Dental Terminology Ch. 13

Endodontics

Endodontia

The branch of dentistry concerned with the diagnosis, treatment, and prevention of diseases of the dental pulp and its surrounding periradicular (around root) tissues

Diagnostic Conditions of Pulpitis

Pulpitis

Inflamed pulpal condition

Necrotic

Pertaining to dead or nonvital, it’s irreversible

Subjective sumptoms

Conditions as described by the patient

Objective signs

Conditions observed by someone other than the patient

Palpation

Application of finger pressure to body tissues, including gingiva

Percussion

(tapping of body tissue, tooth) Usually done by tapping a dental mirror handle on an affected tooth and comparing the sensation to tapping on a healthy or control tooth

Mobility

(capable of movement) Movement of a tooth in its socket during outside force or pressure application

Transillumination

(Passage of light through object/tissue) a light refraction test to reveal fractured tooth tissue

Thermal

(Pertaining to temperature) Pulp sensitivity test with reaction to applications of heat and/or cold to tooth surface

Anesthesia

Numbing the questionable root or nerve ending to dissipate pain

Direct dentin stimulation

Scratching the exposed dentin with an explorer; the presence of pain indicates inflamed or irritated pulp tissue

Electric pulp testing

Applying an electrical current on the enamel surface of the tooth to register the tooth’s pulpal sensitivity and presence of irritability

Radiograph

X-ray examination with digital zoom and color contrasting ability permits a deeper insight to the pulp canal

Miscellaneous tests

Radiovisionography and magnetic resonance imaging to demonstrate early changes of bone structure and periapical involvement of suspected tooth with an inflamed pulp; laser Doppler flowmetry to determine blood flow of pulp tissue, and pulse oximetry to assess pulp vitality

Periodontitis

In acute apical periodontitis, a sharp, painful inflammation of tissues occurs around an affected tooth, pain is lessened or eliminated by removal of the inflamed or necrotic pulp, a chronic apical periodontitis requires management similar to the acute symptoms

Abscess

(local pus infection) an infection that may be an acute or chronic apical abscess; aka suppurative (producing or generating pus)

Pericementitis

Inflammation and necrosis of the alveoli of the tooth

Cyst

Abnormal, closely walled fluid or exudates-filled sac in or around periapical tissues

Cellulitis

Inflammation of cellular or connective tissue

Osteomylitis

An inflammation of the bone and bone marrow, usually caused by bacterial infection

Pulpotomy

Partial excision of the dental pulp, usually reserved for children’s teeth

Pulpectomy

Surgical removal of pulp from the tooth, aka root canal treatment

Apicoectomy

Surgical amputation of a root apex

Retreat

Endodontic retreatment of failed pulpal canal and core treatment with removal of existing filling material and re-obturation of the tooth

anesthesia

Local injection to relieve pain occurring during the procedure

Isolation of the operative area

Accomplished to provide safety and to assure an aseptic (without disease) site

Extirpation

(to root out) removing the pulpal tissue after the pulpal opening

Debridement

(removal of foreign or decayed matter) removing necrotic pulpal tissue and cleaning out the area

Irrigation and cleansing

Using chemicals and instruments to remove tissue dust and material matter from the pulp and pulp canals

Obturation

(to close or stop up) filling and closing the canal area, this may consist of filling from the pulp to the apex or may be completed in a retrograde (backward step) process of filling the canal beginning from the apex of the tooth to the pulp chamber, aka a retrofill endodontic restoration

Restoration

Returning the tooth to normal function and purpose, either permanent or temporary, so that the patient may return to their personal referring dentist for the final step

Dental dam material

Thin layer of latex or nonlatex sheeting that varies in thickness, color, and size

Dental dam frame

device used to hold material in place; may be metal or plastic, rigid or adjustable

Dental dam punch

Device used to place selected holes in the dam material for isolation of a tooth or teeth

Dental dam forceps

Hand device used to transport and place clamps or trainers around the selected tooth

Rubber dam stamp and pad

Marking stamper and pad devices used to indicate alignment spots for puncturing the material with the punch

Dental dam clamp

Retaining device used to hold the material around the tooth; may be metal or resin and vary in size, shape, and style

Dental dam ligature

Material used to hold and secure the dam material in the mouth; can be dental floss, latex stabilizing cord, or a small piece of dental dam material

Broach

A thin, barbed, wired instrument inserted into the root canal to ensnare and remove the pulp tissue and nay natural or placed matter, such as paper points or cotton pellets

Reamer

A thin, twisted, sharp-edged instrument inserted into the canal and rotated clockwise to enlarge and taper the root canal

File

A thin, rough-edged instrument used to plane and smooth pulpal walls, there are K-files, Hedstrom files, and flex files

K-file

Has twisted edges and is used to enlarge as well as to smooth walls; color-coded to denote size

Hedstrom file

(U-shape and S-shaped) Cone-shaped, twisted edged instrument used for enlargement and smoothing; nickel titanium alloy files provide more flexibility

Flex file

Stainless steel or nickel titanium alloy file that is stronger and provides more flexibility; used in narrow, curved canals

Pesso reamers

Thicker, engine-driven reamer with larger and longer parallel cutting edges for use in canal openings

Gates-Glidden drills

Engine-driven, latch-type burs with flame-shaped tip; used to provide an opening and access

Paper points

Small, narrow, absorbent, paper tips that may be inserted into the prepared canal; used to dry the prep site or to carry medication to the area; are available in various gauges and millimeter-marked lengths or may have tips cut off the accommodate size

Stopper

A small piece of elastic band or commercial plug that is moved up or down the shaft of the endo instrumnet; used to mark and indicate the length of penetration; also used to measure insertion length with X-ray view

Rotary burs and stones

Friction grip burs with diamond or carbide tips used to gain access through restorations and crowns

Microsurgery Curettes

Used to incise and elevate periodontal tissue and fibers permitting easier and faster healing time

Root canal spreader

Longer shank with pointed nib; used to carry and insert cement or filling material

Root canal condenser

Handled, long-tip instrument that may be heated and used to condense gutta-percha to the canal walls

Lentulo spiral drill

Thin, twisted-wire, latch-type rotary instrument used to spread calcium hydroxide or cement into the canal, materials may also be spread by small inserts from ultrasonic machines

Ultrasonic and sonic instruments

Vibration energy waves for debridement, irrigating canals, and spreading medicaments or cement; used in conjunction with hand instrumentation

Apex locator machines

Determine the proximity of the test file to the root apex and relate the information to a PC board screen during preparation of the canal

Electric endodontic handpieces

Permits use of instruments at slow speeds for finger instrumentation

Heat carrier machines

Provide adjustable heat to soften, deliver, and condense gutta-percha to the canal

Laser Doppler flowmetry and pulse oximetry

Devices used to test blood circulation and vitality of the pulp in question

Magnifying loupe eyeware

Enlarge vision in working area

SOM

(surgical operation microscope) worn as headgear, similar to loupes, but with intense magnification possibilities and improved halogen lighting

Assorted instruments

Include explorer, spoon excavator, and paddle-ended blades, have increased nib, blade, or neck-length to accommodate extra depth to the working surfaces

Luer-loc syringe

A barrel-type syringe with a piston force plunger, used to inject fluids into the cavity

Gutta-percha points

Tapered points made of a thermoplastic compound; similar in size to silver points or endodontic instruments, and used to fill the root canal; may be millimeter marked along length to help determine penetration insert length

Silver points

Tapered silver points comparable in size to files and reamers; used to fil canals

Cement pastes and fillers

Zinc oxide and eugenol mixes and commercial materials; used to cement points in canal

Chemicals

Chemical action used in conjunction with operator treatment produce a result termed biomechanical action

Chelators

Chemical ion softener

Disccant

(dry up, remove) methanol or ethanol alcohol used to dry the area or clear away other chemical traces

Medicament

(medicine or remedy) used for antimicrobial action, to prevent pain, and to neutralize the pulpal area

Curettage

(scraping of a cavity) scraping of the apical area; may be necessary to remove necrotic tissue

Apicoectomy

A procedure that may be necessary to remove the root apex, particularly where there is a radicular cyst involvement of the affected tooth, aka root end resection

Root amputation

Separating and removing molar roots of affected tooth at the junction to the crown

Root hemisection

Cutting tissue of organ in half, surgical division of multi-rooted teeth that may be performed in a lengthwise manner

Bicuspidization

Surgical division of a tooth retaining booth sides

Traumatized

Wounded

Luxation

Dislocation, tooth movement that may be classified in concussion, subluxation, lateral luxation or extruded

Concussion

Shaken violently, tooth loosened as a result of a blow; usually recovers with minimal attention

Subluxation

Tooth partially dislocated; evidence of bleeding but requires only minor attention

Lateral luxation

Tooth may be partially displaced with the root apex tilted forward

Extruded luxation

Tooth may be forced partially out of its socket

Fracture

breakage; may be a broken cusp, broken crown, broken root, of a spit tooth

Avulsion replantation

Replacing teeth that have been accidentally lost; may undergo RCT at this time or at a future appointment

Care of an avulsed tooth involves

1. Do not touch tooth root

2. Rinse with tepid water

3. Reinsert into tooth socket, hold in place with finger; if unable, tuck under lip, or keep moist in milk or lightly salted water

4. Seek immediate treatment-fast-because time is important

Replantation

Replacing an avulsed tooth in its tooth socket

Transplantation

Transfer of a tooth from one alveolar socket to another; may be completed through autogenous, homogenous, or heterogenous manners

Autogenous

Moving a tooth from 1 position in the oral cavity to another area in the same cavity

Homogenous

Transferring and inserting a tooth from one patient to another

Heterogenous

Transfer from one species to another; not yet a feasible practice