the root canal system, and to create a direct line of access to allow for thorough cleaning, shaping, and filling of the canals. Proper visualization, location of all canal orifices, and flaring of the cavity are essential to achieve these aims. Adequate taper, smooth walls, and space for coronal restoration are also important to optimize disinfection and long-term sealing of the treated tooth.
The document outlines the steps taken in preparing a straight root canal, including initial access and removal of the pulp roof, extending the access cavity, using instruments such as barbed broaches and K-files to shape the canal, determining working length, and tapering and preparing the apical third in steps. It concludes with obturation of the canal using lateral condensation, temporary restoration, and final crown restoration.
The document discusses various techniques for preparing curved root canals, including circular filing, anti-curvature filing, and avoiding procedural errors that could lead to perforations, ledges, or zipping of the foramen. It addresses initial access of non-vital posterior teeth, enlarging the orifice, and removing interferences. The preparation of the coronal two-thirds is outlined along with achieving direct line access and apical instrumentation. Completing the preparation of curved root canals requires various techniques to shape the canal while avoiding complications.
The document discusses the evolution of endodontic file designs from manual stainless steel files to rotary nickel-titanium files. It describes how early manual stainless steel files had limitations like ledge formation and inability to negotiate curved canals. The introduction of greater taper and flexible nickel-titanium files addressed these issues and allowed for faster and more predictable root canal shaping. Modern rotary file systems further improved on these designs with features like progressive tapers and unique cross sections for better debris removal and canal centering.
This document discusses the instruments required for endodontic procedures. It describes both rotary and hand instruments, including high and low speed burs, files, reamers, spreaders and other tools. Rotary instruments include tungsten carbide burs and diamond burs. Hand instruments include mirrors, probes, excavators, tweezers and irrigating syringes. The document provides images and descriptions of various file types including K-files, H-files and Gates-Glidden burs. It also mentions cleaning and sterilization of instruments using an ultrasonic bath.
Endodontics is the branch of dentistry concerned with the study of the dental pulp and periradicular tissues. Endodontic treatment encompasses procedures to maintain the health of the pulp or treat it when diseased, such as pulp capping, pulpotomy, root canal treatment, and surgical endodontic procedures. The history of endodontics dates back to ancient times when toothaches were treated by cauterization or drilling into the pulp chamber for pain relief. Modern endodontics developed in the 19th century with the recognition of infected pulps as sources of infection and advances in local anesthesia, x-rays, and standardized instrumentation.
This document discusses the biology and clinical rationale for root canal therapy. It covers the functions of the dental pulp, including induction of tooth formation, formation and maintenance of dentin, defense mechanisms, and sensation. It also discusses the etiology of pulp and periapical disease, including bacteria, trauma, chemicals, and iatrogenic causes. Finally, it outlines the aims of endodontic treatment, which are to remove debris, destroy microorganisms, and completely seal the root canal system.
Microbiology plays an important role in endodontic infections. Bacteria enter the root canal system through caries, periodontal disease, trauma, or cracks in the tooth. The root canal system becomes infected as bacteria colonize necrotic pulp tissue. Primary endodontic infections involve polymicrobial communities containing 10-30 bacterial species per canal, most of which are strict anaerobes. Key pathogens involved in endodontic disease include black-pigmented Prevotella and Porphyromonas bacteria, as well as Enterococcus faecalis, Fusobacterium, and Candida albicans. Bacterial virulence factors like lipopolysaccharide and capsules allow pathogens to evade the
Endodontics is the branch of dentistry dealing with dental pulp and tissues surrounding the roots of teeth. The document discusses causes of pulpal damage, diagnostic tests and conclusions, and procedures like root canal therapy. It describes the instruments, materials, and techniques used in non-surgical and surgical endodontic treatments, including root canal filling, apicoectomy, and root amputation.
Assessment and Planning in Educational technology.pptxKavitha Krishnan
In an education system, it is understood that assessment is only for the students, but on the other hand, the Assessment of teachers is also an important aspect of the education system that ensures teachers are providing high-quality instruction to students. The assessment process can be used to provide feedback and support for professional development, to inform decisions about teacher retention or promotion, or to evaluate teacher effectiveness for accountability purposes.
বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
আমাদের সবার জন্য খুব খুব গুরুত্বপূর্ণ একটি বই ..বিসিএস, ব্যাংক, ইউনিভার্সিটি ভর্তি ও যে কোন প্রতিযোগিতা মূলক পরীক্ষার জন্য এর খুব ইম্পরট্যান্ট একটি বিষয় ...তাছাড়া বাংলাদেশের সাম্প্রতিক যে কোন ডাটা বা তথ্য এই বইতে পাবেন ...
তাই একজন নাগরিক হিসাবে এই তথ্য গুলো আপনার জানা প্রয়োজন ...।
বিসিএস ও ব্যাংক এর লিখিত পরীক্ষা ...+এছাড়া মাধ্যমিক ও উচ্চমাধ্যমিকের স্টুডেন্টদের জন্য অনেক কাজে আসবে ...
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
How to Add Chatter in the odoo 17 ERP ModuleCeline George
In Odoo, the chatter is like a chat tool that helps you work together on records. You can leave notes and track things, making it easier to talk with your team and partners. Inside chatter, all communication history, activity, and changes will be displayed.
How to Fix the Import Error in the Odoo 17Celine George
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects.
What sets Denis apart is his comprehensive understanding of Business and Systems Analysis technologies, honed through involvement in all phases of the Software Development Lifecycle (SDLC). From meticulous requirements gathering to precise analysis, innovative design, rigorous development, thorough testing, and successful implementation, he has consistently delivered exceptional results.
Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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2. Modern concept of Endodontics has modified the approach to
treatment
Attempting to determine the cause of persistent periradicular
disease. Treatment is directed to eliminate the etiology.
Which is the presence offbbacteria and microbial irritants
in the root canal space.
Microorganism can be survive in the well treated root canals,
in dentinal tubules, canal irregularities, deltas and
isthmus areas. If these completely entombed periradicular
healing should be occur.
Over extended RCT is not indicated for apical surgery but it
will contributed to failure due to toxic material like
formaldehyde
Vertical root fracture
9/15/2009 Endo 15 2
3. Radiolucencey
In
Radiograph
Orthograde -Clean
Root filling -Shape
Treatment of choice -Fill
9/15/2009 Endo 15 3
4. When reading x-ray’s following should be considered
*Natural foramina over the apex
*Other pathological lesions
*maxillary sinus
Treatment of choice
Stress
Orthograde Root filling
Surgery
failure discomfort
Reroot filling
failure
9/15/2009 Endo 15 4
5. General indications for Endodontic surgery
1. Access to the root canal
2. To establish drainage
3. Need to seal the system
4. To repair any defect in the root
5. Surgical resection of multi-rooted teeth
9/15/2009 Endo 15 5
6. Surgical procedures in Endodontics
1. Incision to establish drainage
2. Periapical (Peri radicular) curettage
3. Apicectomy
4. Surgical repair of roots ( Corrective surgery )
5. Root amputation (Resection)
6. Hemi section
7. Intentional replantation
9/15/2009 Endo 15 6
7. Medical history
Well documented medical history is essential
Rheumatic fever (Not contraindicated)
Heart diseases
Diabetes
Blood dyscrasias
Steroid therapy
Impaired renal/hepatic function
CVA
9/15/2009 Endo 15 7
8. Contraindications ( Or Cautions )
Poor Psychological health / poor health
Post radiation therapy
Difficult accessibility
-Palatal roots
-Disto buccal root of upper 7 7
-Distal 7 ( External oblique ridge )
Limited mouth opening
Poor periodontal support
No cortical plate
Very short roots
Beyond capabilities and experience
Anatomical structures in jeopardy ( nerve)
9/15/2009 Endo 15 8
9. (1) Incision and Drainage
The only surgical procedure in acute inflammation
Antibiotics
Drainage through root canal
Anaesthesia
Local
Spray
Gel
Sub mucosal injection
*Incise with bard parker No 11 blade or
*Aspirate with wide bore needle ABST
Extra oral drainage could be referred to a specialized unit
9/15/2009 Endo 15 9
10. (2) Apicectomy & Retrograde apical seal
The term “Apicectomy” refers to only a stage of an operation
Objectives is to seal the canal system at the apical foramen from
the peri radicular tissue. Actually, Apicectomy by it self can’t
resolve root canal failure .It should accompanied the retro seal.
It is an adjunct for Orthograde root filling
Success rate is less than implant
a. Cannot seal all lateral canals
b. Exposed areas of root canal material is greater there for long
term success is also affected
WASHINGTON STUDY
9/15/2009 Endo 15 10
11. Indications for Apicectomy
Retreatment of a failed root filling
*Retreatment of Orthograde is also failed
- Difficulty in removing filling
- Unfilled apical delta
- Original canal cannot be negotiated
- Filling Material has been extruded-with symptoms causing
. deficient apical seal,
9/15/2009 Endo 15 11
12. Procedural difficulty
-Aberrant Anatomy
E.g.,Maxillary molars, Lower incisors, lower premolars
- Unusual root canal configuration
E.g., severe dilacerations
-extensive Secondary dentine formation
E.g.,Ageing process,Calcification
- FractureddIInstrument with symptoms
- Open apex
Vital Ca(oH)2 …………….Apexogenasis
Nonvital Ca(oH)2…………Apexification
Failure Surgery
Conventionally blocked apices
E.g., Existing post in the root canal
---Redo- it/Surgery
9/15/2009 Endo 15 12
13. Surgical repair
latrogenic E.g., Perforated Apex
Pathological---Internal Resorption
---External
Treat with Ca(OH)2 in both occasions, it fails
Surgery
Fracture apical 1/3 of root
When biopsy is required
Cost
Cracked root / tooth
persistent Cyst
Treatment alternatives ?
Diagnostic E.g., biopsy
9/15/2009 Endo 15 13
14. Surgical Technique
Analgesia
Reflection of flap
Location of apex
Curettage of area
Resection of root
Retrograde cavity Preparation
Retrograde filling
Flap replacement
Post op instruction
Suture removal
Follow up
9/15/2009 Endo 15 14
15. Analgesia
1. Anaesthesia
2. Haemostasis – Improved vision
- Less time
- Less blood loss
- Less post op discomfort
Failure to produce good anesthesia is a problem in apical surgery
A. Local
B. General
C. Sedation
9/15/2009 Endo 15 15
17. Flap Designing
Adequate exposure
*Good surgical access
*Visualization
*Lightning
Adequate Blood supply – Avoid tissue necrosis
*Broad base - Adequate blood for margins
Edges of flap should rest on the bone
Clean incisions, it Should not cross -bony eminence e.g.;canine
-neurovascular bundle, ex:
- mental
Healthy Periodontal tissue - lingual, palate
9/15/2009 Endo 15 17
18. Types of flaps
1. Semilunar flap (Partsch incision)
2. Sub marginal (Leubke-orchsenbain)
3. Full mucoperioseteal
----triangular
----rectangular
----trapezoid
----envelope (Horizontal)
9/15/2009 Endo 15 18
19. Semilunar Flap
Simple
Easy to suture
Incision is drawn a semicircle from near the apex of the adjacent
tooth in Apical alveolar mucosa towards the gingival margins
around the area operated on, finishes at the apex of the tooth on the
other side. Margin of the flap should extent up to attach gingivael.
Disadvantages;
Scarring
May lie on unsupported bone if the lesion is larger than
expected
9/15/2009 Endo 15 19
20. Full mucoperioseteal flap
Excellent view
Excellent access
No scaring
Can be extended
Maintain intact vertical blood supply
Problems
-Time consuming
-flap reflection is difficult
-meticulous suturing is necessary
-Possible loss of interdental papilla
9/15/2009 Endo 15 20
21. Reflection of flap
Vertical relieving incisions are placed firmly down the line angle
of the teeth on the either side of the operating teeth in to the
gingival Crevices taking in the gingival papilla.
Horizontal incision made along the gingival crevice
to join the vertical incision
Blade is held in near vertical position
Raised a good mucoperioseteal flap.
9/15/2009 Endo 15 21
22. Location of the apex
-easy when perforated
-use radiographs
- rose head no 1 or tapered fissure bur/ISO 18-24
- priced off the cortical plate
- just exposed the apical area
- Copious irrigation
Curettage
-soft tissues around the apex
to be curetted
-more local at this stage
-uncover the apex
9/15/2009 Endo 15 22
23. Resection of root
Minimum amount of apex is shaved at 300- 450 to provide access to
. the canal ?
Root beveled
Retrograde cavity preparation
-use small ½ or ¼ rose head round bur, ISO 008
- create a simple surface cavity
9/15/2009 Endo 15 23
24. Corrosion
Retrograde root filling
Long term success
-apical area is cleaned with saline. Apical inflammation
-packed the cavity with wet gauze. Mercury ?
-dry with cotton wool.
-Zinc free Amalgam is packed to the cavity.
Hill amalgam carrier.
KG retrograde carrier.
Materials
super EBA Composite resin
IRM Diaket
Glass Ionomer cement MTA
9/15/2009 Endo 15 24
26. Replacement of flap
-4/0 black silk
-vertical mattress
-Suture removalliin 5 days
Post operative period
Pain……………………………Analgesics
Antibiotics
Swelling……………………….ice bags, externally
Discomfort ……………………warm salt water mouth baths
chlorhexidine
Oozing ………………………..24h normal
Activities ………………………Avoid Alchohol / smoking
9/15/2009 Endo 15 26
27. X-rays
Think twice before undertaking
difficult surgical procedure.
Consider carefully risk and benefits of
the surgical procedure.
If you do not have personal skills
always refer to someone with required
skills
Success 25%-90%
9/15/2009 Endo 15 27
28. Tooth which is able to be removed one piece
atruamatically
Curve root teeth not indicated
Perio endo lesions
Root fracture can be cement using dentine
bonding
9/15/2009 Endo 15 28