1. Endodontics Dental Materials I DH 113

2. AAE One of the nine dental specialties Over 6400 members in US, Canada & Internationally Certifying Board – American Board of Endodontics (ABE)

3. What is an Endodontist? Dentist who specializes in root canal (endodontic) treatment Removes damaged tissue from inside the root canals of a tooth Have advanced surgical and nonsurgical skills for complex cases 2-3 year post-graduate course work after dental school

4. Why Endo? Prolonged sensitivity to hot and/or cold Abcess – look for fistula Pain Irreversible Pulpitis –Deep Caries –Trauma (external) –From dental work (nerve dies) –Cracked or chipped tooth http://www.dentalnews.at/en/dental-fistula/

5. Saving the Tooth Infected pulp is removed Pulp canals are cleaned and shaped, then filled Following RCT, tooth generally requires a crown – endo treated teeth may become brittle and are more prone to fracture

6. Alternatives Most often, extraction of the tooth is the only option

8. Cracked root

9. Trauma

10. Retreat

11. Endo Instruments Reamer, K File, Hedstrom File

12. Root Canal Anatomy Multiple Canals Accessory Canals

14. Lateral Canal Extrusion of gutta percha into lateral canal

15. The Root Canal Step 1:Exam & diagnosis » X-Rays, Pulp testing Step 2:Patient preparation » Local anesthetic, place rubber dam Step 3:Open the tooth Step 4:Clean & shape the Root Canal » Endo files, laser, ultrasonic » Additional XR to ensure end of root reached

16. Step 5:Fill the canal » gutta percha and adhesive » glass ionomer-type cement » Calcium hydroxide » ZOE-type Step 6:Make post space for restorative Step 7:Temporary filling Then:Refer back to dentist for permanent restoration Re-evaluate in 6-9 months with follow-up XR

17. Root canal treatment

18. Finding Correct Length Upper right lateral Laterally condensed with diagnostic point gutta percha through apex

19. Apex locator j. morita.com

20. Lower Molar C shaped canal C shaped canals with diagnostic points Gutta percha in place

21. When things go wrong…

22. Apicoectomy

23. Retrofill Endo Lesion Amalgam fills apex

24. Other types of Endodontic surgeries 1) Curettage (removing inflamed tissue) 2) Root amputation (selected removal of roots) 3) Hemisection (dividing the tooth in half) 4) Intentional Replantation (removing and reinserting the tooth).

25. Autoclavable Kit

26. Irrigating the Canal Syringe Narrow tips

27. Paper Points Absorbant

28. Root Canal Sealer Calcium hydroxide/Eugenol sealer with Iodoform

29. Gutta Percha, Points & Fillers

30. Gutta Percha A rubbery substance derived from the latex of any of several tropical trees of the genera Palaquium and Payena, used as an electrical insulator, as a waterproofing compound, and in golf balls. Just a bit of trivia!

31. Endofil Endo filling material based on ZOE

32. ADA News: FDA clears laser root canal therapy (01/29/02) Enamel, dentin and pulp removal as well as shaping the root canal provides optical energy to water, and the water particles provide the cutting of dental hard tissue: Waterlase Postoperatively, it may reduce pain, discomfort, swelling and the need for antibiotics. Laser energy kills viruses and bacteria during debridement phase