Lecture 7: Endodontics (8min)

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En provenance du cours de University of Pennsylvania

Introduction to Dental Medicine

281 notes

University of Pennsylvania

Introduction to Dental Medicine

281 notes

The mouth is the window into human health. This course provides an overview of dental medicine to engage, educate, excite and assist you in improving the oral health of your patients and members of your community. We will review topics in dental medicine including scope of the field, what to expect in function, and some of the many ways that dysfunction may present for different patients. This will include discussions of mouth, jaw, and tooth anatomy, pathology, and treatment. We will talk about differences between patients and the unique roles that different members of the dental field may play in treatment depending on the patient and condition. This course starts from basic concepts and proceeds to review trends in current research and technology. We offer scientific background, some skills for patient evaluation and interview, and some suggestions for further learning for those interested in or involved in dental education.

À partir de la leçon

Week 7 - Overview of Dental Specialties: Scope and Modalities of Treatment

Selected cases in dental medicine ranging from oral surgery to prosthetic reconstruction are discussed in the context of the important role of dental specialists. Each presenter discusses the challenges of focused dental treatment and presents cases with "before" and "after" documentation.

Lecture 1: Dental Specialties: Introduction (1min)1:02

Lecture 2: Periodontal Treatment (11min)11:06

Lecture 3: Oral and Maxillofacial Surgery (7min)7:18

Lecture 4: Orthodontic Treatment (16min)15:56

Lecture 5: Aesthetic Dentistry (8min)8:36

Lecture 6: Periodontics and Prosthodontics (7min)7:10

Lecture 7: Endodontics (8min)7:43

Rencontrer les enseignants

Dr. Uri Hangorsky
Associate Dean for Academic Affairs/ Director PASS
School of Dental Medicine
Dr. Thomas P. Sollecito
Professor and Chairman of Oral Medicine
School of Dental Medicine
Dr. Eric Stoopler
Associate Professor of Oral Medicine
School of Dental Medicine

[MUSIC]

I'm Doctor Karabucak, Associated Professor at the University of Pennsylvania,

department of Endodontics.

I will be reviewing and highlighting the scope of Endodontics and

treatment modalities within Endodontics specialty.

Endodontics is a branch of dentistry recognized by

the American Dental Association and has been playing an important role in

providing dental care as a specialty since 1964.

Our specialty focuses on the human dental pulp,

surrounding periradicular tissues, and bone structure.

It's study and practice encompass the basic and

clinical sciences investigating the etiology, diagnosis,

prevention and treatment of diseases, or injuries of the pulp and

associate tissues such as periodontal tissues and bone supporting roots.

Human dental pulp is a connective tissue containing blood vessels And

nerves, uniquely situated within the rigid,

mineralized tooth structures like dentin, and cementum.

Highly vascularized pulpar tissue differentiates from periodontal tissues,

as soon as it enters into root canal.

Dental pulp resides within the tooth and

extends from the top of the canal space to the tip of the root.

Normal, healthy pulp plays an essential role in tooth and

root development during childhood It maintains vascular tone and

regulates dentin formation and the position which stimulates

tooth eruption through the jaw bone to take it's place within the dental arch.

In case of a disease or an injury,

if dental pulp looses it's vitality root development cannot take place and

surrounding structures will be prone to infections.

During natural and healthy development of the teeth, pulpal tissues continue to

maintain vascular tone and support inflammatory responses by

modifying new dentin formation to support and repair tooth structures.

Due to tooth decay or trauma, the pulp may become inflamed or infected.

This injury to the pulp may trigger discomfort or pain

increasing with temperature change within the oral environment and with mastication.

In these situations the role of endodontists is to

assess the health of the pulp and to treat accordingly.

Extra attention should be made to preserve healthy pulp tissue

to prevent further extensive treatment.

If the level of inflammation is reversible, health of pulp can be

preserved and because of inflammation such as dental decay, should be removed and

the tooth is restored to protect and promote health of the pulp.

However, if the inflammation and infection is advanced, root canal treatments

should be initiated, and the diseased pulp and infected tissues should be removed.

In cases of advanced dental infections,

drainage should be established to reduce localized pressure

more importantly to prevent pooling to spread into facial spaces.

The goal of root canal treatment is to remove the cause of infection, clean and

disinfect canal systems, fill canal systems to maintain clean and disinfected.

Even though in general treatment is done in one visit,

in some cases it may require multiple visits.

The entire treatment must be preformed aseptically to reach best outcomes.

During the treatment different instruments and

irrigation solutions are used to shape and disinfect canals.

A bio-compatible material is used to fill and seal these canal systems.

At different stages of the treatment, or in some cases throughout the treatment,

an endodontic operating microscope is used to facilitate visualization of canals and

to make sure that all canals are located and treated adequately.

It is important to point out that upon completion of root canal treatment,

access should be sealed and the tooth should be restored permanently.

A permanent restoration will prevent recontamination of canal systems,

also will protect remaining tooth structures against chewing forces.

Root canal treated tooth can last a lifetime.

But in some cases, root canal treated tooth does not heal properly when

root canal system becomes really infected or because of its complex root anatomy.

Endodontic retreatment may become necessary to save the tooth.

Retreatment can be either accomplished by reentering the canal system through

a crown portion of the tooth or by accessing diseased root ends directly.

Treatment options should be evaluated for each individual tooth and

discussed with the patient to reach the best expected outcome.

If the treatment decision is non-surgical, new access opening through a crown

is made, and all canal system is clean, disinfected, and sealed.

As you see with this case that previously

untreated canal was located during re-treatment, under microscope.

Post-operative radiograph shows that all canals were

disinfected and filled to promote healing of peridicular tissues.

However, if the treatment decision is to access infected root ends directly,

a surgical flap or a osteotomy around root tip are made to expose disease areas.

This process allows root canal systems to be cleaned and sealed apically.

The procedure is preformed with local anesthesia, and in most cases

it is more conservative compared to previous treatment options we discussed.

It preserves well fitted restorations and

helps to clean anatomical complexities more efficiently.

As you see with this case, that granuloma was removed from the apical

areas of a lower molar an untreated canal was located.

All canals were cleaned and sealed.

Lastly endodontic care doesn't end at the completion of endodontic treatment,

but continues with periodic evaluations.

Periodic evaluations will make sure that the health of teeth structures and

surrounding tissues continue.

And oral health is maintained.

Thank you for your attention.

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