Endodontic Considerations Research Articles

Endodontic Considerations of the Nasopalatine Duct Region

Although rare, anomalies of the nasopalatine region have been reported in the literature mimicking pathoses of endodontic origin. The purpose of this article is to present a case of a patent nasopalatine duct that was originally diagnosed as a sinus tract and referred for endodontic therapy. A review of the anatomy of the nasopalatine region is also discussed.

Endodontic Considerations in Restoration of Partial Overdenture Abutments

Overdenture abutment teeth often require endodontic treatment. Various factors, such as status of the pulp, periodontal state of the tooth, and the sequence of overdenture treatment, influence endodontic management of the patient. After completion of endodontic treatment, the coronal part of the root filling is removed, leaving an adequate amount of the root filling in the apical part of the root canal undisturbed. The abutment tooth is then permanently restored with a filling material, or is prepared for a cast restoration.

Endodontic Considerations When Fabricating Overdentures

Successful use of an overdentures prosthesis depends on the successful completion and maintenance of endodontically-treated teeth. The process of completion and maintenance of teeth so treated in elderly individuals is difficult and less predictable. The purpose of this paper is to discuss treatment considerations to enhance success when treating elderly candidates for endodontic overdenture abutment retention.

Mandibular first molars with six root canals

In this study we present two cases that demonstrate anatomical variations in the mesial and distal roots of two mandibular first molars with a discussion of some endodontic considerations. Both cases were discovered in the course of routine endodontic treatment and have three canals in the mesial and distal roots. In both cases the distal canals have independent orifices in the pulp chamber floor but join immediately, forming two canals. The mesial canals maintain their independence throughout the root.

Endodontic considerations in the design of acid-etched anterior splints for patients with reduced periodontal support

A modification of existing designs for resin-bonded retainers has been introduced. This new design is appropriate for the extracoronal splinting of anterior teeth with reduced periodontal support. The design of the splint will accommodate the increased risk of these teeth for endodontic failure. The versatility and advantages of this design have been presented and compared with other anterior splinting techniques. At present, there appears to be no clinically significant difference in the retentiveness of perforated and nonperforated etched metal retainers.

Endodontic considerations associated with periapical surgery

An attempt has been made to describe a simple, straightforward technique for root-end surgery which, when properly performed, should improve the dentist's effectiveness in managing periapical dental pathosis of endodontic origin.

Dentin dysplasia: Endodontic considerations and report of involvement of three siblings

Dentin dysplasia is an uncommon disturbance of odontogenesis characterized by normal enamel and crown morphology, but with atypical dentin formation, abnormal pulp morphology, and short roots (1, 2). It is reported as an autosomal dominant genetic disease and classified as type I (radicular dentin dysplasia) and type II (coronal dentin dysplasia) (3, 4). Of significant interest to endodontists is the development of periapical radiolucencies, representing granulomas, cysts, or abscesses involving apparently intact teeth. Loosening and premature exfoliation of teeth is also a reported clinical problem. The purpose of this paper is to report the type I condition in three siblings, two of whom developed periapical involvement, who were successfully treated endodontically. Three brothers during dental examinations were discovered to have dentin dysplasia. The boys were Caucasian and had no other discernible medical or skeletal abnormalities. At the time this report was prepared, the oldest boy was 19 (Fig. 1), the second boy 17 (Figs. 2 to 5), and the youngest 15 (Figs. 6 to 8). The 17-yr-old boy had recently completed orthodontic treatment. Dentin dysplasia is an uncommon disturbance of odontogenesis characterized by normal enamel and crown morphology, but with atypical dentin formation, abnormal pulp morphology, and short roots (1, 2). It is reported as an autosomal dominant genetic disease and classified as type I (radicular dentin dysplasia) and type II (coronal dentin dysplasia) (3, 4). Of significant interest to endodontists is the development of periapical radiolucencies, representing granulomas, cysts, or abscesses involving apparently intact teeth. Loosening and premature exfoliation of teeth is also a reported clinical problem. The purpose of this paper is to report the type I condition in three siblings, two of whom developed periapical involvement, who were successfully treated endodontically. Three brothers during dental examinations were discovered to have dentin dysplasia. The boys were Caucasian and had no other discernible medical or skeletal abnormalities. At the time this report was prepared, the oldest boy was 19 (Fig. 1), the second boy 17 (Figs. 2 to 5), and the youngest 15 (Figs. 6 to 8). The 17-yr-old boy had recently completed orthodontic treatment. Displasia dentinaria es una perturbación no comun de la odontogénesis caracterizada por esmalte y morfología coronaria normal, pero con formación dentinaria atípica morfología pulpar anormal y raices cortas (1, 2). Es catalogada com una enfermedad genética autosomal y clasificada como tipo 1 (displasia dentinaria radicular) y tipo 2 (displasia dentinaria coronaria) (3, 4). De interés significante para endodoncistas es el desarrollo de radiolucidez periapical, representando granulomas, quistes o abscesos involucrando aparentemente dientes intactos. Flojedad y caida prematura de dientes es tambien mencionado como problema clínico. La finalidad de este estudio es informar la condición tipo 1 en tres hermanos, dos de ellos desarrollaron problemas periapicales que fueron tratados endodónticamente con éxito. Tres hermanos residentes del colegio Hershey durante exámenes dentales se les descubrió displasia dentinaria. Los chicos eran de raza blanca y no acusaban ninguna otra anormalidad ya sea médica o esquelética. Cuando se hizo este estudio, el mayor tenía 19 años (Fig. 1), el segundo 17 (Figs. 2 y 5) y el menor 15 (Figs. 6 a 8). El de 17 años recién había completado el tratamiento endodóntico. Displasia dentinaria es una perturbación no comun de la odontogénesis caracterizada por esmalte y morfología coronaria normal, pero con formación dentinaria atípica morfología pulpar anormal y raices cortas (1, 2). Es catalogada com una enfermedad genética autosomal y clasificada como tipo 1 (displasia dentinaria radicular) y tipo 2 (displasia dentinaria coronaria) (3, 4). De interés significante para endodoncistas es el desarrollo de radiolucidez periapical, representando granulomas, quistes o abscesos involucrando aparentemente dientes intactos. Flojedad y caida prematura de dientes es tambien mencionado como problema clínico. La finalidad de este estudio es informar la condición tipo 1 en tres hermanos, dos de ellos desarrollaron problemas periapicales que fueron tratados endodónticamente con éxito. Tres hermanos residentes del colegio Hershey durante exámenes dentales se les descubrió displasia dentinaria. Los chicos eran de raza blanca y no acusaban ninguna otra anormalidad ya sea médica o esquelética. Cuando se hizo este estudio, el mayor tenía 19 años (Fig. 1), el segundo 17 (Figs. 2 y 5) y el menor 15 (Figs. 6 a 8). El de 17 años recién había completado el tratamiento endodóntico.

Orthodontic external root resorption—Endodontic considerations

External root resorption in posttreatment orthodontic patients, if severe, may jeopardize the retention of the tooth or teeth involved. Numerous studies (1-5) have been undertaken to determine the relationship between the frequency and severity of external root resorption and orthodontic movement. Some investigators found the incidence of root resorption to be low (6-9), while others found it to be much higher (10, 11). The general conclusion is that external root resorption occurs in nearly all patients undergoing the forces that accompany orthodontic treatment. In recent years the use of calcium hydroxide pastes to inhibit inflammatory external root resorption has become an accepted treatment modality. Heithersay (12) and Andreasen (13) have shown that filling the instrumented root canal with calcium hydroxide can inhibit inflammatory resorptive processes. Burke (14) and Cvek (15) described the arrest of external root resorption in permanent incisors by using calcium hydroxide. These investigations suggest that calcium hydroxide has useful application in the management of a range of endodontic problems. This case is of interest because a patient presented with a chief complaint of extreme mobility of the maxillary incisors. Upon examination of sequential periapical radiographs, it was found that external apical root resorption continued after active and retentive orthodontic treatment had been terminated. A method for inhibiting external root resorption and a technique for esthetically splinting anterior teeth are described.

Combined endodontic and restorative treatment considerations

Endodontic treatment for pulpal pathology should result in an asymptomatic tooth with a sealed canal. Restorative treatment for the pulpless tooth should provide protection against fracture and the needed resistance against masticatory stress to allow the tooth to resume normal function.

Periodontic, Orthodontic, and Endodontic Considerations in Conjunction with Implant Dentistry

Judicious implantation can benefit patients psychologically and in terms of masticatory efficiency. Implants are subject to the same problems, except for caries, as the natural dentition. Therefore, the same care that must be given to the oral cavity prior to any rehabilitative procedure must be given prior to implantation. This means that a most careful study of the complete diagnosis must be made. All facets of dentistry must be taken into account — endodontic, orthodontic, periodontic, and crown and bridge. The pre-existing original physiologic contouring of the dentition as well as the patient's aspirations for when the implant has been completed make up the basis from which the case must be planned. Upon the acceptance and completion of the plan, a postoperative care plan must be assiduously followed by both the dentist and the patient.