1. Introduction to Endodontics
Dr. Feras Aalam

2. Outline
• What is Endodontics??
• Indications
• Contraindications
• Steps
• Instuments

3. Endodontic
• known as "root canal treatment”
• "Endo" is the Greek word ="inside”
• "odont" is Greek ="tooth"
• Endodontic treatment =treats the inside
of the tooth

4. The pulp
• Inside the tooth, under
enamel an dentin, is a soft
tissue called the pulp
• Extends from the crown of
the tooth to the tip of the
roots where it connects to
the tissues surrounding the
root
• Contains
blood vessels,
nerves
connective tissue

5. The pulp
• Ccreates the surrounding
hard tissues of the tooth
during development
• The pulp is important during
a tooth’s growth and
development
• Once a tooth is fully mature
it can survive without the
pulp, because the tooth
continues to be nourished by
the tissues surrounding it

6. What is endodontics??
Endodontics is that branch of dentistry
concerned with the
1.Diagnosis
2.Treatment
3.Prognosis and
4.prevention of
diseases and injuries
of the pulp and
periapical tissues

7. Objectives of Endodontic Treatment
• Relief of pain = symptom free
• To render the affected tooth biologically
acceptable and functioning without a
diagnosable pathosis
• Removal of pulp from root(s) of tooth
• Disinfections of root and surrounding
bone
• Root canal treatment is an attempt to
retain a tooth which may otherwise
require extraction.

8. Indications for Endodontic
Therapy
• a-Teeth with pulpal and /or priapical
pathosis.
• b-Teeth with no pulpal or periapical
pathosis may need endodontic
treatment due to:
1-The need for post and core
construction to rebuild the missing
coronal portion of the tooth
2-Traumatic pulp exposure due to dental
work or accidental fracture.

9. Indications
• 3-Incomplete calcification of the pulp
chamber and root canals
• 4-Internal resorption.
• 5-Over erupted and mesially drifted
teeth when crown reduction may cause
pulp exposure.
• 6-Teeth retained in the mouth to
support overlay denture
• 7-Esthetic requirement.

10. 1-Teeth with insufficient
periodontal support.
2-Teeth with vertical root
fracture.
3-Teeth with external root
resorption.
Contraindications for
Endodontic Therapy

11. 4-Non restorable teeth which can not properly
function after endodontic treatment.
5-Non strategic teeth which can not serve in
occlusion or as abutments after endodontic
treatment.

12. 6-Teeth with root canals not suitable for
instrumentation and /or periapical
surgery such as calcified or severely
curved canals.
7-Patients with systemic conditions
contraindicates surgical endodontics.

13. Phases of Endodontics
treatment
• Diagnostic phase
• Preparatory phase
(cleaning & shaping)
• Obturation phase

14. Diagnostic phase
During this phase the condition of the tooth
is determined and the plan of treatment is
developed.

16. Diagnostic phase
• Determine the condition of the tooth
and the plan of treatment
• Clinical examinations
– Percussion, pain
– Deep caries
• Radiographic examinations
- Periapical radiographs
• Vitality test

17. Clinical examinations

18. Radiographic examinations
Periapical radiographs

19. Vitality test
• Pulp test
• Vitality pulp tests:
– Electric Pulp tester (EPT)
– Thermal Tests:
• CO2 Ice
• Cold water/Ice
• Hot water
• Cavity Test
• Compare the reading with
the opposing or adjacent
tooth

20. Preparatory phase
(Cleaning & Shaping)
• During this phase the condition of the tooth is
determined and the plan of treatment is developed.
• Instuments needed:
– Handpeice low, high speed
– Endo-files
– Saline
– Irrigation syringe
– Paper points
– Calcium hydroxide
– Cotton pellets
– Temporaty filling
– Rubber dam

21. Rubber dam

22. Rubber dam
Rubbere dam over the area to isolate the tooth, keep it
clean and free of saliva during the dental procedure

23. HAND PEICE
LOW SPEED HAND PEICE
HIGH SPEED HAND PEICE

24. Burs

25. Endo-files

27. Preparatory phase
Pulp chamber
Root canal

28. Preparatory phase
• Determine the
working length
• Radiographs
• Add radiograph with
the working lenght

29. RCT of tooth #44

30. RCT of tooth #35

31. Irrigation

32. Paper points
Dry the canals

33. Temporary filling

34. Obturation phase
During this phase the root canals are filled
with an inert material to achieve a hermetic
seal as close as possible to the anatomic
apex.
Instuments needed
1.Gutta percha
2.Paper points
3.Spreader
4.Root canal sealer

35. Gutta percha

36. Spreader

37. Root canal sealer

38. Gutta perchaPaper points

39. Obturation phase

40. RCT of tooth #44

41. RCT of tooth #35

42. Gutta percha

43. Summary

44. Post and core

45. Cats post & core for tooth #35