Tag Archives: endodontic

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What is Involved with Endodontic Treatment

Endodontics is a specialized type of dentistry that deals with abnormal tooth pulp; the causes/origins, diagnosis, prevention and treatment of diseases and injuries to the pulp; and other conditions affecting the tissue surrounding the pulp and canal (channel inside the tooth root).

Tooth pulp, the soft tissue that contains nerves, blood vessels and connective tissues, runs through the hard tissue inside the tooth (dentin) and extends from the crown (top) of the tooth down to the tip of the root in the jaw bone.

Endodontic procedures are used in the diagnosis and treatment of oral pain involving the pulp and periradicular area (just outside or around the root of the tooth origin). Pulp therapy, such as pulpotomy, is a common endodontic procedure in which dental pulp is removed from the pulp chamber. The nonsurgical treatment of root canals, especially in difficult cases such as teeth with blocked, narrow or unusually positioned canals, also is a major part of endodontic therapy(endodontic motor).

A general dentist can perform root canal treatment, but it is most often provided by an endodontist, who specializes in pulp problems.

The endodontist removes the inflamed/infected pulp, cleans and shapes the inside of the canal and fills and seals the space. Afterwards, the endodontist usually will refer you back to your dentist for placement of a crown or other restoration on the tooth to protect it. The restored tooth will have a natural appearance and continue to function like other healthy teeth. With proper oral care, it may last a lifetime.

The cost of endodontic treatment varies depending on the complexity of the condition and which tooth is affected. Most dental insurance plans provide some coverage for endodontic treatment.

Endodontic treatment and restoration generally are less costly than the alternative: tooth extraction and replacement with an implant and dental crown.

Endodontic treatment is necessary when the dental pulp(pulp tester) becomes inflamed or infected as a result of deep tooth decay, repeated dental procedures on the tooth or a crack, chip or other injury to the tooth. Most teeth can be saved by endodontic treatment.

Endodontic treatment may also be required for surgical removal of diseased or abnormal (pathologic) tissues, repair procedures associated with the surgical removal of pathologic tissues, repair of cracked teeth or the replacement (replantation) of teeth knocked out (avulsed) by injury.

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The Cost of Endodontic Treatment

Endodontics is a specialized type of dentistry that deals with abnormal tooth pulp; the causes/origins, diagnosis, prevention and treatment of diseases and injuries to the pulp; and other conditions affecting the tissues surrounding the pulp and canal (channel inside the tooth root). Tooth pulp, the soft tissue that contains nerves, blood vessels and connective tissues, runs through the hard tissue inside the tooth (dentin) and extends from the crown (top) of the tooth down to the tip of the root in the jaw bone.

Depending on your situation, your dentist or endodontist may perform any one or combination of procedures to treat your condition. The cost for endodontic therapy typically averages $600 to $900. The cost for a therapeutic pulpotomy (excluding final restoration) is approximately $150, and the cost for apicoectomy/periradicular surgery ranges from $550 to $700.
Signs and Symptoms of Endodontic(endodontic motor) Problems.

You may need endodontic treatment if you experience the following:

Significant tooth discomfort or pain
Prolonged tooth sensitivity to hot and cold
Gum tenderness to the touch and when chewing
Swelling
Tooth discoloration
Drainage and tenderness in the lymph nodes, jaw bone and gingival tissues

If a root canal procedure is not performed, an abscess (infected pus pocket) can form at the tip of the tooth root that can be painful. Even if there is no pain, the bone holding the tooth in the jaw can be damaged.
When is Endodontic Treatment Appropriate?

Endodontic treatment is necessary when the dental pulp(pulp tester) becomes inflamed or infected as a result of deep tooth decay, repeated dental procedures on the tooth or a crack, chip or other injury to the tooth. Most teeth can be saved by endodontic treatment.

The endodontist removes the inflamed/infected pulp, cleans and shapes the inside of the canal and fills and seals the space. Afterwards, the endodontist usually will refer you back to your dentist for placement of a crown or other restoration on the tooth to protect it. The restored tooth will have a natural appearance and continue to function like other healthy teeth. With proper oral care, it may last a lifetime.

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The Technique of Imaging in Endodontics

CT in addition to 3D images offer several advantages over conventional radiography: it eliminates anatomical noise and high contrast resolution, allows differentiation of tissues with less than 1% physical density difference to be distinguished in comparison to conventional radiography that requires 10%. When examining jaws, axial scans are usually acquired to avoid artifacts caused by posts, crowns, and metallic fillings .

CT can even supply additional information about the morphology of the root-canal system provided that it does not contain metallic root-canal posts . However, the geometric resolution of CT is insufficient to reveal the exact shape of the root-canals , and a very high radiation dose is required to achieve a high enough resolution to assess root-canal anatomy in detail .CT may also be useful for the diagnosis of poorly localized odontogenic pain. In some circumstances in which periapical radiographs reveal nothing untoward, CT may confirm the presence of a periapical lesion .

The assessment of the ‘third dimension’ with CT imaging allows the determination of the number of roots and root canals,as well as where root canals join or divide. This knowledge is useful when diagnosing and managing failed endodontic motor treatment. CT can also be used to localize foreign bodies in the jaws such as gutta-percha and root-canal sealer. CT in endodontics has however some disadvantages such as the high radiation dose and the high costs of the scans . Other disadvantages are scatter due to metallic objects, relatively low resolution in comparison to conventional radiographs.

Micro-computed tomography (micro-CT), another alternative CT technique, has been considered in endodontic imaging .The use of micro-CT remains a research tool limited to in vitro measurementsof small samples; due to the high radiation dose required, and cannot be employed for human imaging in vivo .

Ultrasound imaging is based on the reflection of sound waves (echoes), with a frequency outside the rangeof human hearing (1-20 kHz), at the interface of tissues which have different acoustic properties . The echoesare detected by a transducer which converts them into an electrical signal, and a real-time black, white and shades of grey echo picture is produced on a computer screen .

The technique is easy to perform and may show the presence, exact size, shape, content and vascular supply of endodontic lesions in the bone . Ultrasound has been found to be a reliable diagnostic technique in the differential diagnosis of periapical lesions (granulomas versus cysts) with the aid of the echo picture (hyperechoic and hypoechoic) and through the use of the colour laser Doppler effect to provide evidence of vascularity within the lesion .

See more: https://www.alandental.com/category-82-b0-Dental-Pulp-Tester.html

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How Can You Do a Successful Endodontic Treatment

Various studies around the globe has reported that the most important factor the rotary instrument seperation was the operator. This is probably attributed to their clinical skills or their decision either to use instruments for a specific number of times or until defects were evident.

Successful endodontic motor treatment depends on a series of sequential procedures including shaping and cleaning of the root canal system. Biggest engima for an endodontist is the separation of rotary endodontic instruments .This negates the achievement of efficient bio mechanical preparation , which can result in under-filling of the root canal or the treated case may end in failure.

Preventive procedures related to breakage/ seperation are of utmost importance. Therefore an endodontist should have understanding of the mechanisms and factors contributing to file fracture is essential. It is very essential that both training and adequate skills are imperative for all dental procedures and particularly so in rotary endodontics.

The thumb rule for rotary endodontics as with other endodontic hand instruments is examination of the dental equipment, before and after use, to rule out any stress on the instrument/ stretch marks. Other important rule is that no rotary instruments should not be used in dry canals and or no instrument should be used without any lubrication. Further rotary files should be used according to the manufacturer’s instructions and excessive forces should be avoided. There is a variety of protocols for rotary root canal instrumentation.

Another important factor for rotary instrument seperation is the root canal morphology. More complicated the root canal morphology, the greater the risk of endodontic instrument breakage. A higher prevalence of rotary instrument separation has been reported in molars particularly in the mesial roots of mandibular molars.Further, the risk of instrument seperation in the apical third of the canal is higher when compared with coronal and middle thirds.Rotary files undergo greater fatigue as the curvature increases and the contact surface with the dentinal walls is greater since most curved canals are narrow. Clinically, fatigue of an instrument may be related to the degree of instrument flexure when placed in a curved root canal.

When the curvature of canals is pronounced, the cyclical fatigue of the instrument is greater and thus its life expectancy is lower.The parameters of the angle and the radius of curvature are independent in such a way that even if two canals have the same angle of curvature they may have different radii of curvature, which indicates that some curves are sharper than others.