ENDODONTICS-Endodontics in Clinical Practice, 6e

Index gold-porcelain infusion  271–6 single-visit endodontics  117–18
metal-ceramic  271, 277 treatment of non-infected teeth  118
antibiotics  203 resin crowns  276 Distobuccal canal  45
bone morphogenic proteins  Curative endodontics  112 Dressings
Cytokines  4 antibacterial  117
203 calcium hydroxide  122
calcium hydroxide  203 Dens evaginatus  39 disinfectant  122
corticosteroids  203 Dens invaginatus  39 sedative  256
ferric sulphate  202 Dental history  18 Drug resistance  116
formocresol  201–2 Dental Practitioners’ Formulary  15
glutaraldehyde  202 Dentaport ZX  84f Eikenella corrodens, 233
mineral trioxide aggregate  Dentine Electric pulp test  23–4
Electronic apex locators  83, 100–1
203 drug penetration  120–1 Elements Obturation Unit  89f
pulpectomy  203–4 exposure at  58 Emergency treatment  253–5
pulpotomy  200–1 fracture  213
treatment of immature teeth  fracture with pulp exposure  acute apical periodontitis  254
acute flare-up  255
220–3 213–14 acute periapical abscess  254–5
auto-transplantation of intratubular  36 acute pulpitis  254
tertiary  36, 39–40, 257–8 Enamel
premolars  223 secondary  36 fracture  212–13
avoidance of cervical root Dentine bonding agents, irritant fracture with pulp exposure 

fracture  221 properties  57 213–14
revascularization treatment  Dentine-bonded composite resin  infractions  213
Endodontic triad  98
222–3 177 Endomethasone  150
regenerative treatment  223 Depression  11 Endoring II systems  90
surgical treatment  222 Diagnosis  17–33 Eubacterium spp.  56
treatment of primary teeth  European Society of Endodontology  4
differential diagnosis  26–8 Examination  18–21
198–204 examination  18–21 extraoral  18–19
Chinese, worm theory  1–2 history  18 hard tissues  19–20
Chlorhexidine  116, 122 investigations  21–6 intraoral  19–21
Chlorine  115–16 restorability  28–9 mobility  21
Chloroform  145–6 treatment options  29–30 palpation  20
Chronic apical periodontitis Diaket  177 percussion  21
Dialister spp.  113–14 periodontal probing  21
differential diagnosis  28 Differential diagnosis  26–8 soft tissues  19
Chronic periapical abscess periapical conditions  28 specific tooth/teeth  20–1
Extracoronal restorations  260
differential diagnosis  28 acute apical periodontitis  28 Extraradicular infection  114
Clamp forceps  75 acute periapical abscess  28 Extrusive luxation  217
Clamps  73–5 chronic apical periodontitis  28 Exudation  113, 120
Clindamycin  115 chronic periapical abscess  28
Cocaine  2 normal tissues  28 Ferric sulphate pulpotomy  202
Cold test  22 pulpal conditions  26–7 Ferrule effect  281–2
Composite resin irreversible pulpitis  26–7 Fibre-optic lights  91
normal pulp  26 Files  79
irritant properties  57 pulp necrosis  27
crowns  277 reversible pulpitis  26 Flexofile  79
restoration  271, 277 Dihydrocodeine  14–15 Hedstrom file  79
veneers  271 Discolouration  225–6 K-file  79
Concussion  217 primary teeth  213 K-flex file  79
Cone Beam Computed Disinfectants  115–16 nickel-titanium  79
Disinfection  112–13, 116–18 Flexofile  79
Tomography(CBCT)  25–6 antibacterial dressing  117 Fluticasone  13
Corticosteroids  12–13, 149–50 antibacterial effects of Forceps  85
Formocresol  115
pulpotomy  203 irrigation  117 pulpotomy  201–2
Coronal restoration  150–1 controlled  118
Cracked teeth, pulp response to  63 follow-up studies  117
Critical crestal zone  185–6 instrumentation  90–1, 116–17
Crown fractures  212 predictable  116–18
Crown-root fracture  214–15
Crown-down rationale  103–4
Crown-down technique  104–5
Crowns

all-ceramic  276
ceramic  277
composite resin  277

288

Index

Fractures Haemostasis  162–4 Intra-alveolar root fracture  212
permanent teeth  213–16 Halogens  115–16 permanent teeth  215–16
crown-root fracture  214–15 Hand instruments  78–82
enamel and dentine  213 Intra-alveolar surgery, pulp response to 
infractions and fracture of barbed, broaches  78 64
enamel  213 files  79
intra-alveolar root fracture  reamers  78 Intracanal hard tissue formation 
215–16 Hard tissue barrier  113, 119 257–8
pulp exposure  213–14 Heat test  22–3
primary teeth  212–13 Hedstrom file  79 Intraosseous anaesthesia  256–7
crown fractures  212 History  18 Intrapulpal anaesthesia  256
intra-alveolar root fracture  212 History of pulp treatment  1–2 Intratubular dentine  36
Hollow tube theory  2 Intrusive luxation  218–19
Frames  75 HotShot  89 Investigations  21–6
Friction grip burs  76–7 Hot tooth  255–6
Fusobacterium spp.  113–14 Human immunodeficiency virus (HIV)  bite/cusp loading tests  23–4
Fusobacterium nucleatum, 233 blood flow assessment  24–5
9–10 electric pulp test  23–4
Gates-Glidden burs  77–8 Hunter, William  2 pulp sensitivity tests  21–4
Glass ionomer cement  177 Hydrophilic polymers  146–7 radiographs  25–6
Glass ionomer sealers  134 selective local anaesthesia  24
Glutaraldehyde pulpotomy  202 Ibuprofen  14 test cavity preparation  24
Gold onlays  277 Ice sticks  22 thermal tests  22–3
Gold-porcelain infusion crowns  Implants, response to  64
Incisors cold test  22
271–6 heat test  22–3
GORE-TEX  188 mandibular  46–7 Iodine  115–16
Grossman’s polyantibiotic paste  112 maxillary  40–2 Irrigant delivery devices  84–5
Gulded-tissue regeneration  187–8 primary  49–50 Irrigation
Gutta-percha  135–46, 261 Infection see Bacteria; and individual antibacterial effect  117
drug application by  122
canal filling  135–6 infections root canal  101–2
carrier devices  89–90 Infective endocarditis  12 Irritants  56–9
cold techniques  136–41 Inflammatory mediators  4 bacterial microleakage  57
Instrument fracture  262–3 bleaching  57–8
lateral condensation  136–8, operative dentistry  58
140–1 prevention of  263 dental caries  56–7
Instruments  71–95 dental materials  57–8
cone exposure of dentine  58
at working distance, loose  138 access cavity preparation  76–8 pulp response to  56
beyond working distance  139 basic instrument pack  72
not reaching working distance  burs  76–7 K-file  79
139 disinfection  90–1, 116–17 K-flex file  79
spreaders  139–40 fibre-optic lights  91 Kloroperka  145
irrigant delivery devices  84–5
heat-softened techniques  141–5 loupes  91 Lactobacillus spp.  56
continuous wave of nickel-titanium  79, 104 Laser Doppler Flowmetry (LDF) 
condensation  operating microscopes  91
141–3 retrieval of broken instruments and 24–5
extracanal  143–5 Lateral canal  38
intracanal  141–3 posts  85–6 Lateral condensation  86, 136–8,
operator-coated carrier- root canal filling  86–90
condenser  144–5 root canal preparation  78–82 140–1
precoated carriers  143–4 Lateral luxation  217–18
rotating condenser  143 hand instruments  78–9 Ledermix  112, 120–1, 256
thermoplastic delivery systems  power-assisted instrurnents  Ledges  261–3
144 Leucotrienes  4
warm vertical condensation  141 79–82 Lidocaine (Lignocaine)  14
rubber dam  72–6 Local anaesthesia, selective  24
heat test  22–3 storage and sterilization  90–1 Loupes  91
solvent-softened  145–6 surgery  161–2 Luebke-Ochsenbein flap  165t, 166f
thermomechanical compaction  working length, determination  82–4 Luxation injuries
Intermediate restorative material  177
88 International Normalized Ratio (INR)  permanent teeth  217–20
thermoplasticized injectable  88 avulsion  219–20
Gutta-percha points  86 12 concussion  217
International Organization for

Standardization (ISO)  78

289

Index

extrusive luxation  217 Mineral Trioxide Aggregate (MTA)  5, indications  244
intrusive luxation  218–19 60, 146, 177–9 root amputation  244–6
lateral luxation  217–18 tooth resection  246–7
subluxation  217 pulpotomy  203 anatomy  231–2
primary teeth  212–13 Mobility  21 apical  1–2, 4–5, 111–12, 117,
Molars
M4 Safety handpiece  79 233
Mandibular anterior teeth mandibular  48–9 chronic  28
maxillary  43–6 classification  233–42
surgery  184 primary  50 combined lesions  235–42
Mandibular canine  47 Monoblocks  147–8 complications  242–4
Mucoperiosteal tissue flap diagnosis  242
access cavities  47 full  164–7 effect on pulp  233
surgery  184 limited  167–8 primary endodontic lesion  233,
Mandibular incisors  46–7
access cavities  47 Nickel-titanium alloys  5 242
surgery  184 Nickel-titanium instruments  104 with secondary periodontal
Mandibular molar  48–9
access cavities  49 files  79–80 involvement  235–42
surgery  184 Nitrous oxide  14 primary periodontal lesion 
Mandibular premolars  47–8 Nomenclature  36
access cavities  48 Normal tissues. differential diagnosis  233–5, 242
surgery  184 with secondary endodontic
Masserann trepan  85–6, 260–3 28
Maxillary anterior teeth involvement  237–9
surgery  183 Obtura system  88, 88f, 144 prognosis  242
Maxillary canine  42 Onlays, ceramic  277 Periodontium, effect of inflamed pulp 
surgery  183 Operating microscopes  91
Maxillary incisors  40–2 OraSeal caulking agent  72f 232–3
access cavities  41–2 Orofacial pain  10–11 Periapical abscess, acute  254–5
surgery  183 Orthodontic treatment  226 Periradicular curettage  169
Maxillary molars  43–6 Periradicular surgery see Surgery
access cavities  45–6 pulp response to  63–4 Permanent teeth
surgery  184 Osteomyelitis  4
Maxillary premolars  42–3 fractures  213–16
access cavities  43 Pain crown-root fracture  214–15
surgery  183 differential diagnosis  10–11 enamel and dentine  213
Maxillary sinus  11 endodontic  119 infractions and fracture of
Medical history  18 examination  10 enamel  213
Medication  111–29 history  10 intra-alveolar root fracture 
antimicrobial agents  114–16 persistent orofacial  10–11 215–16
pulp exposure  213–14
antibiotics  114–15 Pain control see Analgesia
disinfectants  115–16 Palatal canal  45 immature  220–3
asepsis, antisepsis and disinfection  Palpation  20 luxation injuries  217–20
Papilla-base flap  168
112–13 Paracetamol  14 avulsion  219–20
diffusion, and solubility  120 Paraformaldehyde  115, 150 concussion  217
history  112 Partsch incision  164 extrusive luxation  217
penetration of dentine  120–1 Paste fillers  149–50 intrusive luxation  218–19
resistance to  116 Penicillin  114 lateral luxation  217–18
smear layer  121 Peptostreptococcus spp.  113–14 subluxation  217
tissue distribution  120–1 Percussion  21 pulp space  40–9
tissue toxicity  121 Periapical abscess trauma  213–20
Meitrac endo safety system  86 Phenols  116
Mesiobuccal canal  45 acute  28 Phenoxymethyl penicillin  14
Metal-ceramic crowns  271, 277 chronic  28 Piezon-Master 400 unit  85f
Metronidazole  14, 114 Periodontal disease, pulp response to  Porphyromonas spp.  113–14
Microorganisms  3–4 Porphyromonas gingivalis, 233
Microscopes, operating  91 64 Post removal devices  86
MicroSeal system  144–5 Periodontal probing  21 Posts  260–1, 277–85
Midazolam  14 Periodonitis  231–52 diameter  281
ferrule effect  281–2
acute  28, 254 fibre
anatomical redesigning  244 bonding systems  283
composite resin core build-up 
bicuspidization  247–8
contraindications  244 285

290

composite resin insertion  283 operative dentistry  58 Index
composte resin cement  283 trauma  58
gutta-percha removal and canal microbes  113–14 Radicular anomalies  242–4
monitoring  29 diagnosis  243
enlargement  283 normal  26 prognosis  243
insertion  283 preservation  29 treatment  243–4
properties  283 regenerative developments 
root canal drying  283 Radiography  25–6
temporary cement and sealer 60–3 root canal length  82–3
response  63–4
remnantsremoval  283 Reamers  78
tooth isolation  283 cracked teeth  63 Reciprocating handpieces  79
ideal properties  282–3 intra-alveolar surgery and Regenerative procedures  60–3,
indications for  277–81
length of  281 implants  64 187–8
metal  281 irritants  56 Replantation  186–7
Potassium oxalate  58 orthodontics  63–4 Resin-based sealers  134
Power-assisted instruments  79–82 periodontal disease  64 Resin crowns  276
reciprocating handpieces  79 Pulp canal  36 Restorability  28–9
rotary handpiece and motor  81–2 Pulp capping  60 Restorations  269–86
rotary NiTi instruments  79–81 direct  200
Precoated carriers  143–4 indirect  199–200 amalgam  276–7
Premolars Pulp chamber  36 anterior teeth  271–6
mandibular  47–8 Pulp–dentine complex  55–6
maxillary  42–3 Pulp horns  36 all-ceramic crowns  276
Presenting complaint  18 Pulp inflammation ceramic or composite resin
history of  18 effect on periodontium 
Preventive endodontics  112 veneers  271
Prevotella spp.  113–14 232–3 composite resin restoration  271
Prevotella intermedia, , 233 Pulp necrosis  27, 216 gold-porcelain infusion crowns 
Primary teeth  197–207 Pulp sensitivity tests  21–4
canines  49–50 Pulp space  36 271–6
discoloration  213 metal-ceramic crowns  271
endodontic treatment  198–204 access cavities  35–53 resin crowns  276
fractures  212 alteration with age  36 choice  271–7
crown fractures  212 anatomy  35–53 composite resin  271, 277
intra-alveolar root fracture  212 effects of tertiary dentine on  effects of endodontic treatment on
incisors  49–50
luxation injuries  212–13 39–40 the tooth  270
medicaments  201–3 permanent teeth  40–9 posterior teeth  276–7
molars  36 primary teeth  49–50
pulp space  49–50 Pulp stones  257 amalgam restoration  276–7
pulpectomy  203–4 Pulpectomy  203–4 composite resin restoration 
pulpotomy  200–1 Pulpitis
Propionibacterium spp.  56 acute  254 277
Prostaglandins  4 irreversible  26–7 gold onlays  277
Prosthetic hip joints  12 reversible  26 composite resin and ceramic
Pulp  55–69 Pulpotomy  60
differential diagnosis  26–7 antibiotics  203 onlays/crowns  277
exposure  58, 60, 213–14 bone morphogenic protein  203 metal-ceramic crowns  277
extirpation  29 calcium hydroxide  203 posts  277–85
irritants  56–9 children  200–1 diameter  281
bacterial microleakage  57 corticosteroids  203 ferrule effect  281–2
bleaching  57–8 ferric sulphate  202 fibre  283–5
chemical  57–8 formocresol  201–2 ideal properties  282–3
dental caries  56–7 glutaraldehyde  202 indications for  277–81
dental materials  57 medicaments  201–3 length of  281
exposure of dentine  58 mineral trioxide aggregate  203 survival of endodontically treated
function/parafunction  58–9 primary teeth  200–1
mechanical  58–9 vital  200 tooth  270
Pulse oximetry  24 timing of restorative procedure 
Punches  73
270–1
Quality assurance  4 Retreatment  189–90, 225

problems with  260–1
broken instruments  262–3
extracoronal restorations  260
ledges and blocked canals 
261–3
posts  260–1
root filling materials  261–2

root canal  30
Reye’s syndrome  14

291

Index

Root amputation  244–6 coronal pulp tissue removal  Super-EBA  177
Root canal  36 98–100 Root-end cavity preparation 

bleeding  113, 120 pretreatment assessment  98 173–4
blockage  261–3 pulp chamber roof removal  Root-end resection  170–3
calcification  105 Rotary handpiece and motor  81–2
configuration  38f 98–100 Rotary NiTi instruments  79–81
curvature  259–60 rubber dam  98
disinfectants  115–16 straight-line  100 core diameter, flute depth  81
exudation  113, 120 apical size  106 flute design  80
medication  111–29 apical patency filing  106 helical flute angle  80–1
retreatment  30 cleaning and shaping  105–7 non-cutting tip  81
treatment  29–30 hand instruments  78–82 rake angle  80
Root canal filling  131–57 barbed broaches  60 surface treatment  81
access and canal preparation  132 files  79 variable taper  80
anatomy  132 reamers  78 Rotating condenser  143
coronal restoration  150–1 instrumentation techniques  Round burs  77
criteria for  132–3 Rubber dam  72–6, 98
follow-up  151 102–5 application of  75–6
gutta-percha  135–46 calcified canals  105 clamp  73–5
crown-down rationale  103–4 clamp forceps  75
carrier devices  89–90 crown-down technique  frame  75
cold techniques  136–41 punch  73
heat-softened  141–5 104–5
solvent-softened  145–6 irrigation  101–2 Safe-ended burs  77–8
hydrophilic polymers  146–7 nickel-titanium instruments  104 Scope of endodontics  3
instruments  86–90 number of visits  106–7 Sealers  133–5
lateral condensation method  86 power-assisted instruments  79–82
materials  133 calcium hydroxide  134
mineral trioxide aggregate  146 reciprocating handpieces  79 calcium silicate-based  135
monoblocks  147–8 rotary handpiece and motor  functions of  133
non-instrumentation technology  glass ionomer  134
81–2 resin-based  134
265 rotary NiTi instruments  79–81 silicone-based  134
paste fillers  149–50 preparation of tooth  98 zinc oxide-eugenol  133–4
problems of  264–5 problems with  257–64 Secondary dentine  36
access cavity preparation  257 Sedation  257
iatrogenic  265 primary preparation  257–60 Sedative dressings  256
non-iatrogenic  264–5 acute canal curvature  259–60 Silicone-based sealers  134
sealers  133–5 intracanal hard tissue formation  Silver points  149, 261–2
calcium hydroxide  134 Single-visit endodontics  117–18
functions of  133 257–8 Sinus, maxillary  11
glass ionomer  134 working length determination  Sinusitis  11
resin-based  134 SmartSeal system  146–7
silicone-based  134 82–4, 100–1 Smear layer  102, 121, 135
zinc oxide-eugenol  133–4 electronic apex locators  83, Sodium hypochlorite  115–16
silver points  149 accidents  263–4
smear layer  135 100–1 application by irrigation  122
thermomechanical compaction  88 measuring devices  83–4 Spreaders  139–40
thermoplasticized injectable radiography  82–3 Stabident  256
Root filling materials Sterilization of instruments  90–1
gutta-percha  88 irritant properties  57 Storage of instruments  90
treatment outcome  151 see also individual-materials Streptococcus spp.  56
vertical condensation method  87 Root resorption  113, 120 Stropko irrigator  177f
Root canal infection cervical external  224 Subluxation  217
persistent  114, 122 external inflammatory  223–4 Sulpha preparations  114
primary  113–14, 122 external replacement  224–5 Super-EBA  177
secondary  114, 122 Root-end cavity filling  174–6 Surgery  159–95
tissue response to  4 materials  176–9 aetiology and evaluation 
Root canal preparation  97–109 dentine-bonded composite resin 
access cavity see Access cavity 188–9
177 anatomy  184–5
preparation Diaket  177
access, gaining  98–100 glass ionomer cement  177
intermediate restorative material 

177
mineral trioxide aggregate 

177–9

292

Index

biopsy  169 limited mucoperiosteal tissue history  210–11
choices  160 flap  167–8 immature teeth  220–3
closure of surgical site  179–80
immature permanent teeth  222 papilla-base flap  168 auto-transplantation of
indications for  160 tissue anaesthesia and haemostasis  premolars  223
instrumentation  161–2
intra-alveolar  64 162–4 avoidance of cervical root
mandibular anterior teeth  184 treatment of root face  179 fracture  221
mandibular molars  184 Suture knots  180
mandibular premolars  184 Suture materials  180 revascularization treatment 
maxillary anterior teeth  183 Systemic disease  11–13 222–3
maxillary molars  184 infective endocarditis  12
maxillary premolars  183 prosthetic hip joints  12 regenerative treatment  223
osseous entry and root warfarin and corticosteroids  12–13 surgical treatment  222
immediate management  210–11
identification  168 Tannarella spp.  113–14 permanent teeth  213–20
periradicular curettage  169 Temporary filling  122–3 fractures  213–16
postoperative Tertiary dentine  36, 257–8 luxation injuries  212–13
primary teeth  212–13
examination and review  183 effect on pulp space  39–40 discolouration  213
patient instructions  181–3 Tetracycline  114–15 fractures  212
radiological assessment  Thermafil obturator  89 intra-alveolar root fracture  212
Thermal tests  22–3 luxation injuries  212–13
180–1 as pulp irritant  58
preoperative assessment  161 cold test  22 types of injury  211–12
regenerative procedures  heat test  22–3 Treatment options  29–30
Thermomechanical compaction  88 lose tooth  29
187–8 Thermoplastic delivery systems  144 pulp extirpation  29
repair of perforation  185–6 Tissue anaesthesia  162–4 pulp monitoring  29
replantation, transplantation  Tissue response to root canal infection  pulp preservation  29
root canal retreatment  30
186–7 4 root canal treatment  29–30
retreatment  189–90 Tooth resection  246–7 save tooth  29
root-end cavity filling  174–6 Tooth Restorability Index (TRI)  28–9 watch and review  29
root-end cavity preparation  Tooth Slooth  24 Tri-Auto ZX  84f
Transplantation  186–7 Treponema denticola, , 233
173–4 Trauma  58, 209–29
root-end filling materials  Veillonella spp.  113–14
complications  223–6 Veneers
176–9 barrier formation coronal to
dentine-bonded composite resin  apex  225 ceramic resin  271
cervical external inflammatory composite resin  271
177 root resorption  224 Vertical condensation  87
Diaket  177 discoloration  225–6
glass ionomer cement  177 external inflammatory root Warfarin  12–13
intermediate restorative material  resorption  223–4 Warm vertical condensation  141
external replacement root Wicking  180
177 resorption  224–5 Working length determination see Root
mineral trioxide aggregate  orthodontic treatment  226
previous injury  225 canal preparation
177–9 root canal treatment  225
Super-EBA  177 Zinc oxide-eugenol cement  57, 59–60
root-end resection  170–3 effect on dental tissues  212 Zinc oxide-eugenol sealers  133–4
soft tissue incision and reflection  examination  210–11

164–8
full mucoperiosteal tissue flap 

164–7

293

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