BDS8124 Aim and scope of endodontic treatment f_3ae243baf24d422a0278181cc658b141.pdf

BDS8124 Scope & Aim Of Endodontic Treatment Date : 24 / 09 / 2019 Aim: The educational aims of this lecture are to explain the variety of treatments provided by endodontics and the aim of each of them Subject Title Goes Here Objectives: On completion of this lecture, the student should have an...

BDS8124 Scope & Aim Of Endodontic Treatment Date : 24 / 09 / 2019 Aim: The educational aims of this lecture are to explain the variety of treatments provided by endodontics and the aim of each of them Subject Title Goes Here Objectives: On completion of this lecture, the student should have an understanding of different treatments related to endodontics, their aims and indications. Scope & aim of endodontic treatment . The term endodontics emerges from the greek word “en” meaning in or within and “ odous” meaning tooth It means the process of working within the tooth. Objectives To render the affected tooth: Functioning Symptom free Biologically Accepted Phases Of Endodontic Treatment Obturation Preparatory Diagnostic phase phase phase Diagnostic phase Preparatory • Aims to determine the disease condition and set a treatment plan. • Aims at gaining access to the pulp chamber and cleaning and shaping the root canals. phase • Aims at three dimensional filling of the root canals. Obturation phase Endodontic treatment options 1- Prevention of pulp disesaes (Vital pulp therapy) Vital pulp therapy is concerned with preservation (management) of the primary and young permanent teeth with pulp involvement TO retain that tooth in a healthy condition. Different forms of pulpal treatment for the primary and young permanent teeth include: Indirect pulp capping. Direct pulp capping. Pulpotomy. Indirect pulp capping:  It is the technique for avoiding pulp exposure in the ttt of teeth with deep carious lesions.  It is a technique where the deepest layer of the remaining carious dentin is covered with a biocompatible material to avoid pulp exposure.” Direct pulp capping:  It is the application of medication or dressing to an exposed pulp in attempt to preserve its vitality. - Treatment of immature teeth: apexogensis or apexification. Apexogenes is It refers to a vital pulp therapy procedure performed to encourage physiological development and formation of the root end. Direct Pulp capping Revascularization 2- Differential diagnosis and treatment of pulp & periapical diseases. A- Pulp pathology: acute or chronic pulpitis, pulp necrosis. B- Pulp calcification, internal or external resorption. C- Apical pathology: acute and chronic apical lesions. Pulp calcification Internal/ external resorption 3-Post-treatment endodontic lesions: Microorganisms may have: 1- Survived the previous treatment. 2- Invaded the filled canal space after treatment mainly due to bacterial microleakage. Management: A- Non surgical retreatment. B-Surgical treatment: surgical removal of periapical pathosis, e.g: apical curettage, root end resection. 4- Intracoronal Bleaching of discolored teeth: Tooth discoloration is defined as any change in the hue, color or translucency of a tooth that may be induced by intrinsic stains incorporated in tooth structures and or extrinsic stains deposited on the tooth surfaces 5- The need for post and core construction to rebuild the missing coronal part of the tooth 6- Management of traumatic tooth injuries, replantation of avulsed teeth. Enamel fractures Root fracture. WHO Classification: Uncomplicated Crown fractures (no pulp exposure) Tooth fractures Complicated Crown fractures (with pulp exposure) Crown-root fractures 7-Perio/endo: Irritants from necrotic pulp can reach periodontum through lat. Canals and apical foramen causing Inflammation in the periodontium. Progressive periodontal disease leads to apical migration of epith attachment leading to root surface exposure to oral cavity & to irritants (bacterial plaque). 8-Endo /prosthetic dentistry: Teeth retained in the mouth To support overdenture. Overerupted and mesially drifted teeth when crown reduction may cause pulp exposure. Retaining the Posterior Bridge Abutment: ( STRATEGIC TOOTH) One of the most important indications for endodontic treatment is a pulpally involved molar with an edentulous space anterior to it. If such a tooth is lost, the entire segment becomes edentulous, with no posterior abutment Converting a bounded saddle to a free end saddle Extraction of teeth will be followed by alveolar bone resorption , so endodontic therapy will retain the tooth which in turn retains supporting alveolar bone preserving mastication, function and facial appearnce. Indications For Endodontic Therapy 1-Teeth suffering from pulp and periapical pathosis: A- Pulp pathology: acute or chronic pulpitis, pulp necrosis. B- Pulp calcification, internal or external resorption. C- Apical pathology: acute and chronic apical lesions. 2- Intentional endodontic treatment can be performed in teeth with healthy pulp in cases of: A- The need for post and core construction to rebuild the missing coronal part of the tooth B- Overerupted and mesially drifted teeth when crown reduction may cause pulp exposure. C- Teeth retained in the mouth To support overdenture. D- Crown fracture with pulp exposure OR traumatic pulp exposure E- Esthetic Requirments Contraindications For Endodontic Therapy 1- Teeth having insufficient periodontal support with severe mobility 2- Non restorable teeth which can't properly function after endodontic treatment 3-Teeth with extensive internal or external tooth resorption 4- Teeth with vertical root fracture 5- Non strategic teeth Strategic tooth Aims: The educational aims of this lecture are to explain the variety of treatments provided by endodontics and the aim of each of them Objectives: On completion of this lecture, the student should have an understanding of different treatments related to endodontics, their aims and indications. Reading material: -The dental reference manual, Geraldine M. Weinstein, springer 2017 (Chapter 12) -Essential skills for dentists, Peter A.Mossey et al, Oxford, 2006 (Chapter 2.6) -Endodontics, Kishor Gulabivala and Yuan-Ling NG, Mosby Elsevier 2014 -Harty`s endodontics in clinical practice, Bun San Chong, Elsevier 2017 -Clinical endodontics, Lief Tronstad, Thieme 2009 (main reference) Thank you