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Root canal anatomy and access cavities
 Definition : Endodontics is the branch of
dentistry dealing with diseases of the
dental pulp.
 The number of canals in a tooth
correlates to the number of roots in a
tooth.
 The space inside the root canals is filled
with a highly vascularized and highly
innervated loose connective tissue,
called the dental pulp.
 The pulp tissue is in communication
with the periodontium and the rest of
the body through the apical foramen.
 Central region contains nerves and
blood vessels.
 Innermost layer, - contains fibroblasts
and undifferentiated mesenchymal cells.
 Zone of Weil  This is a cell free zone,
rich in capillaries and nerve fibres.
 Odontoblastic layer  outermost layer,
contains odontoblasts and is next to the
predetin and mature dentin.
 Primary Function is to form Dentin
 Nutritive  provides nutrients to the
organic surroundings
 Sensory  sensitive to temperature,
pressure or trauma
 Protective  forms secondary dentin,
when under attack from bacteria.
Root canal anatomy and access cavities
 Accessory canals are branches of the main
canal that form a communication between the
pulp and periodontum.
 They also contain vessels and nerves, and can
be located anywhere between the level of
furcation to the apex.
 30% of lower incisors have lingual and labial
canals.
 85% of mesiobuccal roots contain two canals
(MB1 and MB2), in upper molar teeth.
Root canal anatomy and access cavities
The shape of the preparation is dictated
by :
 The shape of the pulp chamber
 The morphology of the canals.
It is important that straight line access to
the apical foramen is created.
 The access cavity is initiated in the
middle of the palatal side of the tooth.
 Initial preparation should be at 90属 to
the palatal aspect of the tooth.
 Once dentine has been reached the
angulation of the bur is changed to
follow a long axis of the tooth using a
slow handpiece.
 Initial preparation is made in the
middle of the fissure. The cavity is then
extended buccally and palatally.
 NB : Marginal ridges must not be
involved in this presentation, as this
would compromise the integrity of the
tooth.
 Initial Preparation is done in the mesial
pit.
 The cavity is then extended in the mesial
half of the tooth to include all canals.
 The mesial marginal ridge must not be
damaged in upper molars as the cavity
should lay mesially to it.
 However lower molar teeth, have a distal
canal, which is located just past the middle
of the tooth.
Root canal anatomy and access cavities
Root canal anatomy and access cavities
Root canal anatomy and access cavities
Irrigation in Endodontic treatment
serves the following purposes:
 Lubricate canal
 Dissolve the pulp remnants
 Washing out debris created by canal
instrumentation
 Kill/remove the bacteria/micro-
organisms in root canal
 Clean the smear layer
 Sodium Hypochlorite :Dissolves necrotic
tissue and kills bacteria quite effectively.
 Kills bacteria quite effectively.
 Chelators: Such as EDTA, remove the
smear layer.
 Hydrogen Peroxide: Used to be used a lot,
however studies have shown it to be
ineffective.
 Chlorhexidine: Has been shown to remove
significant number of bacteria.
 ENDOVAC TECHNOLOGY  the use of
apical negative pressure irrigation,
significantly improves cleaning and
disinfection more closely to the apex.
 ENDOACTIVATOR  Sonically driven
system, enables the irrigant to travel
deep into the pulpal system, enabling
better cleaning.
 Tooth Anatomy  Revision
 Root canal anatomy
 Accessory canals
 Access cavities
 Irrigants
 Recent Developments in Endodontics.
 http://www.dentistrytoday.com/endodon
tics/1043
 http://www.youtube.com/watch?
v=QrUgCNQs038
 Endodontics Lecture from Blackboard.
By Dr Qualtrough.
 http://www.dentistrytoday.info/content/i
rrigation-endo
 http://www.jendodon.com/article/S0099-
2399(07)00095-7/abstract
Root canal anatomy and access cavities

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Root canal anatomy and access cavities

  • 2. Definition : Endodontics is the branch of dentistry dealing with diseases of the dental pulp.
  • 3. The number of canals in a tooth correlates to the number of roots in a tooth. The space inside the root canals is filled with a highly vascularized and highly innervated loose connective tissue, called the dental pulp. The pulp tissue is in communication with the periodontium and the rest of the body through the apical foramen.
  • 4. Central region contains nerves and blood vessels. Innermost layer, - contains fibroblasts and undifferentiated mesenchymal cells. Zone of Weil This is a cell free zone, rich in capillaries and nerve fibres. Odontoblastic layer outermost layer, contains odontoblasts and is next to the predetin and mature dentin.
  • 5. Primary Function is to form Dentin Nutritive provides nutrients to the organic surroundings Sensory sensitive to temperature, pressure or trauma Protective forms secondary dentin, when under attack from bacteria.
  • 7. Accessory canals are branches of the main canal that form a communication between the pulp and periodontum. They also contain vessels and nerves, and can be located anywhere between the level of furcation to the apex. 30% of lower incisors have lingual and labial canals. 85% of mesiobuccal roots contain two canals (MB1 and MB2), in upper molar teeth.
  • 9. The shape of the preparation is dictated by : The shape of the pulp chamber The morphology of the canals. It is important that straight line access to the apical foramen is created.
  • 10. The access cavity is initiated in the middle of the palatal side of the tooth. Initial preparation should be at 90属 to the palatal aspect of the tooth. Once dentine has been reached the angulation of the bur is changed to follow a long axis of the tooth using a slow handpiece.
  • 11. Initial preparation is made in the middle of the fissure. The cavity is then extended buccally and palatally. NB : Marginal ridges must not be involved in this presentation, as this would compromise the integrity of the tooth.
  • 12. Initial Preparation is done in the mesial pit. The cavity is then extended in the mesial half of the tooth to include all canals. The mesial marginal ridge must not be damaged in upper molars as the cavity should lay mesially to it. However lower molar teeth, have a distal canal, which is located just past the middle of the tooth.
  • 16. Irrigation in Endodontic treatment serves the following purposes: Lubricate canal Dissolve the pulp remnants Washing out debris created by canal instrumentation Kill/remove the bacteria/micro- organisms in root canal Clean the smear layer
  • 17. Sodium Hypochlorite :Dissolves necrotic tissue and kills bacteria quite effectively. Kills bacteria quite effectively. Chelators: Such as EDTA, remove the smear layer. Hydrogen Peroxide: Used to be used a lot, however studies have shown it to be ineffective. Chlorhexidine: Has been shown to remove significant number of bacteria.
  • 18. ENDOVAC TECHNOLOGY the use of apical negative pressure irrigation, significantly improves cleaning and disinfection more closely to the apex. ENDOACTIVATOR Sonically driven system, enables the irrigant to travel deep into the pulpal system, enabling better cleaning.
  • 19. Tooth Anatomy Revision Root canal anatomy Accessory canals Access cavities Irrigants Recent Developments in Endodontics.
  • 20. http://www.dentistrytoday.com/endodon tics/1043 http://www.youtube.com/watch? v=QrUgCNQs038 Endodontics Lecture from Blackboard. By Dr Qualtrough. http://www.dentistrytoday.info/content/i rrigation-endo http://www.jendodon.com/article/S0099- 2399(07)00095-7/abstract