Scope of Endodontics PDF

 Scope of Endodontics Dr. Mohamed Samir B.D.S, M.S, Ph.D Head of Endodontics Division  OBJECTIVES  Define Endodontics  Indications of endodontic therapy  Contraindications of endodontic therapy  Endodontic treatment options included in the scope of...

 Scope of Endodontics Dr. Mohamed Samir B.D.S, M.S, Ph.D Head of Endodontics Division  OBJECTIVES  Define Endodontics  Indications of endodontic therapy  Contraindications of endodontic therapy  Endodontic treatment options included in the scope of Endodontics  Phases of endodontic treatment Introduction  Introduction - Endodontology is derived from the Greek language and translated as ‘The knowledge of what is inside the tooth’ Definition  Definition  Endodontics: The branch of dentistry concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues.  Its study and practice encompass the basic and clinical sciences including the biology of the normal pulp and the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. Indications of Endodontics  Indications - Endodontic therapy provides the dentist and the patient the opportunity to save the pulp and periapically involved teeth.  Pathologically involved pulp: ◦ Irreversible pulpitis ◦ Pulp necrosis  Indications  Apical pathology: - Acute and Asymptomatic(chronic) apical lesions(abscess). - Asymptomatic and symptomatic apical periodontitis.  Acute abscess Failed pulpotomy RCT Two- years follow-up Indications One year follow-up Indications Six months follow-up Complete lamina Dura  Indications  Intentional Endodontics: ◦ Treatment can be performed in teeth with healthy pulp in cases of: 1- The need for post and core construction to rebuild the missing coronal part of the tooth.  Indications 2- Overerupted or mesially drifted teeth when crown reduction may cause pulp exposure. 3- Teeth retained in the mouth to retain overdentures. Indications 4- Crown fracture with pulp exposures , large traumatic pulp exposure during dental procedures and traumatic injuries. Contraindications Contraindications  Important considerations that must be evaluated prior to recommending RCT including: a) Is the tooth of strategic importance? b) Is the tooth restorable or is it badly damaged and can not be restored? c) Is the tooth so severely involved periodontically that it would be lost so soon for this reason? Contraindications I. Non strategic teeth , those having no opponent, and would not serve one day as an abutment for prosthesis. II. Non restorable teeth ,which can’t properly function after endodontic treatment ( Subosseous caries, Poor crown/root ratio and Badly fractured tooth ). III. Teeth with extensive internal or external root resorptions. IV. In teeth having insufficient periodontal support with severe mobility. V. Single root teeth with vertical root fracture passing through the root canal. Contraindications Non restorable tooth Contraindications Badly fractured tooth Root Resorptions External Internal Contraindications Periodontally affected teeth Contraindications Vertical root fracture Scope of Endodontics Topic / Subject  Differential diagnosis and treatment of oral pains of pulpal and/or periapical origin.  Vital pulp therapy such as pulp capping, pulpotomy and treatment of immature teeth E X: Apexogenesis and Apexification.  Nonsurgical treatment of root canal systems.  Selective surgical removal of pathological tissues resulting from pulpal pathosis. Topic / Subject  Surgical removal of tooth structure such as in root-end resection, bicuspidization & hemisection.  Replantation of avulsed teeth.  Bleaching of discolored dentin and enamel.  Retreatment of teeth previously treated endodontically. Scope Examples of the Scope of Endodontic Therapy Scope Bicuspidization Scope Hemisection Scope Non vital bleaching Scope Replantation of avulsed teeth Scope Retreatment Phases of Endodontics Phases 1- Diagnostic phase: aims to determine the disease condition and set a treatment plan. 2-Preparatory phase: aims at gaining access to the pulp chamber and cleaning and shaping the root canals. 3-Obturation phase: aims at three dimensional filling of the root canals. Phases Phases of Endodontic Treatment Phases Phases of Endodontic Treatment Prognosis  Success rate is high, around 90%  Teeth without periradicualr radiolucency have better prognosis than teeth with periradicular radiolucency (up to 20% difference) Conclusion  Define Endodontics  Indications of endodontic therapy  Contraindications of endodontic therapy  Endodontic treatment options included in the scope of Endodontics  Phases of endodontic treatment 1+2+3 Question  Enumerate 3 indications for root canal treatment. References 1- Cohen's Pathways of the Pulp, 10th Edition. 2- Endodontics, Principles and Practice, 5th. Edition By Walton and Mahmoud Torabinejad W.B. Saunders Thank You