Endodontics Study Notes

Learning Objectives

  • Define and spell key terms in endodontics

  • Summarize the specialty of endodontics

  • Identify sources of pulpal damage and types of symptoms

  • Differentiate subjective and objective endodontic diagnosis

  • Discuss diagnostic tools: percussion, palpation, temperature, electric pulp testing, radiographic imaging, and endodontic microscope

  • Summarize endodontic procedures, including types of pulp capping, pulpotomy, and pulpectomy.

Pulpal Damage and Disease Progression

  • Causes of Pulpal Damage: Physical irritation (decay), trauma (blow to tooth/jaw)

  • Vital Pulp: Healthy or inflamed, can heal

  • Nonvital Pulp: No response to stimuli, necrotic

Symptoms of Pulp Damage

  • Pain during mastication, sensitivity to temperatures, swelling, fever, tenderness, cracked/discolored teeth

Diagnostic Procedures

  • Subjective Examination: Chief complaints, pain character, duration, sensitivity

  • Objective Examination: Extent of decay, periodontal conditions, pulp exposure

  • Diagnostic Conclusions: Normal pulp, reversible/irreversible pulpitis, necrosis

    • Reversible pulpitis: Pain after thermal stimuli, treat by removing irritant

    • Irreversible pulpitis: Lingering pain, treatment involves root canal or extraction

Endodontic Procedures

  • Pulp Capping: Protects pulp, promotes dentin formation (direct/indirect)

  • Pulpectomy: Complete pulp removal

  • Pulpotomy: Removal of coronal pulp to preserve vitality

Instruments and Materials

  • Instruments: Hand instruments (files, excavators, spreaders), rotary files, ancillary instruments

  • Materials: Gutta-percha (filling material), irrigation solutions (sodium hypochlorite), root canal sealers, and medicaments (calcium hydroxide)

Root Canal Treatment

  • Steps: Anesthesia, isolation, access preparation, canal debridement, obturation

  • Note: Post-treatment complications can occur, such as tooth discoloration or fractures.

Surgical Endodontics

  • Indications for Surgery: Persistent infection, endodontic failure, exploratory surgery

  • Apicoectomy: Removal of the root apex, necessary when healing does not occur

  • Root Amputation/Hemisection: Surgical removal of roots as needed based on extensive bone loss or disease.