This document discusses techniques for endodontic access that minimize damage to tooth structure. It emphasizes maintaining a 360 degree "soffit" or roof around the pulp chamber to strengthen the tooth. Traditional access using round burs is described as damaging, while a new tapered bur technique called "Ninja preparation" aims to create smoother walls and minimize gouges. References are provided on topics like moisture loss in root canal treated teeth, their increased brittleness, and concepts of minimally invasive endodontics.
A detailed presentation on Endodontic failures starting from the basics in case selection to final prosthesis. Good for Post Graduates and Under Graduates.
This presentation is all about restoration of endodontically treated teeth, prefabricated post and core, cast post and core, direct and indirect technique.
Current Concepts in Access Cavity PreparationUrvashi Tanwar
1) Traditional access cavity preparations using large round burs and Gates Glidden drills can remove excessive tooth structure and weaken teeth.
2) A more conservative access design called the "inverse funnel" or "blind funneling" is proposed to preserve the critical peri-cervical dentin through use of smaller tapered burs and partial de-roofing of the pulp chamber while still allowing for adequate debridement and obturation.
3) A study found that endodontically treated teeth with preservation of the peri-cervical dentin and pulp chamber "soffit" had greater fracture resistance compared to traditional access preparations due to reinforcement of remaining tooth structure.
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.
A detailed presentation on Endodontic failures starting from the basics in case selection to final prosthesis. Good for Post Graduates and Under Graduates.
This presentation is all about restoration of endodontically treated teeth, prefabricated post and core, cast post and core, direct and indirect technique.
Current Concepts in Access Cavity PreparationUrvashi Tanwar
1) Traditional access cavity preparations using large round burs and Gates Glidden drills can remove excessive tooth structure and weaken teeth.
2) A more conservative access design called the "inverse funnel" or "blind funneling" is proposed to preserve the critical peri-cervical dentin through use of smaller tapered burs and partial de-roofing of the pulp chamber while still allowing for adequate debridement and obturation.
3) A study found that endodontically treated teeth with preservation of the peri-cervical dentin and pulp chamber "soffit" had greater fracture resistance compared to traditional access preparations due to reinforcement of remaining tooth structure.
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 discusses open apex and apexification treatment. It defines open apex as an immature root with incomplete development and a large apical opening. Treatment depends on pulp vitality - apexogenesis aims to encourage continued root development if the pulp is vital, while apexification induces apical closure if the pulp is necrotic. The document outlines the stages of root development, causes of open apex, complications, diagnosis, and various treatment options and materials used for apexogenesis and apexification such as calcium hydroxide, MTA, and Biodentine.
The document discusses cleaning and shaping objectives, principles, and techniques in endodontics. It aims to remove canal contents, irregularities, and obstructions while maintaining the original canal anatomy and foramen size. Cleaning is achieved through instrumentation and irrigation, assessed by debris removal and smooth canal walls. Shaping provides a continuously tapering preparation from crown to apex. Working length is 1 mm from the radiographic apex. Techniques include step-back preparation from apex to crown in phases using increasingly larger instruments supplemented by irrigation and recapitulation.
introduction, history of rotary instruments in endodontics, classification, properties of NiTi, generations and design features, rotary file systems available
Recent concepts in post endodontic restorationshemam22
This document discusses recent concepts in post endodontic restorations. It notes that with advances in adhesive dentistry, there are now multiple treatment options for restoring endodontically treated teeth. However, determining whether cuspal coverage is needed and selecting the appropriate treatment can be challenging. There has been a paradigm shift from relying on mechanical retention to using adhesion. The document discusses several key concepts including the importance of preserving remaining tooth structure and establishing a ferrule effect to strengthen the restoration and resist forces.
This document discusses irrigation in endodontics. It provides an introduction to irrigation solutions and devices used, challenges of irrigation, and recent advances. It describes the ideal characteristics of endodontic irrigants and commonly used solutions such as sodium hypochlorite. Sodium hypochlorite is the current irrigant of choice and its properties, concentrations, effects on dentin, and safety considerations are discussed in detail. The document concludes by emphasizing the importance of irrigation in endodontic treatment.
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.
The document provides an overview of esthetics with veneers. It discusses the definitions, history, indications and contraindications of veneers. It describes the processes of shade selection, tooth preparation including principles, rationale and types of preparation. It also discusses provisional restorations, cementation, maintenance and failures of veneers. Recent advancements discussed include feldspathic, lithium disilicate and minimally invasive veneers. In conclusion, veneers are a conservative treatment for improving aesthetics when done according to principles of preparation, cementation and maintenance.
The document discusses various endodontic mishaps that can occur during root canal treatment. It describes mishaps related to access preparation, instrumentation, and obturation. Access-related mishaps include treating the wrong tooth, missing canals, damaging existing restorations, perforating the access cavity, and crown fractures. Instrumentation mishaps include ledge formation, perforating the root, and separated instruments. Obturation mishaps include overfilling or underfilling the canal. The document provides details on the causes, recognition, correction, prevention and prognosis of several common endodontic mishaps.
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.
This document discusses factors that affect the success and failure of endodontic (root canal) treatments. It defines what constitutes success, failure, healing and disease. The main factors discussed are incomplete removal of infected tissues from the root canal, ledge formation, separated instruments, overfilling, and anatomic variations. Clinical signs of success are absence of symptoms, while radiographic signs include lack of periapical radiolucency. Retreatment may be needed if the initial treatment is deemed incomplete or unsuccessful.
This document provides an overview of dentin bonding agents. It discusses the history and development of bonding agents from the 1950s to present. Key topics covered include the bonding mechanism, ideal requirements, microstructure of dentin, smear layer, etching of enamel and dentin, hybridization, reverse hybrid layer, wet vs dry bonding, and classifications of dentin bonding agents. The document aims to describe the important concepts and advances in dentin bonding for adhesive dentistry.
The endo-crown is a conservative restoration for endodontically treated teeth that have lost significant coronal structure. It involves preparing the tooth with a 2mm occlusal reduction and cylindrical cavity into the pulp chamber. The endo-crown is then bonded into the cavity as a single ceramic piece, providing strength while preserving tooth structure compared to traditional crowns. Studies have shown endo-crowns distribute stresses similarly to natural teeth and provide effective, long-lasting restorations for molars with extensive decay or fractures.
This document discusses root canal curvatures and methods for determining their degree. It begins with an introduction on the importance of understanding root canal anatomy for successful endodontic treatment. It then covers causes of canal curvatures, various classification systems, and techniques for assessing curvature using periapical radiographs, cone-beam computed tomography, and angular measurement methods. The relationship between curvature degree and ledge formation risk is also addressed, as are canal characteristics often invisible on routine radiographs. The document concludes by emphasizing the challenges of treating severely curved canals and the need for accurate preoperative assessment and proper instrumentation.
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 various obturation techniques for filling root canals including:
1. Cold lateral compaction, the most widely used technique, involves inserting a master cone coated with sealer followed by lateral compaction of accessory cones.
2. Warm vertical compaction uses heated pluggers to vertically compact gutta percha that has been softened with heat.
3. Carrier-based techniques like Thermafil involve heating and inserting a gutta percha coated metal core carrier into the canal.
The document provides details on how to perform each technique and their advantages and disadvantages. A variety of materials can be used for obturation including gutta percha, resins, and single cone techniques.
This document discusses the ferrule effect in restoring endodontically treated teeth. It defines a ferrule as a band of metal encircling the coronal tooth structure that extends at least 1.5-2mm below the finish line. The presence of a ferrule helps resist fracture by reinforcing the tooth against lever forces and post insertion stresses. It also helps prevent root fractures. An adequate ferrule requires sufficient height, width, and number of surrounding walls. Teeth can be classified based on their ferrule characteristics into categories with varying risk levels. When little structure remains, crown lengthening or orthodontic extrusion may help create a ferrule, but extraction may be a better option if
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.
Endodontic mishaps include procedural errors that can occur during root canal treatment such as ledge formation, canal perforation, separated instruments, and overfilling/underfilling of canals. It is important for practitioners to understand how to recognize, prevent, and treat these mishaps. Common causes include inadequate access, excessive force, or improper instrument use. Perforations require immediate sealing with materials like MTA to achieve the best prognosis. Separated instruments may be bypassed or retrieved, while ledges can sometimes be circumvented with smaller files. Overall, minimizing errors requires adherence to principles like conservative access, copious irrigation, and careful instrumentation.
This document discusses various types and classifications of posts used in restoring endodontically treated teeth. It describes custom cast posts and prefabricated metallic and non-metallic posts. Metallic posts discussed include stainless steel, titanium, and fiber posts made of carbon, glass or quartz. The advantages and disadvantages of different post types are provided. Active and passive posts as well as parallel and tapered posts are also summarized. The document stresses the importance of a thorough pretreatment evaluation involving endodontic, periodontal, biomechanical and anatomic factors when determining the best post and core treatment strategy.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Design of a fixed Partial Denture (with Abutment Tooth Preparation)Taseef Hasan Farook
A simplified take on the steps to designing a Fixed partial denture. This presentation also includes an overview of abutment preparation, associated finishes and methods of impression taking prior to the designing of the prosthesis itself
This document discusses open apex and apexification treatment. It defines open apex as an immature root with incomplete development and a large apical opening. Treatment depends on pulp vitality - apexogenesis aims to encourage continued root development if the pulp is vital, while apexification induces apical closure if the pulp is necrotic. The document outlines the stages of root development, causes of open apex, complications, diagnosis, and various treatment options and materials used for apexogenesis and apexification such as calcium hydroxide, MTA, and Biodentine.
The document discusses cleaning and shaping objectives, principles, and techniques in endodontics. It aims to remove canal contents, irregularities, and obstructions while maintaining the original canal anatomy and foramen size. Cleaning is achieved through instrumentation and irrigation, assessed by debris removal and smooth canal walls. Shaping provides a continuously tapering preparation from crown to apex. Working length is 1 mm from the radiographic apex. Techniques include step-back preparation from apex to crown in phases using increasingly larger instruments supplemented by irrigation and recapitulation.
introduction, history of rotary instruments in endodontics, classification, properties of NiTi, generations and design features, rotary file systems available
Recent concepts in post endodontic restorationshemam22
This document discusses recent concepts in post endodontic restorations. It notes that with advances in adhesive dentistry, there are now multiple treatment options for restoring endodontically treated teeth. However, determining whether cuspal coverage is needed and selecting the appropriate treatment can be challenging. There has been a paradigm shift from relying on mechanical retention to using adhesion. The document discusses several key concepts including the importance of preserving remaining tooth structure and establishing a ferrule effect to strengthen the restoration and resist forces.
This document discusses irrigation in endodontics. It provides an introduction to irrigation solutions and devices used, challenges of irrigation, and recent advances. It describes the ideal characteristics of endodontic irrigants and commonly used solutions such as sodium hypochlorite. Sodium hypochlorite is the current irrigant of choice and its properties, concentrations, effects on dentin, and safety considerations are discussed in detail. The document concludes by emphasizing the importance of irrigation in endodontic treatment.
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.
The document provides an overview of esthetics with veneers. It discusses the definitions, history, indications and contraindications of veneers. It describes the processes of shade selection, tooth preparation including principles, rationale and types of preparation. It also discusses provisional restorations, cementation, maintenance and failures of veneers. Recent advancements discussed include feldspathic, lithium disilicate and minimally invasive veneers. In conclusion, veneers are a conservative treatment for improving aesthetics when done according to principles of preparation, cementation and maintenance.
The document discusses various endodontic mishaps that can occur during root canal treatment. It describes mishaps related to access preparation, instrumentation, and obturation. Access-related mishaps include treating the wrong tooth, missing canals, damaging existing restorations, perforating the access cavity, and crown fractures. Instrumentation mishaps include ledge formation, perforating the root, and separated instruments. Obturation mishaps include overfilling or underfilling the canal. The document provides details on the causes, recognition, correction, prevention and prognosis of several common endodontic mishaps.
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.
This document discusses factors that affect the success and failure of endodontic (root canal) treatments. It defines what constitutes success, failure, healing and disease. The main factors discussed are incomplete removal of infected tissues from the root canal, ledge formation, separated instruments, overfilling, and anatomic variations. Clinical signs of success are absence of symptoms, while radiographic signs include lack of periapical radiolucency. Retreatment may be needed if the initial treatment is deemed incomplete or unsuccessful.
This document provides an overview of dentin bonding agents. It discusses the history and development of bonding agents from the 1950s to present. Key topics covered include the bonding mechanism, ideal requirements, microstructure of dentin, smear layer, etching of enamel and dentin, hybridization, reverse hybrid layer, wet vs dry bonding, and classifications of dentin bonding agents. The document aims to describe the important concepts and advances in dentin bonding for adhesive dentistry.
The endo-crown is a conservative restoration for endodontically treated teeth that have lost significant coronal structure. It involves preparing the tooth with a 2mm occlusal reduction and cylindrical cavity into the pulp chamber. The endo-crown is then bonded into the cavity as a single ceramic piece, providing strength while preserving tooth structure compared to traditional crowns. Studies have shown endo-crowns distribute stresses similarly to natural teeth and provide effective, long-lasting restorations for molars with extensive decay or fractures.
This document discusses root canal curvatures and methods for determining their degree. It begins with an introduction on the importance of understanding root canal anatomy for successful endodontic treatment. It then covers causes of canal curvatures, various classification systems, and techniques for assessing curvature using periapical radiographs, cone-beam computed tomography, and angular measurement methods. The relationship between curvature degree and ledge formation risk is also addressed, as are canal characteristics often invisible on routine radiographs. The document concludes by emphasizing the challenges of treating severely curved canals and the need for accurate preoperative assessment and proper instrumentation.
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 various obturation techniques for filling root canals including:
1. Cold lateral compaction, the most widely used technique, involves inserting a master cone coated with sealer followed by lateral compaction of accessory cones.
2. Warm vertical compaction uses heated pluggers to vertically compact gutta percha that has been softened with heat.
3. Carrier-based techniques like Thermafil involve heating and inserting a gutta percha coated metal core carrier into the canal.
The document provides details on how to perform each technique and their advantages and disadvantages. A variety of materials can be used for obturation including gutta percha, resins, and single cone techniques.
This document discusses the ferrule effect in restoring endodontically treated teeth. It defines a ferrule as a band of metal encircling the coronal tooth structure that extends at least 1.5-2mm below the finish line. The presence of a ferrule helps resist fracture by reinforcing the tooth against lever forces and post insertion stresses. It also helps prevent root fractures. An adequate ferrule requires sufficient height, width, and number of surrounding walls. Teeth can be classified based on their ferrule characteristics into categories with varying risk levels. When little structure remains, crown lengthening or orthodontic extrusion may help create a ferrule, but extraction may be a better option if
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.
Endodontic mishaps include procedural errors that can occur during root canal treatment such as ledge formation, canal perforation, separated instruments, and overfilling/underfilling of canals. It is important for practitioners to understand how to recognize, prevent, and treat these mishaps. Common causes include inadequate access, excessive force, or improper instrument use. Perforations require immediate sealing with materials like MTA to achieve the best prognosis. Separated instruments may be bypassed or retrieved, while ledges can sometimes be circumvented with smaller files. Overall, minimizing errors requires adherence to principles like conservative access, copious irrigation, and careful instrumentation.
This document discusses various types and classifications of posts used in restoring endodontically treated teeth. It describes custom cast posts and prefabricated metallic and non-metallic posts. Metallic posts discussed include stainless steel, titanium, and fiber posts made of carbon, glass or quartz. The advantages and disadvantages of different post types are provided. Active and passive posts as well as parallel and tapered posts are also summarized. The document stresses the importance of a thorough pretreatment evaluation involving endodontic, periodontal, biomechanical and anatomic factors when determining the best post and core treatment strategy.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Design of a fixed Partial Denture (with Abutment Tooth Preparation)Taseef Hasan Farook
A simplified take on the steps to designing a Fixed partial denture. This presentation also includes an overview of abutment preparation, associated finishes and methods of impression taking prior to the designing of the prosthesis itself
RCT fixed expert 23-24pptx.pdf second partEl Sayed Omar
The document discusses several factors that are important for restoring endodontically treated teeth, including the need for full coverage restorations, use of posts, and biologic width considerations. It notes that adequate coronal restoration is equally as important as endodontic treatment. Factors like tooth type, structure loss, and occlusal stresses determine need for full coverage restorations. Post length, diameter, and ferrule effect are important principles for restoring teeth with posts. Techniques for managing severely damaged teeth like crown lengthening and orthodontic extrusion are also covered.
The presentation shows the relation between the restorative dentistry and the periodontium , explaining the per-prothetic surgeries and the biological consideration including the biological width. Also, mention how to restore the open embrasures between teeth (the black triangle).
This document provides information on banding instruments and procedures in pediatric dentistry. It discusses the history of bands, various band materials and sizes, advantages and disadvantages of bands, ideal band material requirements, instruments used for banding, and banding techniques. The key points are:
- Bands are thin metal rings placed on teeth, typically molars, to secure orthodontic appliances. Accurate band placement is important for fitting appliances.
- Stainless steel is commonly used due to properties like resistance to tarnish and springiness. Band sizes vary based on tooth type.
- Banding provides strong attachment but risks caries if cement seals fail. Autoclaving is the most reliable steril
This document discusses the prosthodontic management of endodontically treated teeth through post and core restoration. It provides background on the historical development of post and core systems. It describes the characteristics of endodontically treated teeth and outlines the principles and methodology for post and core treatment, including post selection, preparation, and fabrication. Key factors that influence post and core treatment like remaining tooth structure, ferrule effect, stresses, and materials are discussed. The document serves as a guide for proper prosthodontic management of teeth requiring post and core restoration.
Restoration of endodontically treated teethLama K Banna
The document discusses pre-treatment evaluation and restoration options for root canal treated teeth. It covers evaluating the endodontic treatment, periodontal health, biomechanics, and esthetics. Restoration options depend on remaining tooth structure and are classified into 5 classes. Post selection considers root length, diameter, canal configuration and coronal structure. Custom posts can be made directly or indirectly from various materials to best suit each case.
This document provides an overview of inlays and onlays. It defines inlays as restorations that involve the occlusal surface and one or more proximal surfaces of a posterior tooth, while onlays additionally involve restoring the cusp tips. The document discusses the indications, contraindications, classifications, advantages, disadvantages, tooth preparation process, and materials used for inlays and onlays. The goal of inlay and onlay preparations is to eliminate caries while maintaining adequate tooth structure for resistance and retention forms.
Other forms of removable partial denture Amal Kaddah
This document discusses various types of removable partial dentures (RPDs), including unilateral RPDs, swing-lock RPDs, overlay partial dentures, implant-supported RPDs, and attachments for RPDs. It provides details on the design, indications, advantages and disadvantages of each type. Key types discussed include overlay partial dentures, which are constructed over remaining natural teeth for additional support and retention, and attachments for RPDs, which can improve retention and are either precision attachments that are prefabricated, or semi-precision attachments that are fabricated in the dental laboratory.
The document discusses periodontal splinting, including definitions, classifications, objectives, indications, advantages and disadvantages. It provides details on various splint types and materials. The key points are:
Periodontal splinting aims to stabilize mobile teeth affected by periodontal disease. Splints can be temporary, provisional or permanent depending on the material and duration of use. Fiber-reinforced composite splints are an advanced option that provide strength while adapting well to tooth contours. The objectives of splinting include reducing mobility, redistributing forces, and maintaining arch integrity.
How to Extract a Tooth as Atraumatically as Possible (Rosenbach 2015)PPDSG Rosenbach
The document discusses techniques for extracting teeth in a minimally invasive manner. It describes using a long diamond needle bur to section multi-rooted teeth at the furcation prior to extraction, which allows for easier removal of individual roots. The bur can also be used to create space around single-rooted teeth by troughing in the PDL. The 1312.11C NeoDiamond bur is well-suited for these techniques due to its long, tapered shape that removes only necessary bone. When used correctly, it can simplify extractions while preserving surrounding hard and soft tissues.
Enamel reduction techniques in orthodonticsParag Deshmukh
This document discusses interproximal enamel reduction (IPR) in orthodontics. IPR involves reducing the enamel on the proximal surfaces of teeth to gain space for correcting malocclusions. It describes the history and development of IPR techniques from using manual strips to current use of diamond discs. Guidelines recommend a maximum reduction of 0.3mm for incisors and 0.6mm for premolars/molars. IPR provides an alternative to extractions and has advantages of creating precise space while maintaining arch form. Potential disadvantages include increased caries risk and reduced interdental bone if not done properly.
The document provides an introduction to dental implants, discussing why they are used to maintain bone volume, preserve adjacent teeth, and provide a natural emergence profile. It describes the different types of implants including root form, blade, and ramus frame implants and explains the process of osseointegration. The document also covers implant abutment connections, surface treatments, and relative and absolute contraindications for dental implants.
Restoration of endodontically treated teethAnish Amin
Restoration of endodontically treated teeth often requires posts and cores to provide adequate retention and resistance for weakened teeth. Key principles for posts and cores include preserving tooth structure, maximizing retention through post length and design, and providing resistance through features like ferrules. Posts and cores are indicated when there is significant loss of coronal tooth structure and the risk of fracture is high. The amount of remaining tooth structure, presence of a ferrule, and post length and design all influence the success of a post and core restoration.
Marginal intergity and periodontal considerations/certified fixed orthodontic...Indian dental academy
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.for more details please visit
www.indiandentalacademy.com
The document discusses the fundamentals of cavity preparation, including its definition, objectives, and historical development. It covers factors that affect cavity preparation as well as terminology, classification, and the stages of initial and final tooth preparation. The key principles of cavity preparation are to remove all defective tooth structure, protect the pulp, and provide retention for the restorative material. Modern cavity preparation techniques favor prevention of extension and minimal intervention.
Tooth preparation for cast metal restoration / endodontic courses by indian d...Indian dental academy
Welcome to Indian Dental Academy
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.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
Esthetic crowns in pediatric dentistry.pptxgahanamuthamma
Esthetic crowns are used in pediatric dentistry to restore teeth damaged by decay in a way that preserves function and improves appearance. There are various types of crowns including strip crowns made of composite, pre-veneered stainless steel crowns, polycarbonate crowns, and ceramic crowns. Indications include extensive decay, fractures, discoloration or pulp therapy. Contraindications include non-restorable teeth. Placement involves tooth preparation and selection of an appropriately sized crown, which is then bonded or cemented onto the prepared tooth.
Restoration of endodontically treated teeth.Anish Amin
provides an overview of restoring endodontically treated teeth using posts and cores. It discusses the historical background of posts and describes characteristics of teeth that have undergone endodontic treatment. Key points include that these teeth often have reduced strength and require special considerations for retention and resistance. The document outlines indications for posts and cores, principles of preservation of tooth structure and providing retention and resistance. It also describes methodologies for various steps of the post and core procedure.
This presentation was provided by Steph Pollock of The American Psychological Association’s Journals Program, and Damita Snow, of The American Society of Civil Engineers (ASCE), for the initial session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session One: 'Setting Expectations: a DEIA Primer,' was held June 6, 2024.
Walmart Business+ and Spark Good for Nonprofits.pdfTechSoup
"Learn about all the ways Walmart supports nonprofit organizations.
You will hear from Liz Willett, the Head of Nonprofits, and hear about what Walmart is doing to help nonprofits, including Walmart Business and Spark Good. Walmart Business+ is a new offer for nonprofits that offers discounts and also streamlines nonprofits order and expense tracking, saving time and money.
The webinar may also give some examples on how nonprofits can best leverage Walmart Business+.
The event will cover the following::
Walmart Business + (https://business.walmart.com/plus) is a new shopping experience for nonprofits, schools, and local business customers that connects an exclusive online shopping experience to stores. Benefits include free delivery and shipping, a 'Spend Analytics” feature, special discounts, deals and tax-exempt shopping.
Special TechSoup offer for a free 180 days membership, and up to $150 in discounts on eligible orders.
Spark Good (walmart.com/sparkgood) is a charitable platform that enables nonprofits to receive donations directly from customers and associates.
Answers about how you can do more with Walmart!"
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.
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 ...
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Modern Access Cavity Preparation
1.
2.
3. 1. Introduction
2. Glossary of terms for contemporary molar endodontic access
3. A new model for endodontic access
5. Banking/soffit(360)(steppedaccess)
6. Ninja preparation
7. Conclusion
8. References
4. Sr . no. Learning objective Domain Level Criteria
1 Introduction Cognitive Must know All
2 Glossary of terms for contemporary molar
endodontic access
Cognitive Must know All
3 A new model for endodontic access Cognitive Must know All
4 Redesigned access Cognitive Must know All
5 Banking/soffit(360)(steppedaccess) Cognitive Must know All
6 Ninja preparation Cognitive Must know All
Specific learning objectives
8. The world congress of MID defines minimally invasive
dentistry as those techniques, which respect health,
function and esthetics of oral tissue by preventing disease
from occurring, or intercepting its progress with minimal
tissue loss (Nový and Fuller 2008)
13. Banking/ Soffit (360)(Stepped access)
Preparation
• A contracted endodontic cavity preserves a
portion of the roof around the entire coronal
aspect of the pulp chamber. This dentin is
known as dentin roof strut or soffit.
14. Traditional parallel-sided access (left), compared with the Cala Lilly enamel preparation (right). (Left)
Unfavorable C factor and poor enamel rod engagement are typically present when removing old amalgam or
composite restorations or with traditional endodontic access of 90to the occlusal table. (Right) The enamel is cut
back at 45with the Cala Lilly shape. This modified preparation will now allow engagement of nearly the entire
occlusal surface.
15.
16. Only moisture loss of 9% after root treatment.
The predominant reason that endodontically treated teeth are more
prone to fracture relates more than any other attribute to the
structural loss of those root treated teeth requiring restoration.
Helfer A R, Melnick S, Schilder H. Determination of the moisture content
of vital and pulp less teeth. Oral Surg Oral Med Oral Pathol 1972; 34:
661–670
17. • When endodontically treated teeth fail under function, that outcome is
determined primarily by 2 aetiologies. Those causes stated most simply
are:
1) the degree of stress experienced by the tooth under load
2) the inherent biomechanical properties of the remaining structure
responsible for resisting fracture.
18.
19. A) The deroofing problem. The likely bur used by the referring general dentist is
a 56 carbide; one of the most popular burs in dentistry,6 it is possibly the most iatrogenic
instrument in modern medicine. Red arrow delineates the typical gouging. (B) Postoperative
view provided by the endodontist. Blue arrow indicates the grossly excessive dentin removal
of pericervical dentin (PCD). This serious gouging is typical of round bur access. Yellow
arrow indicates the large canal flaring with unacceptable dentin removal (blind funneling).
(C) Green circle highlights worsening lesion on mesial root ends.
20. A NEW MODEL FOR ENDODONTIC ACCESS
• Directed dentin and enamel conservation is the best and only
proven method to buttress the endodontically treated molar.
• No man-made material or technique can compensate for tooth
structure lost in key areas of the PCD.
• The primary purpose of the redesigned access is to avoid the
fracturing potential of the endodontically treated molar
22. It has historically been described as axial wall
dentin covered by the axial wall of the crown (or
bridge abutment restoration).
The research varies on the actual minimal
vertical amount required, but the range of
absolute minimums is from 1.5 to 2.5 mm
24. • The absolute minimum thickness is 1 mm; however, 2
mm is obviously a safer number. Girth becomes more
important closer to the finish lines of the preparation.
• The thickness of the remaining dentin (the wall thickness)
between the external surface of the tooth at the finish line
and the endodontic access is more important apically.
• Axially deep finish lines on root structure can be
extremely damaging to 3DF.
25. 3 mm ferrule needed
4 mm ferrule needed
Deep chamfer marginal
zones common with
today’s porcelain crowns
Needed how much
ferrule???
26.
27. Defined as the dentin near the alveolar crest.
• Critical zone roughly 4 mm coronal to the crestal bone -4 mm apical to
crestal bone. crucial -transferring load from the occlusal table to the root,
• PCD is irreplaceable.
No man-made material or technique can compensate for tooth structure lost
in key areas of the PCD.
Clark D, Khademi J. Modern molar endodontic access and directed dentin conservation.
Dent Clin North Am 2010
28.
29. Why are Gates Glidden (GG) burs so
problematic?
• Since the introduction of rotary files, GG burs have been used more
aggressively and with more reliance on larger sizes (4, 5 and 6) to reduce
binding and fracture of rotary files.
• Gates burs have always been considered safe because they do not end cut
and are self-centering.
• There is a significant problem here, which is cervical self centering. Because
the shank of the GG is so thin, it is difficult to steer the GG away from high-
risk anatomy.
• As the GG straightens the coronal or high curve, it can shortcut across a
fluting or furcation and weaken or even create strip perforations.
• Dr Clark has abandoned, and Dr Khademi has severely curtailed, the use of
GG burs in their respective practices.
33. Why is complete deroofing so dangerous?
• attempts at removing the soffit that are far more damaging to
the surrounding PCD.
• The primary reason to maintain the soffit is to avoid the
collateral damage that usually occurs, namely the gouging of
the lateral walls.
• This 360 soffit or roof-wall interface can also be compared
with the metal ring that stabilizes a wooden barrel.
Complete deroofing
34. • The new vision-based mental model is Look, Groom, and Follow.
• The new instruments are all round-ended tapers
• The rounded ends are to increase the radii of the gouges and nicks that can
act as stress concentration points.
• The flat sides help create smoother, flatter walls and minimize the gouges
and dings that inevitably occur even with the most careful technique
• Small, cone-shaped, low-speed bur (such as the EG2 [SS White ])
35.
36.
37.
38. Banking/Soffit (360)(Stepped access)
Small border amount of the chamber roof near the
point where it curves 90° and becomes the wall
LEFT BEHIND
Tiny “lip” or “cornice” 0.5 mm- 3.0 mm
(strength
continuous
and
ring of
anatomy).
Dentin (BRAZING
EFFECT).
The 360 degree soffit or roof-wall interface provides a brazing effect
39.
40. Dotted line shows the typical cut made to remove the entire
pulp horn.
Area between the lines should be maintained and is referred to
as the soffit
41.
42. Robust coronal dentin -maintained good distance away
from the tooth’s centroid,(cervical) - tooth is stiffened,
resists bending, and should resist fracturing.
Clark D, Khademi J, Herbranson E. Fracture resistant
endodontic and restorative preparations. Dent Today 2013.
68. • Helfer A R, Melnick S, Schilder H. Determination of the moisture content of
vital and pulp less teeth. Oral Surg Oral Med Oral Pathol 1972; 34: 661–670
• Sedgley C M, Messer H H. Are endodontically treated teeth more brittle? J
Endod 1992; 18: 332–335.
• Krasner P, Rankow HJ. Anatomy of the pulp chamber floor;
JOE 2004,30:5
• Reeh E S, Messer H H, Douglas W H. Reduction in tooth stiffness as a
result of endodontic and restorative procedures. J Endod 1989; 15: 512–516.
69. • Yi-Tai Jou et al Endodontic Working Width: current concepts and
techniques
• Minimally invasive endodontics: challenging prevailing paradigms
A. H. Gluskin, C. I. Peters and O. A. Peters
• Pathways of pulp 10th ed. stephen cohen
Editor's Notes
Points of negotiation (PONs)
PONs are statistically predictable anatomic areas that may serve as starting points
during the access portion of endodontic therapy.
Italicized points indicate an undesirable outcome or technique.
Filling and caries leveraged access
Partial deroofing
Soffit
Stepped access
Secondary dentin (2 dentin)
Tertiary dentin (3 dentin)
Biomimetic endodontic shaping (BES)
Arbitrary round shaping (ARS)
The dentinal map
The dentinoenamel junction (DEJ)
The junction of primary and secondary dentin (D2J)
The junction of primary and tertiary dentin (D3J)
Pulp tissue remnants (PTRs)
The Cala Lilly
The traditional method of initiating endodontic access is predicated on mental models that do not represent the day-to-day clinical reality presented to the clinician.
Many texts shows the same round bur technique relying on tactile feedback as the round bur drops
into the chamber.
An access extension or modification that is frequently needed is the fluting or notching of the mesial wall in the area of the MB2. This requirement is due to the pattern of calcification that often places the angle of entry to the MB2 at an untenable distal angle.
Cala Lilly vs butt joint or 70 to 90 degree cavosurface angle