Scope and Definition of endodontics,
relationship with other departments
Asst.Prof.HaticeSAĞLAM
• It is the branch of dentistry related to the morphology, physiology and pathology
of the dental pulp and periradicular tissues.
• Theoretical and practical studies of this branch include the biology of the normal
pulp, the etiology of pathological events, diagnosis, prevention and treatment of
tissue diseases, traumatic injuries of the pulp and periradicular tissues and their
healing.
• The scope of endodontics is not limited to the diagnosis and
treatment of oral and orofacial pains of pulpal and periapical origin.
-Vital pulp therapies like pulp capping and vital amputation
-non-surgical treatment of cases with or without periapical lesions
-root canal treatments and filling of the canals
-Selective surgery of pathological tissues occurring at the root tip due to pulpal
pathologies
-intentional replantation
-replantation of avulsed teeth
-Surgical procedures in which the tooth root is partially removed such
as root tip resection, hemisection
-endodontic implants
-bleaching the color of dentin and enamel of discolored teeth
-Re-treatment and filling of the canals of previously treated teeth when
necessary
-post endodontic restorations
• It is a branch of dentistry that has been accepted as a special science
and clinical branch by the American Dental Association since 1963,
institutionalized in its own branch under the name of the American
Association of Endodontics in the United States and the Turkish
Endodontics Association in our country.
• Today, there are many dentists and academicians who have limited their
professional work only to endodontics, both in the world and in our country.
• Endodontists also bear the responsibility to follow the research, innovation and
techniques in endodontics and to contribute to this development, to share them
with their colleagues at national and international level, and to convey them in
scientific meetings such as scientific journals, symposiums and congresses.
• Endodontics is advancing rapidly by using the benefits of developing
technology in the world and in our country.
• Many developments such as laser, operating microscopy and
microsurgery, endodontic surgery, nickel titanium canal instruments,
rotary instruments, radiovisiography, computerized tomography enter
endodontics clinics.
• Endodontics begins with a good oral diagnosis and differential diagnosis. It is not
correct to consider endodontics alone while performing endodontic treatment.
Since dental tissues, periodontal tissues, oral prostheses must be compatible with
each other; Dentistry departments related to these should also work in
cooperation with each other.
the relationship of endodontics with other
departments
• endodontics-orthodontics relationship
• This relationship ranges from effects on the pulp from orthodontic treatment
and the potential for resorption during tooth movement, to the clinical
management of teeth requiring integrated endodontic and orthodontic
treatment.
• Orthodontic tooth movement can cause degenerative and/or inflammatory
responses in the dental pulp of teeth with completed apical formation. The
impact of the tooth movement on the pulp is focused primarily on the
neurovascular system, in which the release of specific neurotransmitters
(neuropeptides) can influence both blood flow and cellular metabolism.
• The responses induced in these pulps may impact on the initiation
and perpetuation of apical root remodelling or resorption during
tooth movement.
• endodontics-periodontology relationship
• Persistent infection in the pulp may lead to a secondary infection and
breakdown in the periodontium.Likewise the opposite is also true.
• Generally infections of endodontic origin will form retrograde
periodontitis, and infections of periodontal origin will form orthograde
periodontitis.
• These two types of infection can commicate with each other through
physical pathways.The most obvious pathway is the apical foramen,
but there may also be communication through lateral and furcal
accessory canals, and possibly even dentinal tubules.
• In teeth with some anatomical variations, the teeth may lose their vitality by
means of periodontal pockets and endodontic treatment may be required.
(Palatogingival Groove)
• However, the tooth with each groove does not lose its vitality and endodontic
treatment may not be required with correct timing and treatment planning.
endodontics prosthesis relationship
• Since prosthetic restorations often require tooth preparation, they
can cause sensitivity in the teeth.
• When the tooth and gingival harmony is not achieved in the
prosthetic restorations that are not done correctly, endo-perio lesions
may occur and tooth vitality can be lost.
• In addition, sometimes excessive tooth preparation may require endodontic
treatment by causing pulp exposure in the teeth.
• In some cases, prosthetic restoration is recommended if there is excessive loss of
substance in canal treated teeth. If proper restoration is not made, a properly
performed canal treatment will not be long-lasting, tooth loss may occur due to
tooth fractures and leaks.
• Therefore, endodontics and prosthetic parts are closely related to each other.
• endodontics surgery relationship
-There is also a close rs between endo and surgery.Ie; If we cannot heal the
persistent infection in that area with conventional treatment in a tooth that has
been treated endodontically but has lesions in the apical, surgical procedure may
be required. (apical resection )
-In instrument fractures, which are an endodontic complication, when we cannot
eliminate the broken part, surgical procedure may be indicated.
-Likewise, when we cannot reach the resorptions in the root area with the
conventional method, surgical flap removal may be required.
• endodontics radiology relationship
• A correct endodontic indication can be obtained with an accurate radiological
examination.ıe; Knowing the anatomical structures radiologically that may be
superposed on the teeth on radiographic films taken from the lower jaw region will
prevent false indication. (foramen mentale)
• In addition, CBCT may be required when periapical films are not
sufficient (when excess root / canal presence is suspected, resorption
or lesion margins cannot be fully visualized).
• endodontics-restorative relationship
Endodontics is not just about cleaning and shaping root canals. The root canal and
tooth structure should be able to be fully restored. Therefore, a good root canal
treatment alone does not bring success, it requires a properly made restoration.
If the coronal restoration leaks in a well-performed endodontic treatment, lesion
development can be seen.
• Endodontics and pedodontics relationship
• Since the pedodontics department works with a younger age group compared to
endodontics, the physician should be careful about the growth and development
periods of the patients and the root tip closure periods.
• Ie; In a tooth whose root tip closure has not yet occurred due to age, it becomes
unnecessary to perform an apexification procedure, or vice versa; Waiting for a tooth
that can be treated with apexification to close by itself may cause tooth loss.
• As can be seen, although dentistry has different areas of
specialization, it is basically a whole and is in close relationship with
each other.
• Evaluating each area within itself and evaluating with a narrow field
of view can often lead to wrong indications and treatments.
Thank you..