clinical problem solving in endodontics pdf

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Problem solving in endodontics : prevention, identification, and management

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Uploaded by station03.cebu on May 16, 2020

Problem solving in endodontics

Prevention, identification, and management, by james l. gutmann.

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Problem Solving in Endodontics, 5th Edition, by James L. Gutmann and Paul Lovdahl, offers updated techniques and an evidence-based approach to the most common procedures performed at chairside. Ideal for both endodontists and general dentists, this thoroughly revised reference combines the precision of quality endodontic care with achievable and pain-free outcomes for the patient. Each chapter has been carefully designed so that you'll quickly grasp the anatomy, the instruments needed, and what procedures should be performed -- all supplemented by boxed clinical case examples and tips. Going beyond problem solving, it also addresses the major issues in diagnostic, anatomic, restorative, periodontic, traumatic, and surgical aspects of tooth retention. Provides chairside guidance for the endodontic procedures most commonly performed by endodontists and general dentists. Entire text has expanded concepts that are verified in new drawings and clinically relevant cases. Integrates new technologies and materials into every chapter that when applied result in predictable and optimal outcomes. Establishes clear parameters for the retention of teeth. Correlates optimal patient outcomes with an evidence-based approach. Reflects the practical expertise of renowned endodontics authority and past President of the AAE, Dr. James Gutmann, and endodontics specialist, Dr. Paul Lovdahl.

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Problems in Endodontics—Etiology, Diagnosis and Treatment

2010, Journal of Endodontics

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Although every effort has been made to ensure that all owners of copyright material have been acknowledged in this publication, we would be glad to acknowledge in subsequent reprints or editions any omissions brought to our attention.

The word “endodontology” derives from the Greek language and can be translated as “the knowledge of what is inside the tooth.” Thus, endodontology concerns all structures and processes within the tooth, with particular reference to the dental pulp and the space it occupies. But what about “knowledge”? What does it actually mean to “know” things? Most people would probably say that knowledge has something to do with truth and being able to provide reasons for things. It is often believed that dental and medical knowledge is simply scientific knowledge – truth that is supported by scientific research to provide reasons for disease processes and justification for clinical actions. But as practicing dentists, scientific knowledge is not always sufficient, and although it is important to know about the anatomy of the pulp space and the fatigue failure of engine-driven endodontic files, we must also develop sound judgment and the ability to make correct clinical decisions, often in the fa...

The current clinical practice of endodontics includes the utilization of a variety of new technological advances and materials. The last comprehensive survey that compared treatment modalities used in endodontic practices was conducted in 1990. The purpose of the current survey was to determine the frequency with which these new endodontic technologies and materials are being used in endodontic practices today. An e-mail questionnaire was sent to the 636 active diplomates of the American Board of Endodontics with current e-mail addresses. Two hundred thirty-two diplomates responded for a response rate of 35%. Calcium hydroxide was found to be the most frequently used intracanal medicament for all cases diagnosed with necrotic pulps. Ibuprofen was the most frequently prescribed medication for pain, and penicillin was the most frequently prescribed antibiotic when an active infection was present. Eighty-two percent of the respondents are still incorporating hand files in some fashion during the cleansing and shaping phase of treatment. Lateral condensation and continuous wave were the most common methods used for obturation. Digital radiography was reported as being used by 72.5% of the respondents, whereas 45.3% reported using the microscope greater than 75% of the patient treatment. Ultrasonics was used by 97.8% of the respondents. It appears from the results that new endodontic technology is currently being used in the endodontic offices of those who responded to the survey. (J Endod 2009;35:35-39)

Endodontic treatments have evolved in order to prepare the root canal system to receive an airtight filling of this system and thus preserve the health of the periapical tissues and / or restore it, when affected by injuries. Such goals are achieved through obedience to an appropriate chemical-mechanical preparation of the root canals, followed by filling them. The aim of this study is to perform endodontic intervention in a single session in patients in need of endodontic treatment.Fifty patients were treated at the ITPAC / FAPAC-Porto Nacional multidisciplinary clinic, asymptomatic and in need of treatment or endodontic retreatment. In all cases, anesthesia was performed with 2% lidocaine, absolute isolation, irrigation with 2.5% sodium hypochlorite, preparation of the cervical third with the Logic 25/05 rotary system, confirmation of the working length and foraminal patency with locator foraminal Root Zx, instrumentation of the apical third with Logic 25/05 system, final irrigation with agitated 17% EDTA with 25 IRRS ultrasound insert (VDW Endo Ultrasonic Files, Endodontic Synergy, Munich, Germany) at a frequency of 30 kHz for 20 seconds, connected to a piezoelectric device.After complete chemical-mechanical preparation, the thermoplasticized filling was performed in a single session. Then, coronary rehabilitation with composite resin was performed. Proservations of 1, 3, 6 months were carried out to analyze the regression of the infectious process and repair of the apical third. In the immediate postoperative period, 15% of the patients had spontaneous pain, however the incidence of severe pain , flare-ups, was around 5%. At 6 months, all patients were asymptomatic and without fistulas, however, only 60% had complete resolution of the periapical radiolucent areas. Therefore, in the medium term, endodontic treatment in a single session provided 100% of clinical success, but reduced percentage of radiographic success. I.

International Endodontic Journal, 2013

Call for improved research efforts on clinical procedures in endodontics Careful analysis of the scientific basis for the methods that we apply in endodontics has demonstrated extensive shortcomings. For example, the Swedish Council on Health Technology Assessment (SBU), which is a national governmental agency that assesses healthcare technologies, conducted recently a thorough review of the methods that we use to diagnose, prevent and treat inflammation and infection of the dental pulp and the periapical tissue (Swedish Council on Health Technology Assessment 2010). It reported that • We lack diagnostic methods, which can disclose whether a vital but injured pulp can be maintained, or whether it should be removed and replaced with a root filling;

IP Indian Journal of Conservative and Endodontics, 2021

There are cases in the endodontic treatment which are a real challenge. There are teeth with different anatomies of the root canals of different teeth and their treatment. There are most of the cases which are sevely carious and has lost more than 50% of the tooth structure. Patients usually lose their teeth because these problems. The aim of this study is to investigate several cases with different root canal anatomies like in open apex with blunderbuss canals in maxillary central incisors or mandibular premolar and molars with severly decayed crown tooth structures and their management. one case with severly decayed lower mandibular premolar i.e 45, one case of maxillary first molar with severly decayed crown structure i.e 16, a case of severly decayed mandibular first molar i.e 36, Three Cases of maxillary central incisors with immature open apex and blunderbuss canals w.r.t 21. Results are observed after several years. In performing a root canal treatment on such teeth, one shou...

Journal of Conservative Dentistry, 2012

Introduction: An endodontic emergency presents with acute pain and swelling in the involved tooth due to pulpal inflammation and infection. Many factors contribute to pulpal inflammation, which may vary in severity from mild to severe. The treatment of which also depends on the severity of pulpal inflammation and the current state. When pulp is reversibly or irreversibly damaged. It may lead to apical periodontitis and alveolar abscess. And if untreated, it progresses to diffuse life-threatening cellulitis. Most of the cases present with extreme pain, tooth tender on percussion, intra-oral or extra-oral swelling, extrusion, and mobility of teeth as well as some systemic symptoms such as fever, fatigue, etc. The treatment includes proper irrigation and debridement of root canals after establishing drainage of pus, which will relieve the inbuilt pressure and thereby the pain. Once root canal treatment is complete, a restoration is placed. Analgesics and antibiotics must be prescribed ...

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