O.C.P. Introduction to Endodontics

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O.C.P.Introduction to Endodontics
Alan H. Gluskin DDS Professor and Chair
Department of Endodontics
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Treating Dental Problems

• When Tooth Decay Attacks...

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• Endodontics is the branch of dentistry which is
  concerned with the morphology, physiology, and
  pathology of the human pulp and periadicular
  tissues.

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What is Endodontic Therapy?
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What Are The Benefits of Endodontic Therapy ?
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• Endodontic therapy saves teeth that would
  otherwise be extracted. Although the pulp is
  removed, the treated tooth remains alive,
  nourished by the surrounding gums and jaw. There
  is no real substitute for your own tooth which is
  more efficient in chewing and biting than an
  artificial one.

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What Steps Are Involved in Endodontic Treatment?
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The Endodontic Triad

• Seal
• Clean Shape
• Access Opening

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• Endodontic therapy removes infected or damaged
  tissue from inside a tooth. This tissue, called
  the pulp, contains nerves and blood vessels that
  help nourish the tooth. After the pulp is
  removed, the pulp chamber and root canals are
  cleaned, sterilized, filled and sealed.

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What Caused the Problem With My Tooth?
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• The most common cause of pulp damage is severe
  decay or a fracture that exposes the pulp to
  bacteria that may cause infection. Other causes
  of pulp damage include traumatic injury, such as
  a blow to a tooth, a cracked or loose filling or
  repeated fillings in a tooth and occasionally
  periodontal or gum disease.

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Who Performs Endodontic Therapy?
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• All dentists receive some training in endodontic
  therapy in dental school. Endodontists are
  specialists who limit their practices to root
  canal procedures. They have two years
  postgraduate training in addition to dental
  school, and/or have been certified by the
  American Board of Endodontics after passing a
  series of examinations.

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• Its study and practice encompasses the basic
  clinical sciences including biology of the normal
  pulp the etiology, diagnosis, prevention and
  treatment of diseases and injuries of the pulp
  and associated periradicular conditions.

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What Does An Endodontist Do?
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• Diagnoses and Treats Pain. Oral pain often is
  difficult to pinpoint. Because of the vast
  network of nerves in the mouth, the pain of a
  damaged or diseased tooth often is felt in
  another tooth or in the head, neck or ear. An
  endodontist is a specialist in diagnosing and
  treating this type of pain.

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Stop the Pain.
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• Treats Traumatic Injuries. Pulp damage is
  sometimes caused by a blow to the mouth, and the
  endodontist treats these traumatic injuries. A
  blow to a childs permanent tooth that is not
  fully formed can cause injury to the pulp and,
  ultimately the root may cease development.

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Dental and Facial Trauma
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Apexification
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• Performs Orthodontic Extrusion
• the lifting of a submerged root above the gum
  level for restoring, thus avoiding surgical crown
  lengthening.

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• Salvages Avulsed Tooth the complete separation
  of a tooth from its alveolus by traumatic injury.
  Replantation and splinting of the tooth must
  precede any type of treatment.

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• Performs Intentional Replantation the insertion
  of a tooth into its alveolus after the tooth has
  been extracted for the purpose of accomplishing
  root-end filling.

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• Bleaches Discolored Teeth Discolored teeth can
  sometimes be restored to near-natural color with
  either vital or pulpless bleaching procedures.

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• Performs Surgery. Sometimes standard endodontic
  therapy is ineffective. The endodontist may then
  us an in-office surgical procedure to remove the
  damaged pulp and seal the root canals.

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• Performs Apicoectomy a.k.a. root-end resection
  the excision of the apex of the root and attached
  soft tissues.

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Can All Teeth Be Treated Endodontically?
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• Occasionally a tooth cant be saved. Endodontic
  therapy can be performed only if the root canals
  are accessible and can be adequately sterilized
  and sealed. The tooth also must have sufficient
  bone support.

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• Performs Hemisection the surgical separation of
  a mandibular molar tooth, through the furcation
  in such a way that a root and / or the crown
  portion may be removed.

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• Places Post and/or Core Buildups
• The restoration of the coronal structures
  utilizing the root canal system for retention and
  support.

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• Places Endodontic Implants
• The cementation of a metallic post through the
  root canal into periapical tissue spaces to
  improve root length.

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Treatment of Horizontal Fractures
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Middle Third Fracture
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Intraradicular Implant
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Post-Op Radiograph
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7 Year Post-Op Radiograph
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• Performs Endodontic Retreatment
• The redoing of previous treatment that is
  unsuccessful retrieval of canal obstructions and
  complete or partial disassembly of restorative
  materials are frequently required.

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• Performs Guided Tissue Regeneration
• GTR attempts to regenerate lost periodontal
  structures using barrier membrane techniques.

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What Are The Alternatives To Endodontic Therapy?
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• Extraction is the only alternative.
• And unless the tooth is replaced, adjoining
  teeth will shift, interfering with biting and
  chewing. Loss of a tooth can lead to periodontal
  disease and loss of additional teeth. Replacing
  a tooth with an artificial one often requires
  dental procedures on adjacent healthy teeth.

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Next Hour

• Differential Diagnosis of Toothache

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Thank You