O.C.P.
Introduction to Endodontics
Alan H. Gluskin DDS
Professor and Chair
Department of Endodontics
Treating Dental Problems
When Tooth Decay Attacks...
Endodontics is the branch of
dentistry which is concerned
with the morphology, physiology,
and pathology of the human pulp
and periadicular tissues.
What is Endodontic Therapy?
What Are The Benefits of
Endodontic Therapy ?
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.
What Steps Are Involved in
Endodontic Treatment?
The Endodontic Triad
Seal
Clean & Shape
Access Opening
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.
What Caused the
Problem With My Tooth?
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.
Who Performs Endodontic
Therapy?
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.
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.
What Does An
Endodontist Do?
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.
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 child’s permanent
tooth that is not fully formed can cause
injury to the pulp and, ultimately the root
may cease development.
Dental and Facial Trauma
Apexification
Performs Orthodontic Extrusion:
the lifting of a submerged root
above the gum level for restoring,
thus avoiding surgical crown
lengthening.
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.
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.
Bleaches Discolored Teeth:
Discolored teeth can sometimes
be restored to near-natural color
with either vital or pulpless
bleaching procedures.
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.
Performs Apicoectomy: a.k.a.
root-end resection; the
excision of the apex of the
root and attached soft tissues.
Can All Teeth Be Treated
Endodontically?
Occasionally a tooth can’t 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.
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.
Places Post and/or Core Buildups:
The restoration of the coronal
structures utilizing the root canal
system for retention and support.
Places Endodontic Implants:
The cementation of a metallic post
through the root canal into
periapical tissue spaces to improve
root length.
Treatment of Horizontal Fractures
Middle Third Fracture
Intraradicular Implant
Post-Op Radiograph
7 Year Post-Op Radiograph
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.
Performs Guided Tissue Regeneration:
GTR attempts to regenerate lost
periodontal structures using barrier
membrane techniques.
What Are The Alternatives
To Endodontic Therapy?
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.
Next Hour
Differential Diagnosis
of Toothache