Root canal

Abstract: Introduction: An Historic Perspective PART ONE: The Art of Endodontics Diagnostic Procedures Orofacial Dental Pain Emergencies: Endodontic Diagnosis and Management Nonodontegenic Orofacial Pain and Endodontics: Pain Disorders Involving the Jaws that Simulate Odontalgia Case Selection and Treatment Planning Preparation for Treatment Armamentarium and Sterilization Tooth Morphology and Cavity Preparation Cleaning and Shaping the Root Canal System Obturation of the Cleaned and Shaped Root Canal System Records and Legal Responsibilities. PART TWO: The Science of Endodontics Pulp Development, Structure and Function Periapical Pathology Endodontic Microbiology and Treatment of Infections Instrument Materials and Devices Pulpal Reaction to Caries and Dental Procedures PART THREE: Related Clinical Topics Traumatic Injuries Endodontic-Periodontic Interrelationships Endodontic Pharmacology Surgical Endodontics Management of Pain and Anxiety Bleaching Nonvital and Vital Discoloured Teeth Restoration of the Endodontically Treated Tooth Pediatric Endodontics Geriatric Endodontics Nonsurgical Endodontic Retreatment Digital Technologies in Endodontic Practice CONCLUSION: Tomorrow Challenge

Abstract: The influence of various factors that may affect the outcome of root canal therapy was evaluated in 356 patients 8 to 10 yr after the treatment. The results of treatment were directly dependent on the preoperative status of the pulp and periapical tissues. The rate of success for cases with vital or nonvital pulps but having no periapical radiolucency exceeded 96%, whereas only 86% of the cases with pulp necrosis and periapical radiolucency showed apical healing. The possibility of instrumenting the root canal to its full length and the level of root filling significantly affected the outcome of treatment. Of all of the periapical lesions present on previously root-filled teeth, only 62% healed after retreatment. The predictability from clinical and radiographic signs of the treatment-outcome in individual cases with preoperative periapical lesions cases was found to be low. Thus, factors which were not measured or identified may be critical to the outcome of endodontic treatment.

Abstract: Local wound debridement in the diseased pulp space is the main step in root canal treatment to prevent the tooth from being a source of infection. In this review article, the specifics of the pulpal microenvironment and the resulting requirements for irrigating solutions are spelled out. Sodium hypochlorite solutions are recommended as the main irrigants. This is because of their broad antimicrobial spectrum as well as their unique capacity to dissolve necrotic tissue remnants. Chemical and toxicological concerns related to their use are discussed, including different approaches to enhance local efficacy without increasing the caustic potential. In addition, chelating solutions are recommended as adjunct irrigants to prevent the formation of a smear layer and/or remove it before filling the root canal system. Based on the actions and interactions of currently available solutions, a clinical irrigating regimen is proposed. Furthermore, some technical aspects of irrigating the root canal system are discussed, and recent trends are critically inspected.

Abstract: Objective. The purposes of this study were to determine what microbial flora were present in teeth after failed root canal therapy and to establish the outcome of conservative re-treatment. Study design. Fifty-four root-filled teeth with persisting periapical lesions were selected for re-treatment. After removal of the root filling, canals were sampled by means of advanced microbiologic techniques. The teeth were then re-treated and followed for up to 5 years. Results. The microbial flora was mainly single species of predominantly gram-positive organisms. The isolates most commonly recovered were bacteria of the species Enterococcus faecalis. The overall success rate of re-treatment was 74%. Conclusions. The microbial flora in canals after failed endodontic therapy differed markedly from the flora in untreated teeth. Infection at the time of root filling and size of the periapical lesion were factors that had a negative influence on the prognosis. Three of four endodontic failures were successfully managed by re-treatment.