SlideShare a Scribd company logo
Diagnosis and treatment planning
      in Root Canal Therapy




2/23/2009      Endo 5           1
Examination Procedure
a)     General medical history
b)     C/O-      Currant symptoms, past & recent treatment
c)     H/O/C     Pain – location,nature,duration,stimuli,relief,referred
d)     Clinical examination- swelling, facial asymmetry, periodontal
       disease, discharging sinuous, caries, restoration, fracture, attrition,
       abrasion, erosion, and abfraction
e)     Diagnosis tests – percussion, palpation, mobility, pocket
f)     Pulp sensibility test – electric, cold, heat
g)     Radiographic test - IOPA, tube sift, bite wing, panoramic
h)     Other test – biting on individual cusp, trans-illumination, local
       anaesthesia test, test cavity
i)     Investigations –removal of caries of restoration, trans- illumination
       of cavity.

     2/23/2009                         Endo 5                              2
History

• All the problems be determined diagnosis
  maid, appropriate treatment discussed and
  informed consent should be obtained.
• Demographic, medical and dental history
  should be recorded
• Radiograph is Mandatory. early stages of
  pulpitis are not evident


2/23/2009             Endo 5                  3
Patient selection limitations

               1.    Medically compromised patient
               2.    Very old patient
               3.    Poor oral hygiene
               4.    Retain roots
               5.    Calculi
               6.    Carious teeth
               7.    Restricted mouth opening
               8.    Patient’s attitude
               9.    Patient’s compliance
               10.   Cost

2/23/2009                    Endo 5                  4
Patents requiring antibiotic cover

              1. Hisory of infective endodarditis
              2. Ventricular septal defect
              3. Ductus arteriosus
              4
              4. Coarctation of the aorta
              5. Prosthetic heart valve
              6
              6. Degenerative valve disease
              7. Rheumatic heart disease
              8. Persistent heart murmur
              9. Atrial septal defect repaired with a
                 patch
             10. Chronic debilitating disease
2/23/2009                       Endo 5                  5
Pain
• How long have you had the pain
• Do you know which tooth it is
• What initiate the pain
• How would you describe the pain
• Sharp or dull, throbbing mile or severe, localize
  or radiation
• How long does the pain last
• Does it pain most during the day or night
• Does anything relieve the pain


2/23/2009                 Endo 5                      6
Examination
•       Standard oral Hygiene
•       Amount and quality of Restorative work
•       Prevalence of caries
•       Missing and unopposed teeth
•       General medical condition
•       Presence of soft or hard swelling
•       Presence of any sinus tracts
•       Discolored teeth
•       Tooth wear and facets



2/23/2009                       Endo 5           7
Intra--oral Swelling




2/23/2009           Endo 5         8
Extra--oral Swelling




2/23/2009           Endo 5         9
Extra--oral Swelling




2/23/2009           Endo 5         10
Facial asymmetry




2/23/2009         Endo 5       11
Periodontal disease




2/23/2009           Endo 5        12
Intra--oral discharging sinuous




2/23/2009                Endo 5               13
Extra--oral discharging sinuous




2/23/2009                Endo 5               14
Caries




2/23/2009    Endo 5   15
Heavily restored teeth




2/23/2009            Endo 5          16
Fractured teeth




2/23/2009         Endo 5      17
Pulp Testing
• Moribund pulp may give possitive results, multi
  rooted teeth give complicated results. Ideal way
  of measuring vitality leiser dopler flowmeter
  messure blood flow to the pulp
• Electronic gives false possitive reading due to
  stimulation of PDL
• Thermol pulp test
• Heat guttapercha sticks
• Cold ethil chloride
• ice sticks


2/23/2009                Endo 5                      18
Palpation


                    • Palpation the sight and
                       size of any soft or hard
                       swelling – examine for
                       fluctuation and crepitus




2/23/2009      Endo 5                             19
Percussion


                        • Percussion –
                          gentle tapping with
                          finger – both
                          lateral and vertical




2/23/2009      Endo 5                            20
Mobility


                  • Mobility – slight
                    moderate and
                    extensive – lateral
                    and vertical




2/23/2009     Endo 5                      21
Pockets depth

                      • Standard oral
                        Hygiene




2/23/2009        Endo 5                 22
Biting on individual cusp




                               •Wooden stick test



2/23/2009             Endo 5                        23
Mouth opening



                          • restricted
                            mouth
                            opening




2/23/2009        Endo 5                  24
• Local aneasthetics
• Intra ligamental injection
• Fibro-optic light trans illumination teeth to
   show inter-proximal caries, fracture,
   opacity or discoloration
• Cutting a test cavity




2/23/2009               Endo 5                    25
Indication for root canal treatment


• Post space insufficient tooth substance for
  normal restoration
• Over denture
• Teeth with doubtful pulp
• Periodontal disease
• Pulpal sclerosis following trauma

2/23/2009              Endo 5                   26
Tooth selection limitations
               1.    Unrestorable tooth
               2
               2.    Insufficient periodontal support
               3.    Root fracture
               4.    Bizarre anatomy
               5.    Non-strategic tooth
               6
               6.    External/external resorption
               7.    Procedural accident
               8.    Calcified canal
               9.    Post retained crowns
               10.   Open apex
2/23/2009                      Endo 5                   27
Anatomical complications




2/23/2009              Endo 5          28
Non--functional tooth




2/23/2009            Endo 5         29
External / Internal resorption




2/23/2009                 Endo 5             30
Anatomical defects




2/23/2009           Endo 5       31
Anatomical defects




2/23/2009           Endo 5       32
Procedural accident




2/23/2009            Endo 5       33
Procedural accident - zip perporation




2/23/2009             Endo 5                34
Obstruction of canal – foreign body




2/23/2009              Endo 5               35
Obstruction of canal – fractured instrument




 2/23/2009            Endo 5                  36
Obstruction of canal – calcified canal




2/23/2009              Endo 5                37
Open apex




2/23/2009       Endo 5   38
Contra indication (general)


• Inadequate access –
  Restricted mouth opening
• Poor oral hygiene – patient should be able to
  maintain a healthy mouth
  Patients general medical condition –
• Chronic debilitating disease or very old age
• Patients attitude –
  Patient should be sufficiently educated and
  motivated

2/23/2009                 Endo 5                  39
Contra indication (Local)

• Tooth non restorable supra-gingival and supra-
  crestal
• Insufficient periodontal support
• Non strategic tooth
• Root fracture
• Internal or external resorption
• Bizarre anatomy – exceptionally curved tooth,
  dilacerated teeth, congenital palatal roots,
  unusual anatomy



2/23/2009                Endo 5                    40
Indication for re-treatment

             1.   Signs of infected root canal
             2
             2.   Signs of periapical pathology
             3.   Technically inadequate RCF
             4
             4.   Dislodge of post retain crown
             5.   Broken down crown restorations



2/23/2009                    Endo 5                41
• 90-95% success – no
  periapical lesion
• 80--85%success – preoperative
  periapical lesion
• 60-65% success – re root
  filling
2/23/2009      Endo 5             42

More Related Content

What's hot

Protaper endodontic system
Protaper endodontic systemProtaper endodontic system
Protaper endodontic system
muthanna Al-Jubory
 
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Sung-Ki Kim
 
Principles of intra coronal and radicular preparation
Principles of  intra coronal and radicular preparationPrinciples of  intra coronal and radicular preparation
Principles of intra coronal and radicular preparation
IAU Dent
 
Rotary Endodontic Instruments
Rotary Endodontic InstrumentsRotary Endodontic Instruments
Rotary Endodontic Instruments
Dr. Sahana Umesh
 
Dental elevators
Dental elevatorsDental elevators
Dental elevators
Hesham El-Hawary
 
Minimally invasive endodontics by Dr. JAGADEESH KODITYALA
Minimally invasive endodontics by Dr. JAGADEESH KODITYALAMinimally invasive endodontics by Dr. JAGADEESH KODITYALA
Minimally invasive endodontics by Dr. JAGADEESH KODITYALA
Jagadeesh Kodityala
 
Endodontic instruments /certified fixed orthodontic courses by Indian dental...
Endodontic instruments  /certified fixed orthodontic courses by Indian dental...Endodontic instruments  /certified fixed orthodontic courses by Indian dental...
Endodontic instruments /certified fixed orthodontic courses by Indian dental...
Indian dental academy
 
Anatomy of the pulp space and access cavity
Anatomy of the pulp space and access cavityAnatomy of the pulp space and access cavity
Anatomy of the pulp space and access cavity
Zubia Arshad
 
Endodontic hand files
Endodontic hand filesEndodontic hand files
Endodontic hand files
Shankar Hemam
 
Rotary instruments in Endodontics -part1
Rotary instruments in Endodontics -part1Rotary instruments in Endodontics -part1
Rotary instruments in Endodontics -part1
Neha Bedwal
 
Fluorides
FluoridesFluorides
Fluorides
MonikaIrmal
 
HyFlex CM File
HyFlex CM FileHyFlex CM File
ROTARY ENDODONTICS IN PEDODONTICS
ROTARY ENDODONTICS IN PEDODONTICSROTARY ENDODONTICS IN PEDODONTICS
ROTARY ENDODONTICS IN PEDODONTICS
Dr. SHRUTI SUDARSANAN
 
Space maintainers
Space maintainers Space maintainers
Space maintainers
ashwitha belludi
 
rotary instruments in endodontics
rotary instruments in endodonticsrotary instruments in endodontics
rotary instruments in endodontics
Gurmeen Kaur
 
Root canal morphology nidhi
Root canal morphology  nidhiRoot canal morphology  nidhi
Root canal morphology nidhi
drnids_modern
 
Plaque control
Plaque controlPlaque control
Plaque control
Saeed Bajafar
 
Rationale of endodontics
Rationale of endodonticsRationale of endodontics
Rationale of endodontics
alka shukla
 
periapical pathologies- pulpal origin
periapical pathologies- pulpal originperiapical pathologies- pulpal origin
periapical pathologies- pulpal origin
Gurmeen Kaur
 
Access cavity preparation
Access cavity preparationAccess cavity preparation
Access cavity preparation
IAU Dent
 

What's hot (20)

Protaper endodontic system
Protaper endodontic systemProtaper endodontic system
Protaper endodontic system
 
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
 
Principles of intra coronal and radicular preparation
Principles of  intra coronal and radicular preparationPrinciples of  intra coronal and radicular preparation
Principles of intra coronal and radicular preparation
 
Rotary Endodontic Instruments
Rotary Endodontic InstrumentsRotary Endodontic Instruments
Rotary Endodontic Instruments
 
Dental elevators
Dental elevatorsDental elevators
Dental elevators
 
Minimally invasive endodontics by Dr. JAGADEESH KODITYALA
Minimally invasive endodontics by Dr. JAGADEESH KODITYALAMinimally invasive endodontics by Dr. JAGADEESH KODITYALA
Minimally invasive endodontics by Dr. JAGADEESH KODITYALA
 
Endodontic instruments /certified fixed orthodontic courses by Indian dental...
Endodontic instruments  /certified fixed orthodontic courses by Indian dental...Endodontic instruments  /certified fixed orthodontic courses by Indian dental...
Endodontic instruments /certified fixed orthodontic courses by Indian dental...
 
Anatomy of the pulp space and access cavity
Anatomy of the pulp space and access cavityAnatomy of the pulp space and access cavity
Anatomy of the pulp space and access cavity
 
Endodontic hand files
Endodontic hand filesEndodontic hand files
Endodontic hand files
 
Rotary instruments in Endodontics -part1
Rotary instruments in Endodontics -part1Rotary instruments in Endodontics -part1
Rotary instruments in Endodontics -part1
 
Fluorides
FluoridesFluorides
Fluorides
 
HyFlex CM File
HyFlex CM FileHyFlex CM File
HyFlex CM File
 
ROTARY ENDODONTICS IN PEDODONTICS
ROTARY ENDODONTICS IN PEDODONTICSROTARY ENDODONTICS IN PEDODONTICS
ROTARY ENDODONTICS IN PEDODONTICS
 
Space maintainers
Space maintainers Space maintainers
Space maintainers
 
rotary instruments in endodontics
rotary instruments in endodonticsrotary instruments in endodontics
rotary instruments in endodontics
 
Root canal morphology nidhi
Root canal morphology  nidhiRoot canal morphology  nidhi
Root canal morphology nidhi
 
Plaque control
Plaque controlPlaque control
Plaque control
 
Rationale of endodontics
Rationale of endodonticsRationale of endodontics
Rationale of endodontics
 
periapical pathologies- pulpal origin
periapical pathologies- pulpal originperiapical pathologies- pulpal origin
periapical pathologies- pulpal origin
 
Access cavity preparation
Access cavity preparationAccess cavity preparation
Access cavity preparation
 

Viewers also liked

Wl determination & anatomy of the root apex
Wl determination & anatomy of the root apexWl determination & anatomy of the root apex
Wl determination & anatomy of the root apex
Mahavosh
 
Anatomy of root apex and its significance new
Anatomy of root apex and its significance newAnatomy of root apex and its significance new
Anatomy of root apex and its significance new
Dilu Davis
 
Root Canal Treatment
Root Canal TreatmentRoot Canal Treatment
Root Canal Treatment
endodontics
 
Diagnosis and treatment_planning
Diagnosis and treatment_planningDiagnosis and treatment_planning
Diagnosis and treatment_planning
shabeel pn
 
What is a cavity
What is a cavityWhat is a cavity
What is a cavity
Rosa Dental Sacramento
 
Endo note 10 preparation of straight canal
Endo note 10  preparation of straight canalEndo note 10  preparation of straight canal
Endo note 10 preparation of straight canal
Türk Endodonti Derneği
 
Pro taper system / rotary endodontics courses in india
Pro taper system / rotary endodontics courses in indiaPro taper system / rotary endodontics courses in india
Pro taper system / rotary endodontics courses in india
Indian dental academy
 
Canal preparation for RCT
Canal preparation for RCTCanal preparation for RCT
Canal preparation for RCT
Ali Kazami
 
Working length determination
Working length determinationWorking length determination
Working length determination
Saeed Bajafar
 
Intro to endodontics
Intro to endodonticsIntro to endodontics
Intro to endodontics
IAU Dent
 
Radiographs in endodontic diagnosis
Radiographs in endodontic diagnosisRadiographs in endodontic diagnosis
Radiographs in endodontic diagnosis
liya thomas
 
Introduction to endodontics2009(new)
Introduction to endodontics2009(new)Introduction to endodontics2009(new)
Introduction to endodontics2009(new)
drferas2
 
Determination of root canal working length /certified fixed orthodontic cours...
Determination of root canal working length /certified fixed orthodontic cours...Determination of root canal working length /certified fixed orthodontic cours...
Determination of root canal working length /certified fixed orthodontic cours...
Indian dental academy
 
Working length determination IN ENDODONTICS
Working length determination IN ENDODONTICSWorking length determination IN ENDODONTICS
Working length determination IN ENDODONTICS
Sanghmitra Suman
 
Working length determination
Working length determinationWorking length determination
Working length determination
Choco Holic
 
working length estimation in endodontic
working length estimation in endodontic working length estimation in endodontic
working length estimation in endodontic
Marwa Ahmed
 
Working length determination
Working length determinationWorking length determination
Working length determination
liya thomas
 
Diagnosis in Endodontics
Diagnosis in EndodonticsDiagnosis in Endodontics
Diagnosis in Endodontics
Fatima A
 
Endodontic instruments
Endodontic instrumentsEndodontic instruments
Endodontic instruments
Saeed Bajafar
 
CLEANING AND SHAPING USING ROTARY ENDODONTIC INSTRUMENTS /certified fixed or...
CLEANING AND SHAPING USING ROTARY ENDODONTIC INSTRUMENTS  /certified fixed or...CLEANING AND SHAPING USING ROTARY ENDODONTIC INSTRUMENTS  /certified fixed or...
CLEANING AND SHAPING USING ROTARY ENDODONTIC INSTRUMENTS /certified fixed or...
Indian dental academy
 

Viewers also liked (20)

Wl determination & anatomy of the root apex
Wl determination & anatomy of the root apexWl determination & anatomy of the root apex
Wl determination & anatomy of the root apex
 
Anatomy of root apex and its significance new
Anatomy of root apex and its significance newAnatomy of root apex and its significance new
Anatomy of root apex and its significance new
 
Root Canal Treatment
Root Canal TreatmentRoot Canal Treatment
Root Canal Treatment
 
Diagnosis and treatment_planning
Diagnosis and treatment_planningDiagnosis and treatment_planning
Diagnosis and treatment_planning
 
What is a cavity
What is a cavityWhat is a cavity
What is a cavity
 
Endo note 10 preparation of straight canal
Endo note 10  preparation of straight canalEndo note 10  preparation of straight canal
Endo note 10 preparation of straight canal
 
Pro taper system / rotary endodontics courses in india
Pro taper system / rotary endodontics courses in indiaPro taper system / rotary endodontics courses in india
Pro taper system / rotary endodontics courses in india
 
Canal preparation for RCT
Canal preparation for RCTCanal preparation for RCT
Canal preparation for RCT
 
Working length determination
Working length determinationWorking length determination
Working length determination
 
Intro to endodontics
Intro to endodonticsIntro to endodontics
Intro to endodontics
 
Radiographs in endodontic diagnosis
Radiographs in endodontic diagnosisRadiographs in endodontic diagnosis
Radiographs in endodontic diagnosis
 
Introduction to endodontics2009(new)
Introduction to endodontics2009(new)Introduction to endodontics2009(new)
Introduction to endodontics2009(new)
 
Determination of root canal working length /certified fixed orthodontic cours...
Determination of root canal working length /certified fixed orthodontic cours...Determination of root canal working length /certified fixed orthodontic cours...
Determination of root canal working length /certified fixed orthodontic cours...
 
Working length determination IN ENDODONTICS
Working length determination IN ENDODONTICSWorking length determination IN ENDODONTICS
Working length determination IN ENDODONTICS
 
Working length determination
Working length determinationWorking length determination
Working length determination
 
working length estimation in endodontic
working length estimation in endodontic working length estimation in endodontic
working length estimation in endodontic
 
Working length determination
Working length determinationWorking length determination
Working length determination
 
Diagnosis in Endodontics
Diagnosis in EndodonticsDiagnosis in Endodontics
Diagnosis in Endodontics
 
Endodontic instruments
Endodontic instrumentsEndodontic instruments
Endodontic instruments
 
CLEANING AND SHAPING USING ROTARY ENDODONTIC INSTRUMENTS /certified fixed or...
CLEANING AND SHAPING USING ROTARY ENDODONTIC INSTRUMENTS  /certified fixed or...CLEANING AND SHAPING USING ROTARY ENDODONTIC INSTRUMENTS  /certified fixed or...
CLEANING AND SHAPING USING ROTARY ENDODONTIC INSTRUMENTS /certified fixed or...
 

Similar to Endo note 5 examination

Endo note 18 ledge formation
Endo note 18   ledge formationEndo note 18   ledge formation
Endo note 18 ledge formation
Türk Endodonti Derneği
 
Endo note 17 problem solving in endodontics
Endo note 17   problem solving in endodonticsEndo note 17   problem solving in endodontics
Endo note 17 problem solving in endodontics
Türk Endodonti Derneği
 
vertical root fracture and it's management .....
vertical root fracture and it's management .....vertical root fracture and it's management .....
vertical root fracture and it's management .....
ms khatib
 
Endo note 15 surgical endodoic
Endo note 15   surgical endodoicEndo note 15   surgical endodoic
Endo note 15 surgical endodoic
Türk Endodonti Derneği
 
Endo note 13 perioendolesion
Endo note 13   perioendolesionEndo note 13   perioendolesion
Endo note 13 perioendolesion
Türk Endodonti Derneği
 
Pericoronitis
Pericoronitis  Pericoronitis
Pericoronitis
Achi Joshi
 
Acquired diseases of teeth, Dental materials and Dental radiography in small ...
Acquired diseases of teeth, Dental materials and Dental radiography in small ...Acquired diseases of teeth, Dental materials and Dental radiography in small ...
Acquired diseases of teeth, Dental materials and Dental radiography in small ...
GangaYadav4
 
Advanced restorative dentistry
Advanced restorative dentistryAdvanced restorative dentistry
Advanced restorative dentistry
ZainabMohammed31
 
Furcation - session II
Furcation - session IIFurcation - session II
Furcation - session II
Suman Mukherjee
 
Serial extraction.pptx
Serial extraction.pptxSerial extraction.pptx
Serial extraction.pptx
Aminat Farayola
 
Jaw deformities
Jaw  deformitiesJaw  deformities
Jaw deformities
Dr. SHEETAL KAPSE
 
operativevivaquesin dentistry-170219131358.pdf
operativevivaquesin dentistry-170219131358.pdfoperativevivaquesin dentistry-170219131358.pdf
operativevivaquesin dentistry-170219131358.pdf
vermajaya708
 
Operative Dentistry Viva ques
Operative Dentistry Viva quesOperative Dentistry Viva ques
Operative Dentistry Viva ques
Dr. Almas A
 
Overdenture(part 2)
Overdenture(part 2)Overdenture(part 2)
Overdenture(part 2)
Noor Addeen Abo Arsheed
 
Failure of pdf
Failure of pdfFailure of pdf
Failure of pdf
Mai Shawkat
 
Orthodontic & endodontics correlation.pptx
Orthodontic & endodontics correlation.pptxOrthodontic & endodontics correlation.pptx
Orthodontic & endodontics correlation.pptx
Hazimrizk1
 
Gingivectomy
GingivectomyGingivectomy
Gingivectomy
Wendy Jeng
 
Endo note 1 definition and history
Endo note 1    definition and historyEndo note 1    definition and history
Endo note 1 definition and history
Türk Endodonti Derneği
 
11 management of furcation defects
11 management of furcation defects 11 management of furcation defects
11 management of furcation defects
Perio Files
 
treatment of talon cusp in children
treatment of talon cusp in childrentreatment of talon cusp in children
treatment of talon cusp in children
DeepthiS41
 

Similar to Endo note 5 examination (20)

Endo note 18 ledge formation
Endo note 18   ledge formationEndo note 18   ledge formation
Endo note 18 ledge formation
 
Endo note 17 problem solving in endodontics
Endo note 17   problem solving in endodonticsEndo note 17   problem solving in endodontics
Endo note 17 problem solving in endodontics
 
vertical root fracture and it's management .....
vertical root fracture and it's management .....vertical root fracture and it's management .....
vertical root fracture and it's management .....
 
Endo note 15 surgical endodoic
Endo note 15   surgical endodoicEndo note 15   surgical endodoic
Endo note 15 surgical endodoic
 
Endo note 13 perioendolesion
Endo note 13   perioendolesionEndo note 13   perioendolesion
Endo note 13 perioendolesion
 
Pericoronitis
Pericoronitis  Pericoronitis
Pericoronitis
 
Acquired diseases of teeth, Dental materials and Dental radiography in small ...
Acquired diseases of teeth, Dental materials and Dental radiography in small ...Acquired diseases of teeth, Dental materials and Dental radiography in small ...
Acquired diseases of teeth, Dental materials and Dental radiography in small ...
 
Advanced restorative dentistry
Advanced restorative dentistryAdvanced restorative dentistry
Advanced restorative dentistry
 
Furcation - session II
Furcation - session IIFurcation - session II
Furcation - session II
 
Serial extraction.pptx
Serial extraction.pptxSerial extraction.pptx
Serial extraction.pptx
 
Jaw deformities
Jaw  deformitiesJaw  deformities
Jaw deformities
 
operativevivaquesin dentistry-170219131358.pdf
operativevivaquesin dentistry-170219131358.pdfoperativevivaquesin dentistry-170219131358.pdf
operativevivaquesin dentistry-170219131358.pdf
 
Operative Dentistry Viva ques
Operative Dentistry Viva quesOperative Dentistry Viva ques
Operative Dentistry Viva ques
 
Overdenture(part 2)
Overdenture(part 2)Overdenture(part 2)
Overdenture(part 2)
 
Failure of pdf
Failure of pdfFailure of pdf
Failure of pdf
 
Orthodontic & endodontics correlation.pptx
Orthodontic & endodontics correlation.pptxOrthodontic & endodontics correlation.pptx
Orthodontic & endodontics correlation.pptx
 
Gingivectomy
GingivectomyGingivectomy
Gingivectomy
 
Endo note 1 definition and history
Endo note 1    definition and historyEndo note 1    definition and history
Endo note 1 definition and history
 
11 management of furcation defects
11 management of furcation defects 11 management of furcation defects
11 management of furcation defects
 
treatment of talon cusp in children
treatment of talon cusp in childrentreatment of talon cusp in children
treatment of talon cusp in children
 

More from Türk Endodonti Derneği

Pedodontic endodontics-and4951
Pedodontic endodontics-and4951Pedodontic endodontics-and4951
Pedodontic endodontics-and4951
Türk Endodonti Derneği
 
Rotary ii
Rotary iiRotary ii
Diagnosis tx-planning
Diagnosis tx-planningDiagnosis tx-planning
Diagnosis tx-planning
Türk Endodonti Derneği
 
Local anaesthesia 07 03 22 compressed
Local anaesthesia 07 03 22 compressedLocal anaesthesia 07 03 22 compressed
Local anaesthesia 07 03 22 compressed
Türk Endodonti Derneği
 
Self study-pan-anatomy
Self study-pan-anatomySelf study-pan-anatomy
Self study-pan-anatomy
Türk Endodonti Derneği
 
Endo note 16 restoration of root filled
Endo note 16  restoration of root filledEndo note 16  restoration of root filled
Endo note 16 restoration of root filled
Türk Endodonti Derneği
 
Ms 8 protaper
Ms 8  protaperMs 8  protaper
Endo note 14 root resorption
Endo note 14   root resorptionEndo note 14   root resorption
Endo note 14 root resorption
Türk Endodonti Derneği
 
D 2 access cavity
D 2  access cavityD 2  access cavity
D 2 access cavity
Türk Endodonti Derneği
 
Endo note 11 peparation of curved root canal
Endo note 11   peparation of curved root canalEndo note 11   peparation of curved root canal
Endo note 11 peparation of curved root canal
Türk Endodonti Derneği
 
Endo note 12 rotary technique
Endo note 12   rotary techniqueEndo note 12   rotary technique
Endo note 12 rotary technique
Türk Endodonti Derneği
 
Endo note 4 instruments
Endo note 4   instrumentsEndo note 4   instruments
Endo note 4 instruments
Türk Endodonti Derneği
 
Endo note 2 iintroduction
Endo note 2   iintroductionEndo note 2   iintroduction
Endo note 2 iintroduction
Türk Endodonti Derneği
 
Microbiology aspect in endodontics
Microbiology aspect in endodonticsMicrobiology aspect in endodontics
Microbiology aspect in endodontics
Türk Endodonti Derneği
 
Endodontics Chapter 54
Endodontics Chapter 54Endodontics Chapter 54
Endodontics Chapter 54
Türk Endodonti Derneği
 

More from Türk Endodonti Derneği (15)

Pedodontic endodontics-and4951
Pedodontic endodontics-and4951Pedodontic endodontics-and4951
Pedodontic endodontics-and4951
 
Rotary ii
Rotary iiRotary ii
Rotary ii
 
Diagnosis tx-planning
Diagnosis tx-planningDiagnosis tx-planning
Diagnosis tx-planning
 
Local anaesthesia 07 03 22 compressed
Local anaesthesia 07 03 22 compressedLocal anaesthesia 07 03 22 compressed
Local anaesthesia 07 03 22 compressed
 
Self study-pan-anatomy
Self study-pan-anatomySelf study-pan-anatomy
Self study-pan-anatomy
 
Endo note 16 restoration of root filled
Endo note 16  restoration of root filledEndo note 16  restoration of root filled
Endo note 16 restoration of root filled
 
Ms 8 protaper
Ms 8  protaperMs 8  protaper
Ms 8 protaper
 
Endo note 14 root resorption
Endo note 14   root resorptionEndo note 14   root resorption
Endo note 14 root resorption
 
D 2 access cavity
D 2  access cavityD 2  access cavity
D 2 access cavity
 
Endo note 11 peparation of curved root canal
Endo note 11   peparation of curved root canalEndo note 11   peparation of curved root canal
Endo note 11 peparation of curved root canal
 
Endo note 12 rotary technique
Endo note 12   rotary techniqueEndo note 12   rotary technique
Endo note 12 rotary technique
 
Endo note 4 instruments
Endo note 4   instrumentsEndo note 4   instruments
Endo note 4 instruments
 
Endo note 2 iintroduction
Endo note 2   iintroductionEndo note 2   iintroduction
Endo note 2 iintroduction
 
Microbiology aspect in endodontics
Microbiology aspect in endodonticsMicrobiology aspect in endodontics
Microbiology aspect in endodontics
 
Endodontics Chapter 54
Endodontics Chapter 54Endodontics Chapter 54
Endodontics Chapter 54
 

Recently uploaded

BÀI TẬP BỔ TRỢ TIẾNG ANH LỚP 9 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2024-2025 - ...
BÀI TẬP BỔ TRỢ TIẾNG ANH LỚP 9 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2024-2025 - ...BÀI TẬP BỔ TRỢ TIẾNG ANH LỚP 9 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2024-2025 - ...
BÀI TẬP BỔ TRỢ TIẾNG ANH LỚP 9 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2024-2025 - ...
Nguyen Thanh Tu Collection
 
Chapter wise All Notes of First year Basic Civil Engineering.pptx
Chapter wise All Notes of First year Basic Civil Engineering.pptxChapter wise All Notes of First year Basic Civil Engineering.pptx
Chapter wise All Notes of First year Basic Civil Engineering.pptx
Denish Jangid
 
Your Skill Boost Masterclass: Strategies for Effective Upskilling
Your Skill Boost Masterclass: Strategies for Effective UpskillingYour Skill Boost Masterclass: Strategies for Effective Upskilling
Your Skill Boost Masterclass: Strategies for Effective Upskilling
Excellence Foundation for South Sudan
 
BBR 2024 Summer Sessions Interview Training
BBR  2024 Summer Sessions Interview TrainingBBR  2024 Summer Sessions Interview Training
BBR 2024 Summer Sessions Interview Training
Katrina Pritchard
 
Philippine Edukasyong Pantahanan at Pangkabuhayan (EPP) Curriculum
Philippine Edukasyong Pantahanan at Pangkabuhayan (EPP) CurriculumPhilippine Edukasyong Pantahanan at Pangkabuhayan (EPP) Curriculum
Philippine Edukasyong Pantahanan at Pangkabuhayan (EPP) Curriculum
MJDuyan
 
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...
PECB
 
UGC NET Exam Paper 1- Unit 1:Teaching Aptitude
UGC NET Exam Paper 1- Unit 1:Teaching AptitudeUGC NET Exam Paper 1- Unit 1:Teaching Aptitude
UGC NET Exam Paper 1- Unit 1:Teaching Aptitude
S. Raj Kumar
 
spot a liar (Haiqa 146).pptx Technical writhing and presentation skills
spot a liar (Haiqa 146).pptx Technical writhing and presentation skillsspot a liar (Haiqa 146).pptx Technical writhing and presentation skills
spot a liar (Haiqa 146).pptx Technical writhing and presentation skills
haiqairshad
 
clinical examination of hip joint (1).pdf
clinical examination of hip joint (1).pdfclinical examination of hip joint (1).pdf
clinical examination of hip joint (1).pdf
Priyankaranawat4
 
Main Java[All of the Base Concepts}.docx
Main Java[All of the Base Concepts}.docxMain Java[All of the Base Concepts}.docx
Main Java[All of the Base Concepts}.docx
adhitya5119
 
RHEOLOGY Physical pharmaceutics-II notes for B.pharm 4th sem students
RHEOLOGY Physical pharmaceutics-II notes for B.pharm 4th sem studentsRHEOLOGY Physical pharmaceutics-II notes for B.pharm 4th sem students
RHEOLOGY Physical pharmaceutics-II notes for B.pharm 4th sem students
Himanshu Rai
 
Hindi varnamala | hindi alphabet PPT.pdf
Hindi varnamala | hindi alphabet PPT.pdfHindi varnamala | hindi alphabet PPT.pdf
Hindi varnamala | hindi alphabet PPT.pdf
Dr. Mulla Adam Ali
 
Solutons Maths Escape Room Spatial .pptx
Solutons Maths Escape Room Spatial .pptxSolutons Maths Escape Room Spatial .pptx
Solutons Maths Escape Room Spatial .pptx
spdendr
 
ZK on Polkadot zero knowledge proofs - sub0.pptx
ZK on Polkadot zero knowledge proofs - sub0.pptxZK on Polkadot zero knowledge proofs - sub0.pptx
ZK on Polkadot zero knowledge proofs - sub0.pptx
dot55audits
 
NEWSPAPERS - QUESTION 1 - REVISION POWERPOINT.pptx
NEWSPAPERS - QUESTION 1 - REVISION POWERPOINT.pptxNEWSPAPERS - QUESTION 1 - REVISION POWERPOINT.pptx
NEWSPAPERS - QUESTION 1 - REVISION POWERPOINT.pptx
iammrhaywood
 
Wound healing PPT
Wound healing PPTWound healing PPT
Wound healing PPT
Jyoti Chand
 
Walmart Business+ and Spark Good for Nonprofits.pdf
Walmart Business+ and Spark Good for Nonprofits.pdfWalmart Business+ and Spark Good for Nonprofits.pdf
Walmart Business+ and Spark Good for Nonprofits.pdf
TechSoup
 
MARY JANE WILSON, A “BOA MÃE” .
MARY JANE WILSON, A “BOA MÃE”           .MARY JANE WILSON, A “BOA MÃE”           .
MARY JANE WILSON, A “BOA MÃE” .
Colégio Santa Teresinha
 
Advanced Java[Extra Concepts, Not Difficult].docx
Advanced Java[Extra Concepts, Not Difficult].docxAdvanced Java[Extra Concepts, Not Difficult].docx
Advanced Java[Extra Concepts, Not Difficult].docx
adhitya5119
 
ANATOMY AND BIOMECHANICS OF HIP JOINT.pdf
ANATOMY AND BIOMECHANICS OF HIP JOINT.pdfANATOMY AND BIOMECHANICS OF HIP JOINT.pdf
ANATOMY AND BIOMECHANICS OF HIP JOINT.pdf
Priyankaranawat4
 

Recently uploaded (20)

BÀI TẬP BỔ TRỢ TIẾNG ANH LỚP 9 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2024-2025 - ...
BÀI TẬP BỔ TRỢ TIẾNG ANH LỚP 9 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2024-2025 - ...BÀI TẬP BỔ TRỢ TIẾNG ANH LỚP 9 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2024-2025 - ...
BÀI TẬP BỔ TRỢ TIẾNG ANH LỚP 9 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2024-2025 - ...
 
Chapter wise All Notes of First year Basic Civil Engineering.pptx
Chapter wise All Notes of First year Basic Civil Engineering.pptxChapter wise All Notes of First year Basic Civil Engineering.pptx
Chapter wise All Notes of First year Basic Civil Engineering.pptx
 
Your Skill Boost Masterclass: Strategies for Effective Upskilling
Your Skill Boost Masterclass: Strategies for Effective UpskillingYour Skill Boost Masterclass: Strategies for Effective Upskilling
Your Skill Boost Masterclass: Strategies for Effective Upskilling
 
BBR 2024 Summer Sessions Interview Training
BBR  2024 Summer Sessions Interview TrainingBBR  2024 Summer Sessions Interview Training
BBR 2024 Summer Sessions Interview Training
 
Philippine Edukasyong Pantahanan at Pangkabuhayan (EPP) Curriculum
Philippine Edukasyong Pantahanan at Pangkabuhayan (EPP) CurriculumPhilippine Edukasyong Pantahanan at Pangkabuhayan (EPP) Curriculum
Philippine Edukasyong Pantahanan at Pangkabuhayan (EPP) Curriculum
 
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...
 
UGC NET Exam Paper 1- Unit 1:Teaching Aptitude
UGC NET Exam Paper 1- Unit 1:Teaching AptitudeUGC NET Exam Paper 1- Unit 1:Teaching Aptitude
UGC NET Exam Paper 1- Unit 1:Teaching Aptitude
 
spot a liar (Haiqa 146).pptx Technical writhing and presentation skills
spot a liar (Haiqa 146).pptx Technical writhing and presentation skillsspot a liar (Haiqa 146).pptx Technical writhing and presentation skills
spot a liar (Haiqa 146).pptx Technical writhing and presentation skills
 
clinical examination of hip joint (1).pdf
clinical examination of hip joint (1).pdfclinical examination of hip joint (1).pdf
clinical examination of hip joint (1).pdf
 
Main Java[All of the Base Concepts}.docx
Main Java[All of the Base Concepts}.docxMain Java[All of the Base Concepts}.docx
Main Java[All of the Base Concepts}.docx
 
RHEOLOGY Physical pharmaceutics-II notes for B.pharm 4th sem students
RHEOLOGY Physical pharmaceutics-II notes for B.pharm 4th sem studentsRHEOLOGY Physical pharmaceutics-II notes for B.pharm 4th sem students
RHEOLOGY Physical pharmaceutics-II notes for B.pharm 4th sem students
 
Hindi varnamala | hindi alphabet PPT.pdf
Hindi varnamala | hindi alphabet PPT.pdfHindi varnamala | hindi alphabet PPT.pdf
Hindi varnamala | hindi alphabet PPT.pdf
 
Solutons Maths Escape Room Spatial .pptx
Solutons Maths Escape Room Spatial .pptxSolutons Maths Escape Room Spatial .pptx
Solutons Maths Escape Room Spatial .pptx
 
ZK on Polkadot zero knowledge proofs - sub0.pptx
ZK on Polkadot zero knowledge proofs - sub0.pptxZK on Polkadot zero knowledge proofs - sub0.pptx
ZK on Polkadot zero knowledge proofs - sub0.pptx
 
NEWSPAPERS - QUESTION 1 - REVISION POWERPOINT.pptx
NEWSPAPERS - QUESTION 1 - REVISION POWERPOINT.pptxNEWSPAPERS - QUESTION 1 - REVISION POWERPOINT.pptx
NEWSPAPERS - QUESTION 1 - REVISION POWERPOINT.pptx
 
Wound healing PPT
Wound healing PPTWound healing PPT
Wound healing PPT
 
Walmart Business+ and Spark Good for Nonprofits.pdf
Walmart Business+ and Spark Good for Nonprofits.pdfWalmart Business+ and Spark Good for Nonprofits.pdf
Walmart Business+ and Spark Good for Nonprofits.pdf
 
MARY JANE WILSON, A “BOA MÃE” .
MARY JANE WILSON, A “BOA MÃE”           .MARY JANE WILSON, A “BOA MÃE”           .
MARY JANE WILSON, A “BOA MÃE” .
 
Advanced Java[Extra Concepts, Not Difficult].docx
Advanced Java[Extra Concepts, Not Difficult].docxAdvanced Java[Extra Concepts, Not Difficult].docx
Advanced Java[Extra Concepts, Not Difficult].docx
 
ANATOMY AND BIOMECHANICS OF HIP JOINT.pdf
ANATOMY AND BIOMECHANICS OF HIP JOINT.pdfANATOMY AND BIOMECHANICS OF HIP JOINT.pdf
ANATOMY AND BIOMECHANICS OF HIP JOINT.pdf
 

Endo note 5 examination

  • 1. Diagnosis and treatment planning in Root Canal Therapy 2/23/2009 Endo 5 1
  • 2. Examination Procedure a) General medical history b) C/O- Currant symptoms, past & recent treatment c) H/O/C Pain – location,nature,duration,stimuli,relief,referred d) Clinical examination- swelling, facial asymmetry, periodontal disease, discharging sinuous, caries, restoration, fracture, attrition, abrasion, erosion, and abfraction e) Diagnosis tests – percussion, palpation, mobility, pocket f) Pulp sensibility test – electric, cold, heat g) Radiographic test - IOPA, tube sift, bite wing, panoramic h) Other test – biting on individual cusp, trans-illumination, local anaesthesia test, test cavity i) Investigations –removal of caries of restoration, trans- illumination of cavity. 2/23/2009 Endo 5 2
  • 3. History • All the problems be determined diagnosis maid, appropriate treatment discussed and informed consent should be obtained. • Demographic, medical and dental history should be recorded • Radiograph is Mandatory. early stages of pulpitis are not evident 2/23/2009 Endo 5 3
  • 4. Patient selection limitations 1. Medically compromised patient 2. Very old patient 3. Poor oral hygiene 4. Retain roots 5. Calculi 6. Carious teeth 7. Restricted mouth opening 8. Patient’s attitude 9. Patient’s compliance 10. Cost 2/23/2009 Endo 5 4
  • 5. Patents requiring antibiotic cover 1. Hisory of infective endodarditis 2. Ventricular septal defect 3. Ductus arteriosus 4 4. Coarctation of the aorta 5. Prosthetic heart valve 6 6. Degenerative valve disease 7. Rheumatic heart disease 8. Persistent heart murmur 9. Atrial septal defect repaired with a patch 10. Chronic debilitating disease 2/23/2009 Endo 5 5
  • 6. Pain • How long have you had the pain • Do you know which tooth it is • What initiate the pain • How would you describe the pain • Sharp or dull, throbbing mile or severe, localize or radiation • How long does the pain last • Does it pain most during the day or night • Does anything relieve the pain 2/23/2009 Endo 5 6
  • 7. Examination • Standard oral Hygiene • Amount and quality of Restorative work • Prevalence of caries • Missing and unopposed teeth • General medical condition • Presence of soft or hard swelling • Presence of any sinus tracts • Discolored teeth • Tooth wear and facets 2/23/2009 Endo 5 7
  • 15. Caries 2/23/2009 Endo 5 15
  • 18. Pulp Testing • Moribund pulp may give possitive results, multi rooted teeth give complicated results. Ideal way of measuring vitality leiser dopler flowmeter messure blood flow to the pulp • Electronic gives false possitive reading due to stimulation of PDL • Thermol pulp test • Heat guttapercha sticks • Cold ethil chloride • ice sticks 2/23/2009 Endo 5 18
  • 19. Palpation • Palpation the sight and size of any soft or hard swelling – examine for fluctuation and crepitus 2/23/2009 Endo 5 19
  • 20. Percussion • Percussion – gentle tapping with finger – both lateral and vertical 2/23/2009 Endo 5 20
  • 21. Mobility • Mobility – slight moderate and extensive – lateral and vertical 2/23/2009 Endo 5 21
  • 22. Pockets depth • Standard oral Hygiene 2/23/2009 Endo 5 22
  • 23. Biting on individual cusp •Wooden stick test 2/23/2009 Endo 5 23
  • 24. Mouth opening • restricted mouth opening 2/23/2009 Endo 5 24
  • 25. • Local aneasthetics • Intra ligamental injection • Fibro-optic light trans illumination teeth to show inter-proximal caries, fracture, opacity or discoloration • Cutting a test cavity 2/23/2009 Endo 5 25
  • 26. Indication for root canal treatment • Post space insufficient tooth substance for normal restoration • Over denture • Teeth with doubtful pulp • Periodontal disease • Pulpal sclerosis following trauma 2/23/2009 Endo 5 26
  • 27. Tooth selection limitations 1. Unrestorable tooth 2 2. Insufficient periodontal support 3. Root fracture 4. Bizarre anatomy 5. Non-strategic tooth 6 6. External/external resorption 7. Procedural accident 8. Calcified canal 9. Post retained crowns 10. Open apex 2/23/2009 Endo 5 27
  • 30. External / Internal resorption 2/23/2009 Endo 5 30
  • 34. Procedural accident - zip perporation 2/23/2009 Endo 5 34
  • 35. Obstruction of canal – foreign body 2/23/2009 Endo 5 35
  • 36. Obstruction of canal – fractured instrument 2/23/2009 Endo 5 36
  • 37. Obstruction of canal – calcified canal 2/23/2009 Endo 5 37
  • 38. Open apex 2/23/2009 Endo 5 38
  • 39. Contra indication (general) • Inadequate access – Restricted mouth opening • Poor oral hygiene – patient should be able to maintain a healthy mouth Patients general medical condition – • Chronic debilitating disease or very old age • Patients attitude – Patient should be sufficiently educated and motivated 2/23/2009 Endo 5 39
  • 40. Contra indication (Local) • Tooth non restorable supra-gingival and supra- crestal • Insufficient periodontal support • Non strategic tooth • Root fracture • Internal or external resorption • Bizarre anatomy – exceptionally curved tooth, dilacerated teeth, congenital palatal roots, unusual anatomy 2/23/2009 Endo 5 40
  • 41. Indication for re-treatment 1. Signs of infected root canal 2 2. Signs of periapical pathology 3. Technically inadequate RCF 4 4. Dislodge of post retain crown 5. Broken down crown restorations 2/23/2009 Endo 5 41
  • 42. • 90-95% success – no periapical lesion • 80--85%success – preoperative periapical lesion • 60-65% success – re root filling 2/23/2009 Endo 5 42