PROGRAMA DE TRABAJO DEL CURSO DE ENDODONCIA FES Iztacala  UNAM 

 PROFESOR DR. RICARDO RIVAS MUÑOZ. 

 

 

Objetivos Calendarización y Horario Profesores 

Investigación

Contenido (Mapa del sitio) Temario Evaluación y Calificaciones Prácticas Preclínicas y Clínicas Instrumental Recursos Fuentes de consulta

 

Libro Básico del Curso de Endodoncia (REGRESAR A LA BIBLIOGRAFÍA COMPLETA)

 

Weine, Franklin. ENDODONTIC THERAPY. The C.V. Mosby Co. 5th. ed. Saint Louis. 1996. 630 pp

 

 

CONTENTS

1. Basis for successful endodontics

    History of Endodontics

    Principles of Endodontic Therapy

    Indications and Contraindications

    Prognosis for Endodontic Therapy

    Role of Endodontics in Restorative Dentistry

    Role of Endodontics in Reconstructive Dentistry

    Role of Endodontics in Prosthetic Dentistry

 

2. Diagnosis and treatment planning

    Importance of a Medical History

        Rheumatic fever

        Artificial heart valves

        Coronary artery disease

        Hypertension

        Diabetes

        Hepatitis

        Blood diseases

        Prostheses for total replacement of joints

        Other serious diseases

        HIVD, syphilis and other sexually transmitted diseases

        Recent change in weight

        Psycologic problems

        Drug and medication therapy

    Dental History

    Radiographs. The Most Important Diagnostic Aid

    Other Diagnostic Aids

        Visual and digital examination of hard and soft tissues

        Thermal pulp testing

        Electric pulp testing

        Percussion

        Test cavity

        Selective anesthesia

        Transillumination

    VERTICAL FRACTURES OF POSTERIOR TEETH. James A Dewberry, Jr.

    Endodontic Therapy in Total Treatment Planning       

 

3. Histophysiology and diseases of the dental pulp

        Marshall H. Smulson and Steven M. Sieraski

    Histophysiology

        Gross morphology by the dental pulp

        Special environment of the dental pulp

        Structural elements of the dental pulp

                           TABLE. EFFECT OF PULP PATHOSES ON INTRAPULPAR PRESSURE

        Functions of the dental pulp

            Formative function

            Nutritive function

            Nervous function (neurogenic factor)

                Afferent-efferent pathway

                        TABLE. CLASSIFICATION AND FUNCTION OF FIBERS IN PERIPHERAL NERVES

                              TABLE. PAIN FIBERS IN THE PULP (NOCICEPTIVE/ALGOGENIC)

                Basic anatomy of the gate control system

                How the gate works

                Clinical applications of the gate control theory of pain

                Theories of pulpodentinal pain fiber excitation

                Effect of the return impulse (efferent response)

            Defense function

                Dentinal pain

                The smear layer

                Tubular sclerosis

                Irritation (reparative) dentin formation

                Inflammation of the subjacent connective tissue

                Nature of the inflammatory response

                                TABLE. DIFFERENCES BETWEEN ACUTE AND CHRONIC INFLAMMATION

                Role of the dentinoblast

                Primary factors that initiate the acute inflammatory response

                                TABLE. SUMMARY OF INFLAMMATORY ACTIVITY IN PULPAL AND PERIAPICAL CONNECTIVE TISSUE

                Types of inflammation

                Immunologic considerations

    Diseases of the Dental Pulp

        Inflammatory diseases of the pulp

            Hyperalgesia

                Hypersensitive dentin

                                TABLE. COMPARATIVE TERMINOLOGY AND CLASSIFICATION OF PULPAL PATHOSES

                Hyperemia

                Etiology

                        TABLE. DIFFERENTIAL DIAGNOSIS OF POTENTIALLY REVERSIBLE AFFECTED PULPS

                                TABLE. AREA OF SURFACE OF DENTIN AVAILABLE FOR DIFFUSION AT VARIOUS DISTANCES FRAM THE PULP

                Histopathology and clinical symptoms

                Diagnosis

                Treatment

            Painful pulpitis

                Definition

                Classification

                    Acute pulpalgia (acute pulpitis)

                    Chronic pulpalgia (subacute pulpitis)

                Etiology

                Histopathology and clinical symptoms

                Diagnosis

            Nonpainful pulpitis

                Definition

                Classification

                    Chronic pulpitis (ulcerative or open form)

                    Chronic pulpitis (hyperplastic form)

                    Chronic pulpitis (closed form: carious lesions absent)

                Etiology

                Histopathology and clinical symptoms

                Diagnosis

                Treatment

        Additional pulp changes

            Pulp necrosis

                Definition

                Histopathology and clinical symptoms

                Diagnosis

                Treatment

            Retrogressive pulp changes

                Atrophy and fibrosis

                Calcifications                       

 

4. Pulpoperiapical pathology and immunologic considerations

        Marshall H. Smulson, James C. Hagen and Susan J. Ellenz

    Histophysiology of the periapex

        Cementum

        Periodontal ligament

            Nervous function

            Mobility

            Pulpoperiodontal junction

            Periapical cyst formation

        Alveolar bone

    Pulpoperiapical disease (periapical pathoses of pulpal origin)

        Painful pulpoperiapical pathoses

            Acute apical periodontitis

            Acute periapical abscess

            Recrudescent abscess (phoenix abscess)

            Subacute periapical abscess

                        TABLE. COMPARATIVE TERMINOLOGY AND CLASSIFICATION OF PULPOPERIAPICAL PATHOSES

            Etiology

            Histopathology and clinical symptoms

            Diagnosis

            Treatment

        Nonpainful pulpoperiapical pathoses

            Pulpoperiapical osteoclerosis (condensing osteitis, sclerosing osteitis)

            Incipient chronic apical periodontitis

            Periapical granuloma

            Chronic periapical abscess (suppurative apical periodontitis)

            Periapical cyst

            Etiologý

            Histopathology and clinical symptoms

                    TABLE. MOBILIZATION OF A WELL-ESTABLISHED PERIAPICAL GRANULOMA (TYPE I PULPOPERIAPICAL LESION)

                Kronfeld's mountain pass concept

                Chronic periapical abscess (suppurative apical periodontitis)

                Periapical cyst

            Diagnosis

                Pain

                Swelling and palpation

                Percussion and mobility

                Color

                Vitality tests

                Radiographs

            Treatment of nonpainful pulpoperiapical pathoses

                Histopathologic evidence

                    TABLE. CLASSIFICATION AND ETIOLOGY OF CYSTS

                Clinical evidence

            Healing mechanisms of pulpoperiapical cysts

                    TABLE. REPORTED PERCENTAGES OF PERIAPICAL LESIONS

    IMMUNOLOGIC CONSIDERATIONS

        Induction of the immune response

        Components of the immune system

        Chemical mediators of the inflammatory and immune responses

                TABLE. MAJOR CHEMICAL MEDIATORS OF INFLAMMATION

        Role of the immune system in the inflammatory process

        Damaging effects of the immune response

    References

 

5. Endodontic emergency treatment

    EFFECTS OF EMERGENCY TREATMENT

            Flareups even with the best therapy

            Method for reaching new patients

            Demonstration of continued interest in past patients

            Self-satisfaction

    INITIAL THERAPY FOR "HOT TEETH"

            Need for making diagnosis

                    TABLE. EMERGENCY TREATMENT FOR "HOT" TEETH

            Types of diangnostic aids needed

        Acute pulpitis

        Acute pulpitis with apical periodontitis

        Pulp necrosis

        Acute periapical abscess

            Culturing the exudate

            Irrigants used in treating acute abscesses

            Drainage through the tissue and bone

    EMERGENCY TREATMENT OF TRAUMATIC INJURIES - FRACTURES

            Crown fracture without pulp exposure

            Crown fracture with vital pulp exposure

            Crown fracture with necrotic pulp exposure

            Horizontal root fracture

    EMERGENCY TREATMENT OF TRAUMATIC INJURIES - AVULSED TEETH

            Newer philosophies of replantation

            Technique

                Suggested treatment of the avulsed teeth

            Use of transport medium

                Hank's Balanced Salt Solution (HBSS)

                Saliva

                Milk

                Water

            Stabilization

            Postoperative instructions and systemic treatment

            Replantation after an extended extraoral period

            Typical posttreatment sequelae

            Ultimate long-term prognosis for replanted teeth

            Intentional replantation

                Prognosis for intentional replantation

    EMERGENCY THERAPY FOR INTRATREATMENT PAIN

            Apical periodontitis secondary to treatment

            Incomplete removal of pulp tissue

            Recrudescence of a chronic apical periodontitis

            Recurrent periapical abscess

         Preventing flare-ups during treatment

            Preventing postoperative percussion sensitivity - secondary apical periodontitis

            Preventing flare-ups when treating a tooth with a necrotic pulp

            Use of antibiotic and other agents to prevent flare-ups

        Significance of a chronic draining sinus

    References

 

6. Access cavity preparation and initiating treatment

    RULES FOR PROPER ACCESS PREPARATION

          TABLE. TYPICAL TOOTH LENGTH, NUMBER OF ROOTS AND CANAL CONFIGURATION FOR ANTERIOR TEETH

            TABLE. TYPICAL TOOTH LENGTH, NUMBER OF ROOTS AND CANAL CONFIGURATION FOR BICUSPIDS

            TABLE. TYPICAL TOOTH LENGTH, NUMBER OF ROOTS AND CANAL CONFIGURATION FOR MOLARS

    COMMON CANAL CONFIGURATIONS

            Canal configuration studies

            Types of configuration

                     TABLE. CANAL CONFIGURATION STUDIES FOR THE MESIOBUCCAL ROOT OF THE MAXILLARY FIRST MOLAR

                            TABLE. CANAL CONFIGURATION STUDIES FOR MANDIBULAR FIRST BICUSPIDS

                            TABLE. CANAL CONFIGURATION STUDIES FOR MESIAL ROOT OF MANDIBULAR SECOND MOLAR

                            TABLE. CANAL CONFIGURATION STUDIES FOR MESIOBUCCAL ROOT OF MAXILLARY SECOND MOLAR

    ARMAMENTARIUM FOR ACCESS PREPARATIONS

    PULP CANAL ANATOMY AND ACCESS PREPARATIONS

            Maxillary central incisor

            Maxillary lateral incisor

            Maxillary cuspid

            Mandibular central and lateral incisors

            Mandibular cuspid

            Maxillary first bicuspid

            Maxillary second bicuspid

            Mandibular first bicuspid

            Mandibular second bicuspid

            Maxillary first molar

                Names of canals in mesiobuccal root

            Maxillary second molar

            Mandibular first molar

            Mandibular second molar

    GENERAL SHAPE OF WALLS IN ACCESS PREPARATIONS

            Removal of obstructions to the apex

            Need for divergent walls

            Access for badly worn or fractured anterior teeth

    PREPARATION OF AREA OF TREATMENT

            Need for local anesthesia during endodontic therapy

            Types of anesthetic solutions used in endodontics

            Injections needed for removal of vital pulp tissue

                        TABLE. LOCAL ANESTHETIC FOR TREATING TEETH WITH VITAL PULP TISSUE

            Special comments about mandibular block

                Administer correct amount of solution

                Use of the short needle

                Use care when giving an IAN block with a short needle

            Intraligamentary anesthesia

            Application of rubber dam for severly broken-down teeth 

            Use of bands

            Access when deep gingival decay is present

            Aid for a leaky rubber dam

    References         

 

7. Intracanal treatment procedures, basic and advanced topics

    BASIC INTRACANAL INSTRUMENTS

            Broaches

            Methods for using reamers and files

                Reaming

                Filing

                Circumferential filing

             Reamers

            Files

                Need for flexible files

                Hedstrom files

            Styles of instruments

            Standarization

                Prestandardization instruments

                Landmarks of standarized instruments, original and revised

                Quality control

    RULES FOR CANAL PREPARATION

                TABLE. CORRELATION BETWEEN FILES

    DETERMINATION OF CORRECT WIDTH FOR CANAL PREPARATION

            Minimal instrumentation at any appointment - to reach size 25

            Determination of apical width

            Gaining sufficient enlargement for using gutta-percha - the flared preparation

            Canal enlargement in moderately wide and/or straight canals

            Canal enlargement in smaller, relatively straight canals

            Importance of using MAF as final instrument after using flaring files short of the working length

            Overuse and abuse of flaring

            Final test for completion of canal preparation - placement of the finger spreader

            Completing canal preparation when using silver points

    AIDS FOR PREPARING DIFFICULT CANALS

            Problems encountered in canal preparation

            Precurving of files

            Incremental instrumentation

            New instruments with intermediate sizes

            Need for remeasurement when preparing curved canals

    PREPARATION IN EXTREMELY CURVED CANALS  

            Determination of canal curvature

            Observations that canal shape changes

            Plastic block studies

                            TABLE. CANAL CHARACTERISTICS NOT SEEN ON ROUTINE RADIOGRAPHS

            Standard preparation in the sharply curved canal

            Applications on extracted teeth

            Avoiding the apical zip and the elbow

            Application to clinical cases by using customized files

                Use of reverse filing

                New instruments for reverse filing

                The "crown down" technique

                Typical cases

                Curvatures of 60 to 90 degrees

                                TABLE. RELATIVE ABILITY OF THE SYSTEMS

                Curvatures of greater than 90 degrees

                Consequence of position of the elbow

                Preparation of bayonet-curved canals

    NEW FILE SYSTEMS FOR PREPARATION OF CURVED CANALS

            Effects of increased flexibility on final canal shape

            Flexible file systems

            Nickel-titanium files

            Minimizing zipping by flute removal and modification of tips

        Disadvantages of flexible files

            Non-ISO taper file for penetration

    PREPARATION OF TYPE II CANAL SYSTEMS

    COMPLETE ENDODONTIC TREATMENT OF PRIMARY TEETH

    USE OF ENGINE-DRIVEN INSTRUMENTS

            Engine-driven reamers

            Endodontic handpieces

            Gates-Glidden burs and Peeso reamers

    ULTRASONICS

            History of ultrasonics in dentistry

            Method for action

            Techniques for use

            Canal preparation

            Related uses for ultrasonics

    IRRIGANTS AND CHELATING AGENTS

            Functions of irrigants

            Useful irrigants

            Method of irrigation

            Recent studies concerning irrigants and their clinical implications

            Function of chelating agents

                EDTA

                EDTAC

                RC-Prep

    INTRACANAL MEDICAMENTS

            Function of intracanal medicaments

            Phenol and related volatile compounds

            PBSC

            Sulfonamides

            Corticosteroid-antibiotic combinations

            Calcium hydroxide as a medicament for "weeping" cases

    SEALING AGENTS FOR INTERTREATMENT DRESSING

            Need for sealing agents

            Types of available sealing agents

    TREATMENT OF OPERATIVE PERFORATIONS

            General rules for treating operative perforations

            Treatment of furcation perforation by packing the chamber

            Treatment of perforations by enlargement and filling as an additional canal

            Lateral perforations treated by packing gutta-percha adjacent to the defect

            Perforations eliminated by surgery

            Perforations treated surgically or orthodontically

            New materials for perforation repair

    References

 

8. Calculation of working length

    HISTORICAL PERSPECTIVES

    METHODS FOR CALCULATION OF WORKING LENGTH

        Results

    USE OF RADIOGRAPHIC APEX AS TERMINATION POINT

        Is the radiographic apex reproducible?

        Advantages

        Disadvantages

    SPECIFIC DISTANCES SHORT OF THE RADIOGRAPHIC APEX

    ACCORDING TO THE STUDIES OF KUTTLER

        Advantages

        Disadvantages

        Technique for calculating working length

        Additional considerations

            Short exiting

            Effect of periapical radiolucency with resorption

        Symptoms of overinstrumentation

        Conclusions

    USE OF THE APEX LOCATOR

        History

        Development of different types of apex locators

        Technique for calculating working length using the resistance locators

                  TABLE. STUDIES ON THE EFFECTIVENESS OF APEX LOCATORS

        Advantages

        Disadvantages

        Apex locators versus radiographs

    USE OF REFERENCE POINTS

    USING THE BUCCAL OBJECT RULE AND DETERMINING WORKING LENGTH FOR POSTERIOR TEETH

    References

 

9. Canal filling with semisolid materials

    READINESS OF THE CANAL FOR FILLING

            Problems stemming from reliance on negative culture

            Significance of foul odor

            No excessive exudate

            Lack of periapical sensitivity

    NEED FOR FILLING CANALS

    RATIONALE FOR USING SEMISOLID MATERIALS

            Effect of canal preparation

            Effect of original shape

            Indications

    GUTTA-PERCHA

            Phase transitions of trans-polyisoprene

            Advantages

            Disadvantages

            Composition of gutta-percha cones

            Importance of canal preparation

            Availability of cones

                    TABLE. CONSTITUENTS OF COMMERCIAL GUTTA-PERCHA CONES

    CANAL FILLING IN NONCOMPLICATED CASES

        Filling large, relatively straight canals

            Obtaining master cone

            Customized master cone development

        Lateral condensation in larger canals

            Armamentarium

            Technique

                    TABLE. CORRESPONDENCE OF FINGER SPREADERS TO APICAL CANAL WIDTH AND AUXILIARY CONES

    CANAL FILLING IN COMPLICATED CASES

        Filling smaller curved canals

            Fitting the finger spreader

            Obtaining the master cone

            Lateral condensation

        Filling molar teeth

            Fitting the finger spreader

            Obtaining the master cone

            Lateral condensation

            Arrangement for restoration

        Care of finger spreaders

    ALTERNATIVE CANAL FILLING METHODS

        Warm gutta-percha

            Rationale

            Technique

            Comparison with other methods

            Indications

    THERMOPLASTIC GUTTA-PERCHA DELIVERY SYSTEMS

        Compacted gutta-percha

        Injection-molded techniques

            Obtura II

            Ultrafil

            Use of sealers with thermoplastics

            Need for apical dentin matrix

        Partially dissolved gutta-percha

            Disadvantages

        Modified chloropercha

            Indications

    RETREATING FAILING GUTTA-PERCHA CASES

            Re-treating short fills

            Re-treating for insufficient canal preparation and/or condensation

    SEALERS WITH SEMISOLID MATERIALS

            Functions

            Rickert's formula

            Tubliseal

            Wach's paste

            Procosol

                    TABLE. SEALERS

            Calcium hydroxide sealers

            Selection of sealer

    References

 

10. Solid-core canal filling materials: theory, technique and re-treatment

    HISTORY OF SOLID-CORE FILLINGS

            Overuse of silver points

            Binding of silver points into dentin

            Corrosion potential of silver points

            Evaluation of well-treated silver points cases

            Future for solid-core filling materials

    TECHNIQUE FOR FILLING WITH SILVER POINTS

            Readiness of the canal for filling

            Selection of the trial point

            Preparation of the trial point

            Placement of the trial point

            Filling the canal

            Final temporary filling with silver points

    IMPROVED SILVER POINTS

            Specifications

            Advantages

    SECTIONAL OR "TWIST-OFF" TECHNIQUE

            Problems of gaining room for a post

            Indications for sectional technique

                Technique

                Determination of position for notching

                Use of twist-off to terminate at chamber floor

                Finishing and temporization

    TREATMENT OF FRACTURES OF MIDDLE THIRD OF ROOT

    THERMOPLASTIC SEMISOLID + SOLID-CORE = THERMAFIL

            History

            Basic for success

            Size verification

            Importance of canal preparation

            Carriers

            Sealer with Thermafil

            Steps for Thermafil obturation

    SEALERS WITH SOLID MATERIALS

            Other functions of sealer

    RE-TREATMENT OF SILVER POINT CASES

            Points that offer no problem in removal

            Points that cannot be easily gripped

            Ultrasonic treatment to remove tightly fitting points and posts

            Potential danger of the ultrasonic

            Re-treating a portion rather than the entire tooth

            Re-treating Thermafil failures

    References   

 

11. Periapical surgery

        Franklin S. Weine and Manuel A. Bustamante

    FALSE INDICATIONS

    SURGERY FOR CONVENIENCE OF TREATMENT

            Teeth with radiolucencies and brief period of time available for completion of therapy

            Recurrent acute exacerbations

            Root configurations presenting a strong possibility of failure if treated nonsurgically

            Teeth with most convenient access available by way of the apex

    SURGERY TO RE-TREAT A FAILURE OR SYMPTOMATIC CASE

            Failure of an incompletely formed apex to close

            Marked overfilling associated with failure

            Persistent pain

            Acute exacerbation after canal filling

            Lack of apical seal

            Unfilled portion of the canal

            Failures for unknown clinical reason

    SURGERY AFTER PROCEDURAL ACCIDENT

            Broken instruments

            Broken filling materials

            Ledging

            Root perforation

    SURGERY TO GAIN INFORMATION FROM A BIOPSY

            Medical history of a malignancy

            Findings of a periapical lesion, vital pulp, and extensive apical resorption

            Lip paresthesia

            All tissues removed must be examined microscopically

    FLAPS AND INCISIONS

            Functions of a flap

            Requirements of an ideal flap

                Making sure base is widest point of flap

                Avoiding incision oven a bony defect

                Including the full extent of the lesion

                Avoiding sharp corners

                Avoiding incision across a bony eminence

                Guarding against possible dehiscence

                Placing a horizontal incision in the gingival sulcus or keeping it away from the gingival margin

                Avoiding incisions in the mucogingival junction

                Avoiding improper treatment of periostium

                Taking care during retraction

                Types of flaps

                    Semilunar flap

                    Vertical flaps

                    Palatal flaps

                    Ochsenbein-Luebke flap

    ARMAMENTARIUM

    OPERATIVE AND PATIENT PRESURGICAL PREPARATION

            Operatory preparation

            Patient preparation

            Surgeon preparation

    TWO-STEP OR FILLING-FIRST TECHNIQUE

            Canal preparation before filling

            Disinfection immediately prior to filling

            Technique for using phenol

            Canal filling

    CURETTAGE AND APICOECTOMY

            Preparation of the surgical site

            Opening the flap

            Locating the apex

            Curettage

            Curettage as opposed to apicoectomy

            Completing the surgery

            Surgery from palatal access

    POSTRESECTION FILLING TECHNIQUE

            Disadvantages and advantages

            Armamentarium

            Technique

            Removing broken instruments and filling materials

    REVERSE FILLING PROCEDURES

            Indications

            Use of ultrasonic tips for reverse filling preparations

            Types of preparations

            Types of filling materials

            Reverse filling of a tooth with an incompletely formed apex

            Reverse filling incompletely sealed cases

            Reverse filling of significant lateral canals

            Reverse filling to seal perforations

            Reverse filling when the most convenient access is from the apex

            Filling when enlargement access is obtained from the apex

            Handling of the surrounding tissues during reverse filling

            Re-treating reverse filling failures

    SURGERY FOR ROOT FRACTURES

            Importance of diagnosis

            Choices of surgical therapy

            Removing an apical fragment

            Placing a chrome-cobalt alloy pin

    USE OF THE OPERATING MICROSCOPE

    SUTURING

    POSTOPERATIVE INSTRUCTIONS

    References

  

12. Root amputations

            Causes of failure

            Alternatives in periodontal therapy

    INDICATIONS AND CONTRAINDICATIONS

            Cautions to observe before starting amputation

                Sufficient support available for the segment to be retained

                Proper restoration of retained segment practical

        Periodontal indications for root amputation

        Endodontic and restorative indications for root amputation

        Contraindications for root amputations

    ARMAMENTARIUM

    GENERAL RULES FOR ROOT AMPUTATION

        Importance of root anatomy

        Endodontic therapy prior to root amputation

        Root amputation on periodontically involved teeth

        Vertical-cut method

        Presurgical crown-contouring method

        Vertical as opposed to horizontal preparation

    ROOT AMPUTATION FOR MAXILLARY FIRST MOLAR

        Root anatomy

        Amputation of the mesiobuccal root

        Amputation of the distobuccal root

        Amputation of a palatal root

        Amputation of both buccal roots

        Amputation of the palatal and distobuccal roots

    ROOT AMPUTATIONS FOR MAXILLARY SECOND MOLAR

        Root anatomy

        Amputation of the mesiobuccal root

        Amputation of the distobuccal root

        Amputation of both buccal roots

        Amputation of adjacent roots of the maxillary molars

        Amputation of the distobuccal root of both the first and second molars

    AMPUTATION PROCEDURES ON MANDIBULAR MOLARS

        Root anatomy

        Amputation of the mesial root

        Amputation of the distal root

        Bicuspidization

        Retaining the distal root of the first molar with the mesial root of the second molar

    POSTOPERATIVE INSTRUCTIONS

    TREATMENT PLANNING PROBLEMS IN ROOT AMPUTATION CASES

        Problems of vital root amputation

        Technique for emergency treatment following vital root amputation

        Modification for mandibular molars

    REFERENCES

 

13. Endodontic-periodontal problems

    CLASSIFICATION OF ENDODONTIC-PERIODONTAL PROBLEMS

            Types of endodontic-periodontal problems

                Class I

                Class II

                Class III

                Class IV

    EFFECT OF PERIODONTAL TISSUES ON PULP

            Exposure or irritation through auxilliary canals

            Furcation canals

            Vital but not normal pulp

            Effect of periodontal therapy on the pulp

    EFFECT OF PULP ON PERIODONTAL TISSUES

            Furcation canals - possible role in the development of Class I endodontic-periodontal lesions in molars

            Other types of Class I endodontic-periodontal  problems

    RATIONALE FOR TREATMENT OF CLASS I ENDODONTIC-PERIODONTAL CASES

            Similarity to a sinus tract

            Recording of the defect

            When a Class I lesion is not a Class I lesion

    TREATMENT OF COMBINED-LESION CASES

            Separate and unrelated lesions

            Single lesions with both endodontic and periodontal components

            Periodontal and endodontic lesions that have merged

    ENDODONTIC STABILIZERS

            Armamentarium

            One - sitting as opposed to three-sitting treatment

            Procedure for one - appointment treatment

            Procedure for three - appointment treatment

            Selection of cases

            Problems of canal enlargement

            Reasons for partial effectiveness yet ultimate failure of stabilizers

    REFERENCES

 

14. Endodontic-orthodontic relationships

        Franklin S. Weine and Steven R. Potashnick       

    EFFECT OF ORTHODONTICS ON THE TOOTH BEING MOVED

            Orthodontics as the etiologic agent for endodontics

            Resorptive defects

            Necessary monitoring by the orthodontist and the general dentist

            Treating teeth after orthodontic treatment

            Treating teeth during orthodontic treatment

    ENDODONTIC-ORTHODONTIC COMBINED THERAPY

            Basic periodontal principles for forced eruption

            Basic endodontic principles for forced eruption

            Basic orthodontic principles for tooth movement

            Forced eruption - methods and materials

                Tooth lacking a clinical crown

                Tooth having an intact clinical crown

    REFERENCES

 

15. Microbiology of endodontics

        Jerome V. Pisano and Franklin S. Weine

    ROUTES OF MICROORGANISM INGRESS

            Through the open cavity

            Through the dentinal tubules

            Through the gingival sulcus or periodontal ligament

            Through the bloodstream

            Through a broken occlusal seal or faulty restoration of a tooth previously treated by endodontic therapy

            Through extension of a periapical infection from adjacent infected teeth

    MICROORGANISMS FOUND IN ROOT CANALS AND ASSOCIATED PERIRADICULAR LESIONS - HISTORIC AND CURRENT

            Aerobes and their significance

            Anaerobes - disease production and symptoms

    SIGNIFICANCE OF MICROORGANISMS IN ENDODONTIC THERAPY

    TROUBLESHOOTING

    THE CULTURE - HISTORIC AND CURRENT PERSPECTIVES

            Culture media

            Methods for taking cultures

            Other microbiologic identification techniques

    STERILIZATION AND DISINFECTION

            Office infection control

            Sterilization procedures

            Disinfecting solutions

            Sterilization monitoring

    REFERENCES

 

16. Alternatives to routine endodontic treatment

    VITAL PULP THERAPY

        Why vital pulp therapy?

        History and review of the literature

        Consequences of calcium hydroxide pulp cappings

        Pulp capping as opposed to pulpotomy

        Best indications for successful vital pulp therapy

        Contraindications for vital pulp therapy

        Pulp capping of posterior teeth

        Formocresol pulpotomy for posterior teeth

        Pulpotomy treatment of anterior teeth

        Follow-up after vital pulp therapy

    TREATMENT OF TEETH WITH INCOMPLETE APICAL DEVELOPMENT

        Problems of the open apex

            Treatment of open apex with vital pulp

            Apexification procedures - treatment of open apex with nonvital pulp

        Canal filling after completion of apexification

        Mechanisms of apexification

        Long-term results of apexification

        Apexification in molars

        Treatment of perforating internal resorption

        Treatment of aggressive external resorption

    THEORY OF REPEATED TRAUMAS

    PASTES AS CANAL FILLING MATERIALS

        Disadvantages

        Indications

        Technique

    The N2 Sargenti technique

        Sargenti methos

        Opposition by American endodontists

        Re-treatment of failing N2 cases

    REFERENCES

 

17. Restoration of the endodontically treated tooth

        Steven R. Potashnick, Franklin S. Weine and Sherwin Strauss

    PHILOSOPHY OF RESTORING TEETH AFTER ENDODONTIC THERAPY

            Possible overuse of posts

    BIOMECHANICAL PRINCIPLES OF POST SELECTION

            Types of posts

            Importance of post length

            Cementation

            Other considerations

    CHOICES FOR RESTORATION

    PREPARATION OF POST AND CORE

    PREPARATION OF THE ORIFICE

    TYPES OF CORES

    CAST VERSUS PREFABRICATED POST AND CORES

    CAST POST AND CORES

            Types of materials available for fabricating posts

            Tooth with an adequate clinical crown

            Tooth with an inadequate clinical crown

            Additional considerations in post-and-core procedures for a tooth with little or no clinical crown

            Selection and setting of post

    TAKING IMPRESSION FOR POST AND CORE

    TEMPORIZATION

    LABORATORY TECHNIQUES FOR INDIRECT POST AND CORE FABRICATION

    FABRICATION OF POST AND CORE BY DIRECT METHOD

    CEMENTATION OF POST AND CORE

    METAL POST AND COMPOSITE RESIN COMBINATION

    SCREW POST METHOD FOR REBUILDING TREATED TEETH

            Advantages and disadvantages

    ENDODONTICS PERFORMED AFTER FINAL PREPARATION OF THE TEETH

    RESTORATION OF TEETH AFTER ROOT AMPUTATION

            Mandibular molar - retaining the distal root

            Mandibular molar - retaining the mesial root

            Mandibular molar - retaining the mesial and distal roots

            Maxillary molar - retaining the mesiobuccal or distobuccal and palatal roots

            Maxillary molar - retaining the buccal roots

            Maxillary molar - retaining the palatal root

    OVERLAY DENTURE

            Minimum restoration of abutments

            Restoration of abutments with telescopes

    BLEACHING

    REFERENCES

 

18. Endodontics following complex restorative procedures

    PREVENTING POSTRECONSTRUCTIVE PROBLEMS PRIOR TO RECONSTRUCTION

            Utilize the pulp canal space to retain the post

            Avoid vital pulp therapy for abutments

            Recognize the potential endodontic-periodontal relationships

            Be certain to re-treat endodontic failures and potential failures prior to reconstruction

    SOLVING PROBLEMS IN POSTRECONSTRUCTIVE ENDODONTICS

            Difficulty in diagnosis on postreconstructive cases

            Be aware of pulpal damage indicated by lateral canals

            Problems related to locating canals

            Problems in identifying canals

            Problems related to sheared crowns

            Problems related to bombed abutments

            Problems related to coronoradicular stabilization            

    REFERENCES

 

19. Endodontic timetables

            References for the steps of treatment

            Need for having predetermined objectives

                    TABLE. TIMETABLE FOR TREATING TEETH WITH ONE CANAL

                           TABLE. TIMETABLE FOR TREATING TEETH WITH TWO CANALS

                           TABLE. TIMETABLE FOR TREATING MOLARS

                           TABLE. TIMETABLE FOR TREATING TEETH TO BE LEFT OPEN OR THOSE ALREADY LEFT OPEN

            Degree of canal enlargement

            Time requirements

            Filling canals of molar teeth at different appointments

            Leaving teeth with acute abscesses open versus keeping them closed

            Third appointment when treating teeth left open

            Fourth appointment when treating teeth left open

            Timetables necessarily subject to change by the clinician

            One-sitting endodontic treatment

            Filling roots of molar teeth several years apart

    REFERENCES

 

20. Drug therapy useful in endodontics

        Franklin S. Weine and Jeffrey L. Wingo

    IMPORTANCE OF MEDICAL HISTORY

    ANALGESICS

            TABLE. ANALGESICS FOR RELIEF OF MILD TO MODERATE PAIN

                TABLE. ANALGESICS TO RELIEVE MODERATE TO SEVERE PAIN

                TABLE. SUGGESTED ANALGESICS AFTER CERTAIN ENDODONTIC PROCEDURES OR CONDITIONS

    ANTIBIOTICS

            TABLE. TYPES OF PENICILLIN FOR USE DURING ENDODONTIC THERAPY

                TABLE. NONPENICILLIN ANTIBIOTICS FOR USE DURING ENDODONTIC THERAPY

    SEDATIVES AND TRANQUILIZERS

            TABLE. SEDATIVES AND TRANQUILIZERS USEFUL DURING ENDODONTICS

    DRUGS FOR CHILDREN

    REFERENCES

 

Index

 

 

Objetivos Calendarización y Horario Profesores 

Investigación

Contenido (Mapa del sitio) Temario Evaluación y Calificaciones Prácticas Preclínicas y Clínicas Instrumental Recursos Fuentes de consulta