Endodontic Treatment Overview 1

Endodontic Treatment Scope & Aim

• Endodontics is a dental branch focusing on the morphology, physiology, and pathology of the human dental pulp and periapical tissues.
• It involves diagnosis, prevention, treatment, and prognosis of pulp and periapical tissue diseases and injuries.
• The educational aim of the lecture is to explain the different treatments offered by endodontics and their respective aims.
• Upon completing the lecture, students should understand various endodontic treatments, their objectives, and indications.
• The goal of endodontic treatment is to make the affected tooth functioning, symptom-free, and biologically accepted.
• Endodontics combines the Greek words "en" (in or within) and "odous" (tooth). It describes the process of working within a tooth.
• Key phases of endodontic treatment include a diagnostic phase (determining disease and treatment plan), a preparatory phase (accessing the pulp chamber and shaping root canals), and an obturation phase (three-dimensional filling of root canals).
• Root canal treatment involves opening, filing, and filling the infected pulp to eliminate infection.

Endodontic Treatment Options

• Prevention of pulp diseases (Vital Pulp Therapy): This therapy aims to preserve primary and young permanent teeth with pulp involvement, maintaining a healthy tooth.
• Indirect Pulp Capping: A technique used to prevent pulp exposure in deep carious lesions. A biocompatible material covers the remaining carious dentin to protect the pulp.
• Direct Pulp Capping: Applying medication or dressing to exposed pulps. This aims to preserve vitality.
• Treatment of Immature Teeth (Apexogenesis or Apexification): These procedures involve apexogenesis or apexification to promote the development of the tooth roots.
• Apexification: A series of visits, at least six months, are required to allow a barrier to form at the apex of the root to control infection.
• Apexogenesis: Encouraging the physiological development of the root end, fostering the tooth's natural root formation.
• Revascularization: A vital pulp therapy that involves preserving the tooth and regenerating the pulp.

Differential Diagnosis and Treatment of Pulp & Periapical Diseases

• Pulp Pathology: Acute or chronic pulpitis or necrosis.
• Pulp Calcification: Internal or external resorption.
• Apical Pathology: Acute or chronic apical lesions.
• Different diseases are diagnosed and treated.

Post-Treatment Endodontic Lesions

• Microorganisms may survive previous treatment or enter the filled canal—bacterial microleakage is a major factor.
• Management strategies include non-surgical retreatment and surgical treatments such as apical curettage or root end resection.

Intracoronal Bleaching

• Tooth discoloration results from a change in hue, color, or translucency, from intrinsic or extrinsic stains.
• Intracoronal bleaching aims to address discoloration within the tooth's structure.

Need for Post and Core Construction

• Post and core construction is needed to rebuild missing coronal parts of teeth.

Management of Traumatic Tooth Injuries and Replantation

• Replantation of avulsed teeth involves handling and reimplanting the tooth to prevent damage.
• The WHO classifies tooth fractures as uncomplicated (no pulp exposure), complicated (with pulp exposure), and crown-root fractures.

Perio/Endo

• Peri-endo considerations identify conditions where both the periodontal and endodontic tissues are affected.
• Irritants from necrotic pulp can reach the periodontium via canal and apical foramen, leading to inflammation.
• Progressive periodontal disease leads to apical migration of the epithelial attachment.

Endo/Prosthetic Dentistry

• Teeth retained in the mouth can support overdentures.
• These teeth are treated with endodontic techniques.

Overerupted and Mesially Drifted Teeth

• Overerupted and mesially drifted teeth can lead to pulp exposure during crown reduction.

Retaining Posterior Bridge Abutments

• Endodontic treatment is a critical step in the treatment of teeth supporting the posterior bridge or when teeth are lost in the posterior arch.

Extraction of Teeth

• Endodontic treatment can help maintain alveolar bone during tooth extraction to maintain chewing function.

Indications for Endodontic Therapy

• Teeth with pulp and periapical pathosis, as in cases of acute or chronic pulpitis or necrosis, pulp calcification, internal or external resorption, and acute or chronic apical lesions.

Contraindications for Endodontic Therapy

• Teeth with insufficient periodontal support and severe mobility, teeth that cannot be restored after endodontic treatment, and teeth with extensive internal or external tooth resorption and vertical root fractures, and non-strategic teeth.

This quiz explores the scope and aims of endodontic treatment, focusing on dental pulp and periapical tissue health. Students will learn about diagnosis, prevention, and various treatment methodologies in endodontics. It emphasizes the goals of achieving symptom-free, functional teeth.