Introduction to Endodontics Forth Year

1. INTRODUCTION TO
ENDODONTICS
DR. N. UDAYA BHASKER
COURSE DIRECTOR
PRE-CLINICAL ENDODONTICS

2. DEFINITION:
Branch of dentistry concerned with the
Morphology
Physiology and
Pathology
of the human dental pulp and periradicular tissues.

3. Its study and practice encompass the basic and clinical
sciences including

biology of the normal pulp

the etiology

diagnoses

prevention

treatment of diseases and injuries of the pulp and
associated periradicular tissues.

4. Principles of endodontic therapy
 Diagnosis
 Patient education
 Local anaesthesia
 Isolation – Rubber dam isolation
 Access cavity
 Working length
 Instrumentation
 Obturation
 Final restoration

5. Diagnosis:
According to Ingle, diagnosis is the procedure of
 accepting a patient
 recognizing that he has a problem
 determining the cause of the problem and
 developing a treatment plan that will solve or alleviate
the problem

6. Chief complaint
History
[ Medical/Dental]
Objective
examination
Subjective
examination
Radiographs
Diagnosis

7. Patient education:
Patient should be informed about the condition of
his teeth and the treatment options available
Instructions to the patient about improvement of the
oral hygiene

8. Local Anaesthesia:
Similar to the local anaesthesia given for various
other dental procedures.
Supplemental anaesthesia may be required for
certain cases – "HOT TOOTH"

9. Isolation:
Rubber Dam isolation - usually a single tooth isolation
Isolation is very important not only for maintaining a
sterile field but also to prevent Aspiration of irrigation
materials and instruments

10. Access cavity

11. Working length

12. Instrumentation:

13. Obturation

14. Final Restoration:

15. Indications & Contraindications
Indications:
 Carious teeth [caries involving pulp]
•
teeth with irreversible pulpitis
• necrotic pulps
 treatable periodontal conditions [endo-perio lesions]

salvageable resorptive defects
 Supra-erupted teeth with good bone support
 Fractured teeth involving pulp
 Intentional endodontics for FPD's or overdentures

16. Contraindications:
•Insufficient periodontal support
•Canal instrumentation not Practical

calcification of the canal

Sharp dilaceration/curvature of the roots

17. •
Non restorable teeth

18. Inadequate crown root
ratio
Vertical tooth/root fracture

19. Patient's general medical condition
Patients general medical condition is never an absolute
contraindication to endodontic therapy

20. Considerations prior to endodontic therapy
•
Is the tooth needed or important? Does it have an opponent?
Could it some day serve as an abutment for prosthesis?
•
Is the tooth salvageable, or is it so badly destroyed that it
cannot be restored?
•
Is the entire dentition so completely broken down that it
would be virtually impossible to restore?
•
Is the tooth serving esthetically, or would the patient be
better served by its extraction and a more cosmetic
replacement?

21. •
Is the tooth so severely involved periodontally that it
would be lost soon for this reason?