endodontics dental materials i dh 113. aae one of the nine dental specialties over 6400 members in...
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Endodontics
Dental Materials I
DH 113
AAE
• One of the nine dental specialties
• Over 6400 members in US, Canada & Internationally
• Certifying Board – American Board of Endodontics (ABE)
What is an Endodontist?
• Dentist who specializes in root canal (endodontic) treatment
• Removes damaged tissue from inside the root canals of a tooth
• Have advanced surgical and nonsurgical skills for complex cases
• 2-3 year post-graduate course work after dental school
Why Endo?
• Prolonged sensitivity to hot and/or cold
• Abcess – look for fistula
• Pain
• Irreversible Pulpitis– Deep Caries– Trauma (external)– From dental work (nerve dies)– Cracked or chipped tooth
http://www.dentalnews.at/en/dental-fistula/
Saving the Tooth
• Infected pulp is removed
• Pulp canals are cleaned and shaped, then filled
• Following RCT, tooth generally requires a crown – endo treated teeth may become brittle and are more prone to fracture
Alternatives
• Most often, extraction of the tooth is the only option
Cracked root
Trauma
Retreat
Endo Instruments
• Reamer, K File, Hedstrom File
Root Canal Anatomy
• Multiple Canals
• Accessory Canals
Accessory Canals
Lateral Canal
• Extrusion of gutta percha into lateral canal
The Root Canal
Step 1: Exam & diagnosis» X-Rays, Pulp testing
Step 2: Patient preparation» Local anesthetic, place rubber dam
Step 3: Open the toothStep 4: Clean & shape the Root Canal
» Endo files, laser, ultrasonic» Additional XR to ensure end of root reached
Step 5: Fill the canal» gutta percha and adhesive » glass ionomer-type cement» Calcium hydroxide» ZOE-type
Step 6: Make post space for restorativeStep 7: Temporary filling
Then: Refer back to dentist for permanent restoration
Re-evaluate in 6-9 months with follow-up XR
Finding Correct Length
Upper right lateral Laterally condensed
with diagnostic point gutta percha
through apex
Apex locator
j. morita.com
Lower Molar
• C shaped canal• C shaped canals with diagnostic points• Gutta percha in place
When things go wrong…
Apicoectomy
Retrofill
Endo Lesion Amalgam fills apex
Other types of Endodontic surgeries
1) Curettage (removing inflamed tissue)
2) Root amputation (selected removal of
roots)
3) Hemisection (dividing the tooth in half)
4) Intentional Replantation (removing and
reinserting the tooth).
Autoclavable Kit
Irrigating the Canal
• Syringe
• Narrow tips
Paper Points
• Absorbant
Root Canal Sealer
• Calcium hydroxide/Eugenol sealer with Iodoform
Gutta Percha, Points & Fillers
Gutta Percha
• A rubbery substance derived from the latex of any of several tropical trees of the genera Palaquium and Payena, used as an electrical insulator, as a waterproofing compound, and in golf balls.
• Just a bit of trivia!
Endofil
• Endo filling material based on ZOE
ADA News: FDA clears laser root canal therapy (01/29/02)
• Enamel, dentin and pulp removal as well as shaping the root canal
• provides optical energy to water, and the water particles provide the cutting of dental hard tissue: Waterlase
• Postoperatively, it may reduce pain, discomfort, swelling and the need for antibiotics.• Laser energy kills viruses and bacteria
during debridement phase