Fiji 1

							  Endodontics &
Dental Traumatology

  Introduction
     Dr arpana
Definition of Endodontics
 Endodontics is the branch of dentistry that is
 concerned with the morphology, physiology and
 pathology of the dental pulp and the periradicular
 tissues.

 Its study and practice encompass basic clinical
 sciences including the biology of the normal
 pulp, and the aetiology, diagnosis, prevention,
 and treatment of diseases and injuries of the pulp
 and the associated periradicular conditions.
What is an Endodontist ?
An Endodontist conducts that part of specialist
dental practice which deals with the diagnosis,
the surgical and adjunctive treatment of diseases,
injuries and defects of the dental pulp and
associated structures.


 Endodontic treatment must be conducted in the
    context of a concern for the patient's total
              oral and general health.
           Scope of Endodontics
   Root canal therapy            Iatrogenic problems
   Endodontic re-treatment       Deciduous endodontics
   Periapical surgery            Dental trauma
   Pain diagnosis                Replantation of teeth
   Treatment planning            Tooth bleaching
   Removing posts & crowns       Vital pulp therapy
   Pulpless teeth                Root fractures
   Insurance reports             Cracked teeth
   Dento-legal reports           Calcified canals
   Removing fractured files      Root perforations
   Canal obstructions            Endo-Perio lesions
   Pre-prosthetic pulp           Caries control
     analysis                     Radiography
Incidence & Prevalence of Endodontics

   Western Australia: 1990-91      (Abbott 1993, AEN)

          3 teeth / 100 people / year
          ~ 4.5% treated by Endodontists
   Fiji
      ????
Incidence & Prevalence of Endodontics

   Western Australia: 1990-91       (Abbott 1993, AEN)

        3 teeth / 100 people / year
        ~ 4.5% treated by endodontists

   Time dentists spend doing endodontics:
        6.1% (Aust. 1983-84) -   Spencer & Lewis 1989

        9.1% (Qld 1985) -   Spratley & Coyne 1989
Incidence & Prevalence of Endodontics

   Western Australia: 1990-91       (Abbott 1993, AEN)

        3 teeth / 100 people / year
        ~ 4.5% treated by endodontists

   Time dentists spend doing endodontics:
        6.1% (Aust. 1983-84) -   Spencer & Lewis 1989

        9.1% (Qld 1985) -   Spratley & Coyne 1989

        Average 63 teeth per year (WA 1990-91)
          - Abbott 1993
   How common is periapical pathosis?
   How common is periapical pathosis?
       Epidemiological studies:
            Prevalence of apical periodontitis

                 33 - 70 % of individuals
                      Based on several studies
                      e.g. Eriksen 1998, Aleksejuniene et al 2000
   How common is periapical pathosis?
       Epidemiological studies:
            Prevalence of apical periodontitis

                 33 - 70 % of individuals
                      Based on several studies
                      e.g. Eriksen 1998, Aleksejuniene et al 2000

                 Increases with age

                 Not evenly distributed amongst
                  individuals
   How common is periapical pathosis?
        Epidemiological studies:
               Prevalence of apical periodontitis   (Eriksen 1998)


Age group             20-30 30-40     40-50    50-60        60+

% of teeth present     1.8     3.4      5.2     6.8          8.6

% of Individuals       33      40       48      57           62
   How common is periapical pathosis?
         Epidemiological studies:
               Prevalence of apical periodontitis     (Eriksen 1998)


Age group                  20-30 30-40   40-50   50-60        60+

% of teeth present         1.8    3.4     5.2     6.8          8.6

% of Individuals            33    40      48      57           62

Marg. Periodontitis          0    14     20      25            26
(% individuals; > 5.5mm)
   How common is periapical pathosis?
       Epidemiological studies:
            Prevalence of apical periodontitis

                 33 - 70 % of individuals


       Apical periodontitis is very common !!
            More widespread than marginal periodontitis

       Implies a significant diagnostic and
        treatment challenge for dentists
Endodontic Treatment Needs
Endodontic Treatment Needs
Endodontic Treatment Needs
Endodontic Treatment Needs
Endodontic Treatment Needs

                           With more
                         education the
                          same would
                        happen with Fiji




                          ~ 50% 
Endodontic Treatment Needs
 What is Endodontic Treatment ?

Commonly called:

 “Root Canal Treatment”

 “Root canal filling”


   “Having a root canal”

   “Removing the nerve”
Why do Endodontic Treatment ?
Why not just extract it ?
Why do Endodontic Treatment ?
Why not just extract it ?
Why do Endodontic Treatment ?
Why not just extract it ?
   Other teeth -
          Tilt - esp. mesially
          Over-erupt
          Food packing
          Caries
          Periodontal disease
          Loss / extraction
          Occlusal changes
          Masticatory muscle
           inflammation / pain
          TM Joint problems
Why do Endodontic Treatment ?
Why not just extract it ?
Why do Endodontic Treatment ?
Why not just extract it ?
Why do Endodontic Treatment ?
Why not just extract it ?




            
           Scope of Endodontics
   Root canal therapy            Iatrogenic problems
   Endodontic re-treatment       Deciduous endodontics
   Periapical surgery            Dental trauma
   Pain diagnosis                Replantation of teeth
   Treatment planning            Tooth bleaching
   Removing posts & crowns       Vital pulp therapy
   Pulpless teeth                Root fractures
   Insurance reports             Cracked teeth
   Dento-legal reports           Calcified canals
   Removing fractured files      Root perforations
   Canal obstructions            Endo-Perio lesions
   Pre-prosthetic pulp           Caries control
     analysis                     Radiography
Periapical Surgery
EIGHT Years Review
           Scope of Endodontics
   Root canal therapy            Iatrogenic problems
   Endodontic re-treatment       Deciduous endodontics
   Periapical surgery            Dental trauma
   Pain diagnosis                Replantation of teeth
   Treatment planning            Tooth bleaching
   Removing posts & crowns       Vital pulp therapy
   Pulpless teeth                Root fractures
   Insurance reports             Cracked teeth
   Dento-legal reports           Calcified canals
   Removing fractured files      Root perforations
   Canal obstructions            Endo-Perio lesions
   Pre-prosthetic pulp           Caries control
     analysis                     Radiography
Avulsion
1 week
3 mths
6 mths
9 mths
Bleaching
3 years

Too much to
  handle
 Well   touch luck