ENDODONTICS
I. Definition:
-is a branch of dentistry concerned with the etiology, prevention,
diagnosis and treatment of diseases or injuries that affect dental
pulp, tooth root, and periapical tissue.
- That segment of dentistry concerned with the diagnosis and
treatment of diseases and injuries of pulp and periapical tissue.
- The branch of dentistry concerned with morphology and
physiology…
1. Basic science- dealing with normal pulp and supporting
structures
2. Clinical science- dealing with etiology, diagnosis, treatment,
and prevention of disease and injuries of pulp and periapical
tissue
II. HISTORY
PRE-SCIENCE PERIOD (1776-1826)
During this period:
 Tooth with abscesses were treated with leeches or
toasted fig poultices
 Pulp tissue was cauterized with red hot cautery
 Root canals were being filled with gold foil
AGE OF DISCOVERY (1826-1876)
This period is marked by:
 Publication of first dental journal
 The founding of first dental school
 Discovery of general anesthesia
 Barbed broaches became available for cleaning and
enlarging canals
 Medications were created for treating pulpal infections
and cements were discovered to fill them
 Gutta percha points were created to fill root canals
 Dr. Angelo Sartini introduced the single unit
endodontics- practices of any power driven root canal
preparation
DARK AGE (1876-1926)
This period was highlighted by:
 Discovery/development of x-ray/roentgen
 C. Edmund Kells used radiographs for diagnosis and
during root canal treatment
 Advancement of general anesthesia to local anesthesia
 It was also this period where there was setback in
endodontic practice, due to wide acceptance of theory
of focal infection
 “Focal Infection Theory” states that bacteria from
inflamed part would migrate and metastasize to other
parts of the body
 Wholesale extraction of both vital and pulpless teeth
took place
 Hardly any innovation took place
THE RENAISSANCE PERIOD (1926-1976)
 Golden period- it was in this period where:
 Improvements of radiographs and anesthetics took
place
 Introduction of new medicaments such as CaOH and
EDTA
 Root canal medications were antibiotics
 The focal infection theory rapidly declined and a more
sensible attitude toward endodontic surgery was
developed
 Introduction of standardize instruments and cavity
prep
 Rise and decline of silver root canal point
 The American Association of Endodontics was formed
followed by the American board of Endodontics
 Continuing education in endodontics was widely
disseminated to eager professionals
 Publication of first endodontic textbook by Dr.
Grossman, entitled “Root Canal Therapy”
 Introduction of gyromatic handpiece
 Gutta percha became the material of choice for
obturation
 Variety of obturation techniques were introduced
 Establishment of numerous dental schools worldwide
 Huge number of research projects for post-graduate
curriculum
THE INNOVATION ERA (1977 to present)
 Improved and better instruments, equipments, and
techniques were introduced
 Obturation techniques are becoming simpler, easier and
faster
 The single use endodontic therapy become globally
accepted by all school of thoughts
 Improved visibility is now available with the advent of
the….
 New better and more reliable apex locators were
introduced
SCOPE OF ENDODONTICS
 Differential diagnosis
 Treatment of of oral pains of pulpal and/or periapical in
origin
 Vital pulp theory
a. Pulp capping
b. Pulpotomy
 Nonsurgical treatment of of root canal systems with or
without periradicular pathosis of pulpal origin
 Intentional replantation and replantation of avulsed
teeth
 Selective surgical removal of pathological tissues
resulting from pulpal pathosis
 Bleaching of discolored teeth
 Retreatment of endodontically treated tooth
 Treatment procedure related to coronal restorations
RATIONALE:
1. Saving the natural teeth
2. Restore efficient mastication
3. Control pain and swelling
4. Speech and phonation
5. Preserve occlusion
6. Aesthetics
PRINCIPLES:
1. Basic principles
a. Chain of asepsis
b. Correct diagnosis and treatment planning
c. Atraumatic handling of tissues
d. Cleaning of the canal, debridement and removal of
biofilm sticking on the root canal
e. Shaping of the canal
f. Complete obturation
 g. Restoration
h. Recall
OBJECTIVES OF ENDODONTIC TREATMENT
 To be able to relieve pain experienced by patient
 To be able to retain a tooth in oral cavity which may
otherwise require restoration
 To remove unhealthy/diseased pulp from the tooth
 Disinfection of root and surrounding bone by cleaning
and shaping of root canal walls
 Complete filling of the root (obturation)
 To render the affected tooth biologically acceptable
(which means that tooth is asymptomatic, functional,
and without diagnosable pathosis)
BASIC CONCEPT OF RCT
- If bacteria and by-product of pupal inflammation has
been reduced to a non-cervical level of infection, it will
affect a cure allowing resolution and repair of damaged
periradicular tissue
- The extent of damage depends on the virulence or
number of microorganisms and resistance of host