Endodontic Prognosis: Clinical Guide for Optimal Treatment Outcome

Foreword......Page 6
Preface......Page 8
Acknowledgments......Page 9
Contents......Page 10
1: Introduction: Endodontic Prognosis and Outcome......Page 12
 1.1 Introduction......Page 13
 1.2 Multifactorial Nature of Endodontic Outcome......Page 14
 1.3 Preoperative Factors......Page 16
 1.4 Intraoperative Factors......Page 19
 1.7 Outcomes in Endodontic Therapy......Page 20
 References......Page 21
2: Microbiology and Immunology of Endodontic Infections......Page 24
  2.1.3 Oral Health and Disease......Page 25
  2.2.2 Pulp Inflammatory Reaction......Page 26
  2.2.5 The Endodontic Pathogen......Page 27
  2.2.6 Polymicrobial Nature of Root Canal Infections......Page 28
  2.3.2 Biofilms Formed in Root Canals......Page 29
  2.3.4 Biofilm Resistance to Antimicrobials......Page 30
  2.4.1 Microbial Identification by Culture and Molecular Methods......Page 31
 2.5 Prognosis of Root Canal Infections......Page 33
  2.5.1 Where Are Bacteria Located After Treatment......Page 34
  2.5.3 Most Resistant Species......Page 35
 2.6 Concluding Remarks......Page 36
 References......Page 37
3: Diagnosis of Pulpal and Periradicular Disease......Page 39
  3.2.3 Dental History......Page 40
   3.2.4.3 Diagnostic Pulp Tests......Page 41
    Test Site......Page 42
    Reliability of Pulp Tests......Page 43
 3.3 Diagnosis of Periapical Disease......Page 45
   3.3.3.1 Conventional Intraoral Radiography......Page 47
   3.3.3.2 Cone Beam Computed Tomography......Page 48
  3.3.4 Clinical Diagnostic Terminology of Periapical Disease......Page 49
 References......Page 51
4: Endodontic Treatment of Mature Teeth......Page 53
 4.2 Pathosis of the Pulpal-Periapical Tissue Complex......Page 54
 4.3 Biological Considerations of Treatment of Endodontically Involved Mature Teeth Without Apical Periodontitis......Page 59
 4.5 Healing of the Apical and Periradicular Tissues Following Endodontic Treatment......Page 60
  4.6.1 Symptomatic Irreversible Pulpitis......Page 64
  4.6.4 Posttreatment Endodontic Pain or Swelling......Page 67
 4.7 Prognosis of Mature Teeth with and Without Apical Periodontitis After Nonsurgical Endodontic Treatment......Page 68
 4.8 Quality of Root Fillings and Coronal Restorations in Endodontic Prognosis......Page 69
 References......Page 70
5: Regenerative Approaches in Endodontic Therapies of Immature Teeth......Page 74
 5.1 Introduction......Page 75
  5.2.2 Direct Pulp Capping......Page 76
  5.2.3 Indirect Pulp Capping......Page 77
  5.2.4 Partial and Complete Pulpotomy......Page 78
 5.3 Tissue Engineering in Endodontic Therapies: Rationale and Progress to Date......Page 80
  5.3.1 Revascularization......Page 83
  5.3.2 Pulp-Dentin Regeneration......Page 85
  5.4.1 Vital Pulp Therapy......Page 87
  5.4.2 Root Canal Obturation (Apical Barrier Formation) with CSCs......Page 88
  5.4.3 Pulp Revascularization......Page 89
 References......Page 92
6: Endodontic Pharmacotherapeutics......Page 96
   6.1.1.1 Nociceptive Pain......Page 97
   6.1.1.2 Inflammatory Dental Pain......Page 99
   6.1.1.4 Neuropathic Pain......Page 100
   6.2.1.1 Inflammation Reduces the Efficacy of Local Anesthetics......Page 101
   6.2.1.3 Pulpal Anesthesia Versus Soft Tissue Anesthesia......Page 103
   6.2.1.5 On Choosing a Local Anesthetic......Page 104
   6.2.2.1 Prognostic Factors Related to Endodontic Postoperative Pain......Page 105
   6.2.2.2 Nonsteroidal Anti-inflammatory Drugs......Page 107
   6.2.2.5 Steroids......Page 108
  6.3.1 The Role of Bacteria in Endodontic Pathology......Page 109
  6.3.2 Antibiotics in the Management of Endodontic Infections......Page 111
 References......Page 113
 7.1 Introduction......Page 124
 7.2 Root Canal Anatomy......Page 125
  7.3.1 Principles of Access Preparation......Page 129
  7.3.3 Pulp Chamber Anatomy and Canal Location......Page 130
 7.4 Working Length Determination......Page 134
 7.5 Concluding Remarks......Page 135
 References......Page 136
 8.1 Introduction......Page 139
  8.1.2 Challenges in Root Canal Preparation [1, 2, 5]......Page 140
   8.1.4.1 Irrigants......Page 141
 8.2 Irrigants for Smear Layer Removal......Page 142
 8.3 Intracanal Medication......Page 143
  8.3.2 Outcome Studies: Intracanal Medication......Page 145
 References......Page 146
 9.1 Introduction......Page 149
 9.2 Indications for Endodontic Obturating Materials......Page 151
 9.3 Evidence-Based Practice and Endodontic Prognosis......Page 152
 9.4 Types of Material and Their Rationale for Use......Page 153
  9.5.1 Core Materials......Page 155
  9.5.2 Sealers......Page 156
  9.5.3 Materials for Root-End Filling and Perforation Repair......Page 157
 9.6 Modes of Placement......Page 158
 9.7 The Radiograph of the Final Root Filling: Factors of Prognostic Significance......Page 159
 9.8 Concluding Comments......Page 161
 References......Page 162
10: Restoration of Endodontically Treated Teeth......Page 168
 10.2 Interim Restorations......Page 169
 10.3 Restoration of Mature Teeth......Page 172
 10.4 Restoration of Immature Teeth with Open Apices......Page 178
 10.5 Prognostic Factors and Treatment Outcome......Page 185
 References......Page 190
11: Local, Systemic, and Genetic Considerations of Endodontic Treatment Prognosis......Page 200
   11.1.1.2 Number of Roots......Page 201
   11.1.2.3 Periapical Status......Page 202
   11.1.2.5 Factors Related to Previous Treatment......Page 203
   11.1.3.2 Factors Related to Cleaning and Shaping......Page 204
   11.1.3.3 Procedural Errors......Page 205
   11.1.3.6 Flare-Up......Page 206
   11.1.3.7 Obturation......Page 207
   11.1.4.1 Type and Quality of Restoration......Page 208
  11.2.3 Systemic Diseases and Medications......Page 209
  11.2.4 Geriatric Patients......Page 211
 11.3 Summary......Page 212
 References......Page 213
12: Criteria for Outcome Assessment of Nonsurgical Endodontic Treatment......Page 218
 12.1 Introduction......Page 219
 12.2 Strindberg’s Criteria......Page 220
 12.3 Radiographic Evaluations Have Been Inconsistent......Page 222
 12.4 The Periapical Index (PAI) Scoring System......Page 226
 12.5 Outcome Definitions Have Been Inconsistent......Page 227
 12.6 The American Association of Endodontists Outcome Criteria......Page 228
 12.9 Outcome Rates for Orthograde Endodontic Treatment......Page 229
 References......Page 233
13: From Tooth Retention Through Root Canal Treatment to Extraction and Replacement......Page 236
  13.1.2 Patient-Centered Outcomes of NSRCT......Page 237
  13.1.4 Endodontic Treatments Following Non-healing Initial NSRCT......Page 238
  13.1.6 Fixed and Removable Dental Prostheses and Implant Alternatives......Page 240
 References......Page 242
Index......Page 246