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PubMed1984

Endodontics. An overview.

The changes that have taken place in endodontic treatment over the past 25 years can be summarized succinctly. Although the methods and materials have changed markedly, the basic principles of asepsis, enlargement, and seal remained unchanged. Predictably successful endodontic treatment is an everyday occurrence in the 1980s. It is a result of understanding the basic principles of treatment, combined with the ability to deliver these services in an orderly, expeditious, and thorough manner. With future advances in research and technology, the elusive goal of 100 per cent success may become a reality in this century.

Asepsis↗
PubMed1984

Advanced techniques for intracanal preparation and filling in routine endodontic therapy.

In conclusion, these techniques have been presented to develop a logical sequence of events based on the objectives of conventional endodontic therapy. The elimination of the soft organic content of the root canal and subsequent elimination of that space as a potential source of periradicular inflammation or infection is a demanding task. These techniques provide a consistent and reproducible level of clinical success and provide a foundation to expand clinical expertise in routine and moderately difficult endodontic situations.

Dental Instruments↗
PubMed1984

The enigma of the lateral canal.

It is difficult to summarize an article of this type, in which the author is certain that his case has been presented fairly, but is aware that other views that are contrary could be stated and endorsed by pertinent clinical cases. Bearing this fact in mind, I wish to reiterate the following: Lateral canals are demonstrated in endodontic cases with much less frequency than they exist. This variance rarely, if ever, causes an endodontic failure. Some demonstrated lateral canals may really be other conditions. Preoperative evaluation should include examination of radiographs for lateral, as well as periapical, lesions. Lateral canals may be demonstrated by a variety of filling techniques. Careful canal preparation may enhance the frequency of such demonstration. Cases with necrotic pulps probably yield more frequent demonstration than do cases with vital pulps. Lateral canals harboring inflamed and/or infected material may cause pain during endodontic treatment. They may simulate periodontal disease and may cause problems with treatment if present when a tooth is left open for drainage. Periodontal disease may cause pulp exposure via lateral canals located coronally. Improper use of post room may lead to lateral failure from breakdown of tissue in a lateral canal. The enigma of the lateral canal has been the object of description and discussion in many articles, but no one is truly certain of their exact significance in endodontic therapy for the long haul.

Dental Pulp Cavity↗
PubMed1984

One-visit endodontics.

I would like to conclude with some personal observations and comments on the use of single-visit endodontics in private practice based on my 12 years of experience utilizing this procedure. I cannot stress in strong enough terms that one-visit endodontics should not be undertaken by the novice. As an evolutionary philosophy of treatment, its use grows out of a full understanding of fundamental endodontic principles by the experienced practitioner. It is only after considering all of the indications and contraindications in each case on an individual basis, that a decision should be made as to whether or not it can be completed in a single visit. However, it is also important for the practitioner to have a clinical sense of what can be accomplished once the rubber dam has been placed and work commenced on the tooth. I submit to you that this very important clinical sense can be gained only after many years of clinical experience. Therefore, the endodontic competence of the practicing dentist becomes the overriding factor in determining the outcome of any one particular case. This is not to say that only a specialized few can and should perform this procedure. However, it does mean that a high degree of clinical skill is necessary to perform it in a successful manner. The performance of better endodontics in multiple visits will ensure success in single visits. Therefore, it is incumbent upon the individual practitioner to objectively evaluate his or her endodontic skills. The clinician should critically evaluate every aspect of his or her endodontic practice by determining the incidences of biomechanical errors such as ledging, perforations, overinstrumentation, broken instruments, interappointment flare-ups, and failures. For only after evaluating these areas will the clinician have an indication as to his or her level of endodontic skill and whether or not future study and practice need be done in one or more specific aspects of endodontic practice. Once a high level of competence is attained, one-visit endodontics can be successfully performed if well-skilled clinicians choose their cases carefully and adhere to basic endodontic principles.(ABSTRACT TRUNCATED AT 400 WORDS)

Clinical Competence↗
PubMedDate not supplied

[Indications for the treatment of bone rarefactions of endodontic origin].

Bone rarefactions arising from dental lesions are commonly thought to be sustained by the microbiol component or by the toxins spread out into the surrounding bone by the disintegrated pulp. In thise case endodontic therapy is the only one capable of obtaining a full recovery. In our opinion the most suitable endodontic procedure is that described by Schilder: with his technique infact a great deal of substantial results can be achieved. Bone rarefactions are to be surgically treated only when endodontic therapy does not guarantee the complete removal of microrganisms and that of the tissue debris arising from the disintegrating pulp possibly located in the root's area. This event may occur in the following circumstances: 1) fracture of endodontic instruments; 2) partial filling with cement or any other not removable material; 3) misleading endodontic therapy (distored roads or circular steps); 4) a peculiar anatomy of the dental rost such as that resulting when the apex bears a drop or a trumpet-like appearance; 5) bent roots, very hardly treated; 6) when a dry root's dent cannot be obtained because of the presence of large and continually secreting cysts. Bone rarefactions should then be treated by surgical procedures such as apicectomy backward filling of the root's canal and root's apex locking with direct view of the apex. Apicectomy should only be visualized asd a surgical transport of the apex from a point where the apex is open to an other where is apex is completely filled up by the endodontic treatment. Surgical procedure of the backward filling of the root's canal should be followed only when the root's canal unapproachability does not allow any endodontic treatment such as that suggested by Schilder. Finally surgical procedure to fill up the root's canal with direct view of the apex results from the combination of two surgical treatments: 1) the filling up of the root's canal (Schilder procedure), and 2) the modelling of the root's canal up to a point where the last one is hermetically sealed. This result can be achieved removing the apex when it bears a drop or trumpet-like appearance or the transported apex foramen. It can also be obtained by removing the wounded apex or the radicular canal when it is unapproachable along the 2 or 3 distal mms. and finally ad dry root's canal when it remains wet by the continuous secretion of the liquid material endowed in the cystic cavity.

Bone Cysts↗