Nightguard Vital Bleaching 291
Before bleaching, the teeth are cleaned and a stone gel with a cotton swab or a toothbrush. If the mouth-
cast is made from an alginate impression. On the cast, piece is worn only at night, treatment may require 4-6
resin spacers are placed on the labial surfaces of the weeks. If the bleaching tray is also worn all day and the
teeth that are to be bleached. These are brought no solution or gel is changed every 2-3 hours, maximum
closer than 0.5 mm to the gingival margins to prevent
irritation. A thin, soft mouthpiece is then vacuum- whitening can be achieved in only 7-10 days.
formed over the cast. At the following appointment the In a study by Haywood (1991) a success rate of 91 %
mouthpiece is first tried and the patient is instructed
how to wear it. After evening toothbrushing the patient is reported for this bleaching method. In 66% of the test
places a small amount of the gel inside the mouthpiece, subjects, slight gingival irritation appeared and it was
seats it slowly over the teeth, and removes the excess necessary to interrupt treatment for 1-2 days
(Haywood et al. 1992).
789 Gel spacers
Spacers are placed on the casts of
the teeth to be bleached to create
spaces for the bleaching gel. The
spacers should be placed no clos-
er than 0.5 mm from the gingiva so
that the gel will not irritate the
mucosa. If the gingivae do become
i nflamed, bleaching should be
i nterrupted for 2 days.
790 Insertion
After the mouthpiece is lined with
bleaching gel it is slipped over the
teeth to be bleached with gentle,
uniform pressure. Any overflowing
gel is then removed with a cotton
swab or a toothbrush.
791 Duration of treatment
The teeth are significantly lighter
after 3 weeks of combined treat-
ment. The mouthpiece is worn day
and night. The clinical photograph
shows the persisting results 8
months after completion of treat-
ment.
Treatment by T. P. Croll
292 Bleaching of Teeth
792 Clinical results
Left: Severe discoloration and
superficial enamel defects as a
result of multiple fluoride applica-
tions in an 11-year-old child. The
two central incisors were micro-
abraded and then further bleached
with carbamide peroxide gel for 21
days.
Right: One year after treatment the
two teeth no longer exhibit the
brownish discoloration.
793 Clinical results
Left: The upper central incisors of
this 13-year-old girl were not as
severely discolored as in the
previous case. They were also
bleached by the combined tech-
niques.
Right: Six months after treatment
the discoloration is still gone and
the teeth are clearly whiter.
794 Treatment relapse
Left: Three years before this photo-
graph was taken, the four maxillary
i ncisors were treated by microabra-
sion because the patient had gene-
ralized white demineralization. The
teeth subsequently assumed a light
yellow coloration.
Right: Six months after a 21-day-
l ong vital bleaching procedure
with carbamide peroxide, all the
maxillary teeth are harmonious in
color.
795 Partial success
Left: Severe defective mineraliza-
tion of the enamel with brown and
white spots in a 14-year-old girl.
Right: Fifteen months after micro-
abrasion followed by the night-
guard vital bleach method and
improved oral hygiene, the teeth
appear lighter and the brown dis-
colorations are gone.
Treatment by T. P. Croll
293
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The flood of new literature in the field of endodontics list below makes no pretext of being all-inclusive,
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survey it all. The authors have attempted to document
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Illustration credits
Many of the illustrations in this atlas were generously Subdivisions of illustrations are indicated by L (left),
made available to us for publication by the contri- C (center) and R (right).
butors listed below in alphabetical order. All other
original photographs are by the principle authors.
Prof. Dr. C. Benz The following illustrations have been taken from the book Die Lokal-
1 05 to 107 anasthesie (M. Lipp, Quintessenz Verlag, Berlin 1992): 208 to 213
Dr. T. P Croll The following illustrations have been taken by M.A. Baumann from the
780 to 795 work Die raumliche Darstellung des Endodonts (M.A. Baumann,
Hanser, Miinchen 1995): 110, 111 R, 112 L, C, 113, 114, 114 L, 115 C, R,
Prof. Dr. F F Eifinger 116C,R, 117L,C,R
20, 21 The following illustrations have been taken by R. Beer from the work
Praktische Endodontie (R. Beer, M. A. Baumann, Urban & Schwarz-
Prof. Dr. M. Frentzen enberg, Miinchen 1994): 26 R, 28 R, 29, 31 L, 36, 44, 46, 66, 67 R, 70,
1 63 to 168, 170 71, 84 L, 96, 270, 271, 274 L, 284 L, 321, 376 R, 380 L, 381, 383, 399, 400,
402, 416 R, 421 R, 422, 424, 461, 463, 464, 466, 474, 475 L, 522, 524 to
Prof. Dr. S. Friedman 526, 530, 531, 532, 534 to 539, 546 L, C, 548L, 553 to 555, 560, 561,
656 562 L, 563 R, 564 L, 567, 616 R, 617 L, 619 R, 621 C, 706, 708, 710, 733,
734, 737, 738 L, 753 R, 754 R, 758, 768 R, 772, 778
Prof. Dr. J. L. Gutman n
622 to 624, 690 to 692
Prof. Dr. D. Heidemann
111 C
Prof. Dr. Dr. W. Ketterl
111 L
Prof. Dr. S. Kim
625 to 686
PD. Dr. M. D. W. Lipp
208 to 211
PD. Dr. A. Lussi
2 to 7, 11 to 13, 15, 16, 506, 508 to 511, 513 to 517.
Dr. G. Mayerhofer
763, 764
Prof. Dr. H. Plank
670
Dr. C. J. Ruddle
485 to 490, 501, 503 to 505
Dr. B. Suter
518
30 6
Index
A apical resorption, working length 114-15 wax 242 progression 1, 40, 204
apical seal 208 bridge proximal 2-3
abscess apical stop 177 pulp tissue penetration 22
alveolar 162, 163 fitting 281 pulpal necrosis 16, 17
dens invaginatus 206 working length 114, 115 fixation 282 with pulpitis 10
palatal 28 apical zone, critical 110 bubbles, cavitation 195 radiographic diagnosis 40
periapical 27, 28-9 apicoectomy 244 removal 91
periodontal 262 C smooth surface 7
phoenix 28 handpieces 68 stagnation 1
pulp 14 microsurgical endodontics 234 Calasept 208
ultrasound application 67 calcium binding 104 Carr Tips 248
access cavity, endodontic 270 vertical root fracture 263 calcium hydroxide 25, 29, 111, 113, Cavit 232, 260, 268, 269
acid-etch resin bonding technique 260 articaine 87, 89, 90 cavitation
AH-26 cement 166, 167, 169, 173 1 58-9
Ainsworth punch 77, 78 B apexification 208 bubbles 195
alveolar nerve anesthesia 88 application after bleaching 287 effect 67
amalgam back pack 191, 192 bacterial flora 147 ultrasonic phenomenon 152
bacteremia 151 carrier 158 cellular defense mechanisms 1
endodontically treated teeth 271 bacteria coronal restoration 272 cement
retrograde fillings 251 coronal seal 268 application systems 73
tooth discoloration 285 apical periodontitis 114, 146 crown-root fracture 261 coronal restoration agent 273
anesthesia, local calcium hydroxide dressings 147 direct pulp capping 203 root canal 165, 166, 167
agent selection 90 critical apical zone 110 dressing 73, 115, 119 cementoenamel junction 283
conduction 87 dentin 23 glycerin suspension 159 cementoid hard tissue formation 208
i nfiltration 87 dentinal tubule 26 i nterim dressing 157, 164, 260 cementum
i ntraligamentary injection 87 dentinal wall 26 deposition 114
mandibular surgery 90 endodontic failure 212 apical periodontitis 160, 161, 162, fracture 257
maxillary surgery 90 fistula association 146 1 63 resorption 14
solutions 88-9 interim dressing 145, 147 i on release 203 chalky spots 7
topical 87 invasion in dens invaginatus 206 l i ngual root groove 207 chlorhexidine 85
vasoconstrictors 89 li popolysaccharides 158 packing after re instrumentation 229 i rrigation 148
antimicrobial preparations 145 pain association 146 paste 203 mouth rinse 254
apex, radiographic 111 pulp tissue 146 powder 159 chloroform 218, 219
apexification 208 root canal 23, 26 pulpotomy chloropercha 166
deciduous teeth 199 deciduous teeth 201 chlorophenol 269
Apexit 170 i nfection 22-3 mixed dentition 205 cleaning apparatus 194
apical constriction 107 smear layer adherence 155 sealed root canal 163 cleaning and shaping
working length 110 bacterial endocarditis 35 sealer 170 Profile 04 137
apical cyst see radicular cysts bacterial infection suspension medium 158 root canal filling 118-19
apical enlargement 140 secondary 28 calcium phosphate 101 cleaning solution, biological compatibility
apical foramen 107 treatment 24-5 Calxyl 73, 287 1 94
excessive enlargement 108 bacteriocins 23 Canal Master 142 cleansing, mechanical 24
apical master file (AMF) 123, 226 Bacteroides 29 Canalfinder system 64, 134, 135, 144 CO 2 l aser 71
recapitulation 123 balanced force technique 120-1, 125, Cancellier instrument 223 cold test 38
apical periodontitis 1, 112 1 76, 220 canines collagen, denatured 231
acute 26-7 biting test 39 mandibular 53 complement activation in irreversible pul-
bleaching gel 290, 291 maxillary 52 pitis 11
drainage 162 bleaching of teeth 283-92 carbamide peroxide 290, 292 composite cement, coronal restoration
i nterim dressing 162-3 filling replacement 286 carbonic acid snow 38 273
bacteria 146, 172 home technique 290 caries 1 composite filling, bleaching of teeth 287
caries 26 microabrasion method 288-9 apical periodontitis 26 conservative endodontics 236
chronic 30-1, 114 mouthpiece 290, 291 arrested media 8 contrast enhancement, digital radiog-
i nterim dressing 160-1 prognosis 283 crown infractions 264 raphy 44, 45
radicular cysts 32-3 relapse 283 dentinal 8 coronal destruction, rubber dam appli-
instrumentation 148 solution 286 excavation 12, 13 cation 86
irrigation 148 thermocatalytic 286 fissure 4-6 coronal filling, impervious 25
pulp necrosis 26 walking bleach technique 287 diagnosis 4 coronal pulp chamber floor 94
retreatment indications 213 bleaching tray 291 enamel breakdown 6 coronal reference point, working length
root canal necrosis 22 bone extent 5 110
tooth injuries 255 breakdown 19 i ncidence in children 199 coronal seal 267
treatment 24, 168 destruction in apical periodontitis 30 i ndex 199 calcium hydroxide 268
apical regeneration 207 freeze-dried granules 231 mineralization 101 i nterim dressing 268, 269
apical resection 240-1 resorption 14, 165 pain 39 provisional 268-9
angle 240-1 sodium hypochlorite irrigation 268
isthmus preparation 241 apical periodontitis 114 coronal-apical instrumentation technique
1 24
I ndex 307
corticosteroids 145, 157 shavings coronal perforations 232 filling material 212
crown accumulation 181 demineralization 216 formaldehyde 18, 19, 157, 201
endodontic failure 215 fractured instrument bypassing
access preparation 212 root canal cement 165
artificial 273 tertiary 8, 14, 70, 284 228-9 formocresol 201, 269
discoloration 283 treatment in deciduous dentition 199 gutta-percha fillings 218-21 fractures, post removal 217
flap design 239 tubular tertiary 203 i nterim dressings 214 funnel formation 126
fracture 255, 258-9 dentinal bridge lateral perforation repair 230-1 fusobacteria 151, 163
calcium requirement 203 pain 214-15 Fusobacterium nucleatum 23
complicated 258, 259 laser vital amputation 71 post-core removal 216-17
uncomplicated 257, 258 dentinal tubules 20, 128 radiographs 213 G
pain 214 bacteria 26 retreatment 209
partial veneer 270-1 Gates-Glidden drills 97, 119
perforations 232 penetration 17 indications 212-13 canal shaping 136, 137
provisional 93 bleaching agent penetration 285 root canal anatomy 210-11 Lightspeed instrumentation 142, 143
removal 214, 216 closure 129 endodontic inflammation 12
retreatment decomposition product penetration endodontics Gelfoam 231
completion 213 failed therapy 198, 236 hemostasis 242
indications 212 284 lasers 69-72
stabilization 265 hydrogen peroxide penetration 283 radiography 42-3 giant cell granuloma 212
crown infractions sealing 70 treatment error 236 gingiva examination 39
caries 264 dentinocemental junction 107 endodontium 47 Giromatic system 64
pain 264 dentinoplasty 115 communication to periodontium 241
pulpitis 265 developmental defects in teeth 206-8 components 51 handpiece 134, 135
root canal filling 266 devitalization, intentional 18-19 Endolift 1134, 135 glass ionomer cement 92, 111, 232
crown restoration 211, 267, 272-3 diagnosis 35 Endomethasone 169
cast dowel-core 279 Diaket 166, 169 endosonic ultrasonic synergistic system coronal restoration 273
cementing agent 273 digital radiography 67 crown fracture 276
failure rate 281 contrast enhancement 44, 45 Endosonore file 66 dye penetration test 167
fracture risk 272 dynamic 45 endotoxins, bacterial 11 partial veneer crowns 271
temporary filling 267 false color representation 44 periapical bone resorption 158 vertical root fracture 262
treatment results 280-1 filters 45 pulp necrosis 17, 156 Gonon post remover 217
crown-root fracture 256,260-1 intraoral 44 root canal filling penetration 267 Gram-negative bacteria 11
calcium hydroxide 261 millimeter grid 44 engine-driven instrumentation granulation tissue, periapical 31
complicated 261 positive-negative representation 44, canal surface 144 granulocytes see polymorphonuclear
coronal fragment 260 root canal preparation 134-5 leukocytes
crown fragment bonding 260 45,46 epinephrine 89, 90, 242 Grossman cement 166, 169, 269
post-core 261 projection angle 45 epithelial rests of Malassez 34 gutta-percha 74-5
pulp vitality maintenance 261 resolution 45 erythrocytes 20 adaptation 172-5
pulpal necrosis 261 uses 46 erythromycin 215 condensation 173-5
root canal obturation 261 disinfection 145 ethoxybenzoic acid cement 252-3
cyanoacrylate cement 223 dressings 145 ethylenediamine, smear layer removal corrections 176-7
post cores 279 gutta-percha 75 1 54 overextension 177, 178-9
posts 275 eucalyptol 218, 219 condenser 73
D-11 spreader 176 dowel-core, cast 279, 280 eugenol 269 disinfection 75
deciduous teeth, early loss 199 down pack 189, 190, 191, 192 Excalibur handpiece 134 dissolution 218, 219
demineralization 1 dressings elongation 177
disinfection 145 F filling 179
bleaching of teeth 292 medicated 73, 156-7 balanced force technique 220
endodontic failure 216 dressings, interim 145, 147, 156-7 facial nerve anesthesia 89 endodontic failure 218-21
dens in dente 206 access opening sealing 163 fi beroptic cables interim dressing 220
dens invaginatus 206 apical periodontitis 160-1, 162-3 removal 219
dental floss calcium hydroxide 164 breakage 72 retreatment 218-21
frames 84 coronal restoration 272 laser transmission 69 three-dimensional 186-7
rubber dam application 83, 86 coronal seal 268, 269 fibroblasts working length measurement
denticles 100 crown fracture 259 chronic apical periodontitis 30
chronic inflammation 101 crown-root fracture 260 transformation 145 219-20
reversible pulpitis 9 endodontic failure 214 fibrodentin 100 finger spreaders 75
dentin 128 gutta-percha filling removal 220 files 60 forms 74
adhesive 21 posts 275 flexible 135 hand spreaders 75
bacteria 23 drills, trephining 228 nickel-titanium alloy 63 heated 76
Dycal 269 wear 63 heating 188, 189, 191
in wall 26 dye penetration test 167 filling material i nstruments 76
balanced force technique 121 foreign body reactions 212 lateral condensation 170-1, 174
carious 8 E pulp necrosis 19-20 master point 139, 170
decalcification 104 root canal 165
endodontically treated teeth 270, EDTA fillings, bacterial penetration 37 apical condensation 190
lubricant 104, 105 fistula broken instrument fragment re-
272,273 obstruction removal 180 bacterial association 146
excessive removal 127 smear layer removal 154 extraoral 36 moval 227
exposure 258 intraoral 37 condensation 171
fracture 255, 257 electric caries meter 4 maxillary molar 132 coronal filling 191
fragment accumulation in apical electric pulp test 38 fistulous tract fractured instrument bypassing
enamel gutta-percha point 168
region 113 irrigation 150 229
hydroxyl ion diffusion 161 caries penetration 2 li ngual root groove 207 i nsertion with posts 275
intrapulpal 100 crown fracture 258 flaps, microsurgical endodontics 238-9 i ntroduction 182
laser treatment 70 fissure caries 6 Flex-R file 61, 120 overextension 177
lesions 2, 3 fracture 255 Flexicut file 97 reinsertion 221
overloading 176 microabrasion 288-9 Flexofile 61 short 180-1
peritubular dissolution 154 enamel-dentin fractures 256 Flexogates 61 shortening 179, 190
permeability 105, 154 Endo Access bur 94 Flexoreamer 61 trial insertion 173
radiolucency 3 Endo Vacuum Set 250 fluoride treatment 289 vertical condensation 189
removal 119, 181 Endocursor 64 tooth discoloration 284 overextension 177
resorption 14 endodontia, laser therapy 69 fluorosis 288 point 74-5, 99, 100, 182
root canal sealing 71 endodontic diagnosis 12-13 foreign body reactions 165 accessory 171
secondary deposition 56 endodontic failure fistulous tract 168
broken instrument fragment removal fitting with overinstrumentation
222-7 178
inflammatory reaction 178
lateral condensation 179, 181
master cone 123
master cone radiograph 121
308 I ndex
gutta-percha, point reinstrumentation 223 sealing 71 C-shaped canal 58
obturation and operating micro- root canal obturation 227 vital amputation 71 crown infraction 264
scope 131 working length 224, 225, 226 lateral condensation technique 127 first 58
pulpotomy in mixed dentition 205 bypassing fractured 228-9 latex allergy 78 second 58
sealer coated 172, 173 fragment exposure 228 Lentulo spiral 73, 159, 172 maxillary 56-7
thermomechanical condensation i nflammatory reaction 229 l idocaine 87, 88, 90 access cavity 132
182 i nstrumentation 228 Lightspeed instruments 65, 142-3 distobuccal root 57
working length 102 steel 229 l ingual canal 98 embryonic development 210
working length marking 109, 115 trephining drills 228 l ingual root groove 207 endodontic failure 210
cutting efficiency 63 l ipopolysaccharides, bacterial 158 first 51, 57
posts 274 engine-driven 64-5 Listerine 254 fistula 132
removal 218 flexible 61 lymph nodes of head and neck, exami- fourth canal 56
root canal microapicoectomy 68 nation 36, 39 i nstrumentation for root canal
penetration depth 62 lymphokines 10
filling 165 retrograde microsurgery 68 preparation 132-3
obturation 111, 119, 169, 170-1 sonic systems 66-7 M l i ngual root 57
packing 106 standards 59 mesiobuccal root 57, 132, 133
solvents 218, 219 sterilization 63 macrophages 8, 14, 17 mesiolingual entrance to canal
standardization 74, 75 titanium alloy 62-3 AH-26 pulp reaction 166
Thermafil system 183 ultrasonic systems 66-7 apical periodontitis 27 1 32
thermoplastic injection technique 184-5 i nterleukin-1 (IL-1) 30 chronic apical periodontitis 30 mesiopalatal canal orifice 133
Trifekta technique 184, 185 I ntra-Endo 3LD 64, 134 polyketone-based resin cement 165 second canals 132, 133
Ultrafil system 184-5 i odoform 157, 285 periapical lesion 36
vertical condensation 188-91 I RM cement 232, 268, 269 McSpedden Compactors 159 mucoperiosteal flap, microsurgical endo-
zinc oxide filler 74 i ron sulfate 242 Maillefer 73, 74, 75 dontics 238
i ron sulfide 284 mandible, radiographic diagnosis 41
H i rrigation 73 mandibular nerve anesthesia 89 N
broken instrument fragment removal mandibular radiolucency 40
H file 60, 97 226, 227 mandibular teeth N2 cement 169
halothane 218, 219 canula 149 nasopalatine nerve anesthesia 88
handpieces, sonic instrumentation 66 fully automated cleaning 194 access preparations 95 Nd:YAG laser 71, 72
Hedstrom file see H file medicated 147, 148-9 anterior 53 neurologic investigations 36
Heidemann spatula 83 microbial control 148-9 marsupial ization 150 neutrophilic granulocytes 8, 10, 14, 17
Heliapical 61 necrotic pulp tissue dissolution 149 master cone, radiograph 121
Helifile 61 periapical lesion 150-1 maxillary radiolucency 40 AH-26 pulp reaction 166
Helisonic instrument 66 maxillary teeth apical periodontitis 27
hemisection 282 recall evaluation 149 access preparations 95 migration 20, 21
hemostasis root canal preparation 110 anterior 52 nickel-titanium alloys 62-3
sodium chloride 151 membrane, resorbable 232 corrosion 63
direct pulp capping 203 sodium hypochlorite 194, 195 mepivacaine 87, 88, 90 nickel-titanium instrumentation of canal
microsurgical endodontics 242 solutions 67 microapicoectomy 68 surface 144
pellet technique 242 microbrasion of teeth 288-9 nickel-titanium instruments
pulpotomy biological compatibility 194 microscope, operating 235 engine-driven 65
ultrasonic 24, 152-3 microstreaming, ultrasonic phenomenon Profile 04 136
deciduous teeth 200, 201 ISO standardization 59 152 separation 139
mixed dentition 205 isthmus 244-5 microsurgery, retrograde 68 nightguard vital bleaching 290-1, 292
humoral defense mechanisms 1 cleaning 246 microsurgical endodontics 233 Nitinol files 135
hydrogen peroxide 286, 287 clinical treatment 246-7 apical resection 240-1 Nitinol spreaders 173, 174
penetration 283 communication between root canals cavity drying 250
hydroxyl ions 161 errors 240 0
hyperemia, infrared laser beam 70 244-5 flap design/execution 238-9
direction 247 hemostasis 242 odontoblastic layer, calcium hydroxide
filling 247 il l umination 234, 235 dressing 160
preparation 245 indications 236
shape 246 instrumentation 234 odontoblasts 20
Ivory punch 77, 78 isthmus 244-5 secondary 203
i buprofen 215 K preparation 241 oral hygiene 254
i mpedance measurement of tissue 116 magnification 234, 235 orthodontic appliance, fixed 86
i mpression making 92 K file 60, 97 osteotomy planning 237 osteoblasts 30
i ncisors step-back technique 122, 123 periapical lesion localization 237 osteoclasts 114
titanium alloy 62 presurgical examination 237 osteodentin 203
canal entrance uncovering 95 ultrasonic 66 principles 234 osteomyelitis 29
magnetic resonance imaging 50 radiography 237 osteotomy planning 237
mandibular 53 K flex 61 resected surface inspection 243 overinstrumentation 110
K reamer 60 resection angle 240-1
second root canal 51 Kerr compound 80 retrograde preparation 248-9 P
maxillary 52 Kerr Endolift 64
i nflammation 145 Kerr sealer 167, 173 amalgam 251 pain
corticosteroid suppression 157 drying 250 bacterial association 146
periapical 11, 17 vertical condensation 189 Super EBA cement 252-3 caries 39
i nflammatory reaction reverse obturation 250, 251 cracked teeth 264
fractured instruments 229 L Super EBA cement 252-3 crowns 214
gutta-percha point 178 sutures 254 endodontic failure 214-15
initial apical file (IAF) 122, 123 l aser treatment error 236 history 35
instruments delivery systems 69 ultrasonic unit 248-9 mechanism 9
broken fragment removal 222-7 dentin treatment 70 microtitanium instruments 62, 63 origin 35
direct radiation of root canal 69 mineralization patient examination 39
apical instrumentation 226 Doppler probe vitality test 70 advanced caries 101 periapical lesions 164
apical master file 226 endodontics 69-72 reversible pulpitis 9 pulp condition 12, 13
canal entrance probing 225 i nfrared beam 70 mobilized flaps, microsurgical endodon-
deep preparation 224 pulp treatment 70 tics 239
drying 227 root canal MOD amalgam retorations 271
i rrigation 226, 227 preparation 72 molars
master point fitting 227 canal entrance uncovering 95
microscopic inspection 224, 225, magnetic resonance imaging 50
mandibular 58
226
radiographic diagnosis 222
radiography 224, 225
I ndex 30 9
pulp tissue extirpation 19 removal in endodontic failure 216-17 Quantec instruments 65 gutta-percha
reversible pulpitis 13 vertical root fracture 263 series 2000 140-1 obturation 111, 169, 170-1
root canal treatment 214-15 postendodontic care 267 packing 106
paper points 73, 103, 250 postendodontic infection 110 R
paper tips 108 predentin 128 i nfection 29, 169
Para-post dowels 279 calcium hydroxide dressing 160 Racer System 134, 135 microbial 146-7
paraposts 217 Prema 289 radicular cysts 34
parapulpal pins 111 premolars isthmus communication 244-5
pastes mandibular 55 chronic apical periodontitis 32-3 laser
application systems 73 pocket 33
fillers 73, 159 root canal system 211 true 33, 34 expansion 72
patient examination 35 maxillary 54 radiographic diagnosis 40-1 preparation 72
clinical 39 endodontics 42-3 treatment 69
extraoral 36 crown infraction 264 radiography lateral 194
intraoral 37 Prevotella buccae 146 diagnostic 42 lateral canals 186-7
therapy selection 39 Proco-Seal 173 digital technique 44-6 length determination 101
penicillin 215 Proco-Sol 167 eccentric 41 mandibular molars 58
peptostreptococci 151, 163 Profile 04 136-7 endodontics 42-3 mandibular premolars 55
Peptostreptococcus micros 23 propylene glycol 158 first measurement 42 maxillary molars 56-7
percussion test pulp lawsuit defense 43 maxillary premolars 54
intraoral examination 37, 39 master point 43 mineral deposits 101
tenderness 12 abscess 14 root canal anatomy 48 multiple ramifications 211
perforations amputation rubber dam 86 obliterated 100-1
coronal 232 working length 42 obliteration 76
lateral 230-1 crown fracture 259 radiolucencies, diagnosis 40 crown fracture 259
location 230-1 deciduous teeth 200 Radix Anchor 277 obstructions 104
repair 231 mixed dentition 204 RC-Prep 112, 118 overfilled 241
sealing 231 vital 71 obstruction removal 180 overlooked primary 210
periapical abscess 27, 28-9 apical periodontitis 27 reamers 60, 119 periapical abscess 28
pus evacuation 29 bacteria 146 remineralization 1 pulp necrosis 14
periapical inflammation 11 capping smooth surface caries 7 retrograde surgery 68
pulpal necrosis 17 direct 199, 203, 259 resin cement, polyketone-based 165 sealer wall coating 172
periapical lesion indirect 199 retrosurgery sealers 169, 170
apical enlargement 151 material 205 i nserts 67 sealing 71
coronal restoration 281 carious exposure 14-17 microscopic 68 straight 129
decompression 151 chamber with ultrasound 67
i rrigation 150-1 access for pulpotomy 204 reverse obturation 250, 251 system 193
localization for microsurgical endo- anatomy 51 Super EBA cement 252-3 treatment
floor 99 Rispisonic instrument 66
dontics 237 internal architecture 47, 48 root cast post-cores 278
size 30 l ocation 99 development assessment 204 gutta-percha filling 97
sodium chloride irrigation 151 opening 94 external resorption 283 i rreversible pulpitis 13
therapy-resistant 212 roof penetration 96 growth completion 199 mishaps 236
periapical radiolucency, retreatment indi- roof removal 270 perforation 230 pain 214-15
cations 213 compression 113 resected surface 243 radiography 43
periapical resorption 42, 114 extirpation 112 resorption with tooth injuries 255 tooth mechanical properties 272
periodontal abscess, root fracture 262 fracture 257 tip root canal filling 13, 19, 21, 76, 102, 168
periodontal fracture 257 i nnervation 9 apical 190
periodontal pocket i ntentional devitalization 18-19 apical palpation 37, 39 bubble formation 198
formation 187 l aser treatment 69, 70 complexity 243 calcium hydroxide dressing 119
vertical root fracture 262 necrosis 14, 16-17, 156 root canal cement covering 283
periodontium communication to endo- apexification 208 amputation 193 chronic apical periodontitis 32, 33
dontium 241 apical periodontitis 26 anatomy 47, 51 cleaning 118-19
phenol, tooth discoloration 285 bacterial penetration 172 3D computer reconstruction 49 condensation 173, 174-5
phenolic compounds 25 crown fracture 258 contour-based reconstruction 49 i nadequacy 198
phosphoric acid etching 285 crown-root fracture 261 histologica sections 48 coronal 191
Piezo Ultrasonic System 66 dens invaginatus 206 magnetic resonance imaging 50 restoration 25
plasma cells, chronic apical periodontitis endodontically treated teeth 270 methods of reproduction 48-9 seal 111
30 filling materials 19-20 radiography 48 crown infractions 266
pluggers 188, 189, 190, 191 l ingual root groove 207 volume-based reconstruction 49 defective 213
pulpectomy in deciduous teeth 202 tooth discoloration 284, 285 anterior mandibular teeth 53 failure 198
polycarboxylate cement 273 tooth injuries 255, 257 anterior maxillary teeth 52 fully automated obturation 196-7
post-cores 279 necrotic tissue dissolution 149 apical constriction 107, 108 glass ionomer cement 111
polyp 14, 15 apical ramifications 210 gutta-percha points 99, 100
polymorphonuclear leukocytes 10, 14 bacteria 23, 26 master 139
apical periodontitis 27, 30 stump emulsification 112 infection 22-3 obturation 119, 131
tissue penetration 172 reinsertion 221
Porphyromonas sop. 23, 27, 29, 146, biological evaluation 173 hemisection 193
1 63 removal in deciduous teeth 200 C-shaped 58 i nadequate 209
toxin penetration 11 configuration classification 51 i nflammatory reaction to removal 229
post vital extirpation 170 conical shaping 106 i nterim dressing 115
coronal portion enlargement 274 pulpectomy, deciduous teeth 199, 202 curvature 98, 99 lateral canals 186-7
disinfection 275 pulpitis 1 curved 120-1, 129 lateral condensation 259
endodontic 274-7 acute irreversible 10-11 calcium hydroxide filling 159 marginal adaptation 243
insertion 211, 273, 277 crown infractions 265 obturation 187, 193 material 165
interim dressing 275 i nflammatory cell accumulation 10 dressing for apexification 208 overextension prevention 115
parallel-sided 279 i nflammatory reaction 10-11 drying 73, 103 overfilling 135
prefabricated systems 261 i rreversible 12, 13, 39 enlargement 101 periapical abscess 29
removal 216, 217 reversible 8-9, 13, 39 fourth 168 postoperative radiograph 109
screw 216 pulpits aperta 14, 15 radiography 43, 117
tapered systems 279 chronic 15 retrograde 251
granulomatosa 14 shaping 118-19
post and crown, failure rate 281 pulpoblasts 100 step-down technique 125
post space 274 pulpotomy Thermafill 137, 183
thermomechanical condensation 182
preparation 275, 276, 277 deciduous teeth 199, 200-1 thermoplastic injection technique
post-core 274 mixed dentition 204-5 1 84-5
three-dimensional 186-7
build-up 277 tooth discoloration 285
cast 278-9 Ultrafil system 184
cementation 279 vertical condensation 188-91
crown-root fracture 261 see also working length
hemisected teeth 282
preparation 278
31 0 I ndex
root canal obturation 106, 113, 159, 161, apical periodontitis 160 silver amalgam, retrograde fillings 251 Tri Auto ZX 138-9
1 65, 169 ultrasonic 152-3 silver point fragments 229 file breakage prevention 139
broken instrument fragment removal lateral condensation technique 127 smear layer removal 154-5
227 length determination 97, 101 smear plugs 128 tricalcium phosphate 205
crown-root fracture 261 l ubricants 104 sodium chloride, irrigation of periapical Trifekta technique 184, 185
curved canals 193 medication diffusion into pulp 145 trioxide, mineralized 231
endodontic failure 217 necrotic pulp removal 97, 98 lesion 151 Tubiseal 170
fractured instrument bypassing 229 obliterated canal 100-1 sodium hypochlorite 24, 25
fully automated 196-7 entrance location 102, 104 ulcer, extraoral 36
healing 192 opening 103, 104 contraindication in bacteremia 151 Ultrafil system 184-5
lateral perforation repair 231 overinstrumentation 110, 127 cytotoxicity 194 ultrasonic cleaning 67
l i ngual root groove 207 gutta-percha master point fitting i nterm dressing flushing 157 ultrasonic phenomena 152
partial vacuum method 196-7 i rrigation 73, 124, 148, 149, 194, 195 ultrasound
retreatment 213, 215, 217 178
success rate 192-3 patency coronal seal 268 isthmus preparation 246, 247
tooth fracture 271 gutta-percha filling removal 220 post removal 216
confirmation 119 root canal 103 retrograde preparation for micro-
root canal preparation 91, 107 testing 124 ultrasonic 152
access opening 118 perforation of wall 127 tissue-dissolving 195 surgical endodontics 248-9
Tri Auto ZX 138 previous restoration removal 91 ultrasound combination 67 Unifiles 61
acid rinse 180, 181 provisional closure 101 sodium perborate 287
after extirpation 128 provisional crowns 93 soft tissue healing, sutures 254 vasoconstrictors 89
antimicrobial preparations 145 pulp chamber Sonic Air instrument 66 vitality test, laser Doppler probe 70
apical enlargement 151 floor 99 spirals 73, 159
apical instrumentation 144 opening 94 spreaders 173 W
bacterial flora 147 pulp removal 118 conical 171
balanced force technique 120-1, radiographic length determination corrections during condensation walking bleach technique 287
125, 176 108-9 1 76-7 Wedjets 80
blockages 180 reamers 119 finger 170, 171, 173 Wolinella recta 23
bonding of provisional restoration 93 recapitulation 119 hand 171 working length
broken instrument fragment removal re instrumentation 223 i nsertion 173
222-3 retrograde 247 material 173 adjustment 113
canal enlargement 139 shaping with Quantec series 2000 stagnation of disease 1 anatomic points 110
canal entrance instrumentation 141 stains, external 290 apical resorption 112, 114-15
probing 96-7 step formation 126 step formation 126 apical stops 114, 115
uncovering 95 step-back technique 122-3 step-back technique 122-3 balanced force technique 121
canal location 95, 97 Lightspeed instrumentation 143 Lightspeed instrumentation 143 determination 111
with surgical operation micro- step-down technique 124-5 step-down technique 124-5, 176
scope 102-3 straight-line access 98-9 apical preparation 125 electronic 116-17
caries removal 91 surface i nstrumentation 124, 125 problems 110-11
cast fabrication 93 after engine-driven instrumenta- l ubrication 124 engine-driven instrumentation 134
cervical ledge removal 98 sterilization of instruments 63 gutta-percha point marking 115
chelating agent rinse 180, 181 tion 144 Streptococcus faecium 155 impedance profile 116, 117
chemical aids 104-6 following manual instrumentation Stropko Irrigator and Dryer 250 Lightspeed instrumentation 142
coronal enlargement 99, 223 Super EBA cement 252-3 loss 112-13
Lightspeed 142 128-30 Suprasson P-Max 67 measurement correction 108
Profile 04 136 trepanation 130 surgical operation microscope 102-3 overinstrumentation 110
crown penetration 96 wide coronal access cavity 113 sutures 254 preparation length adjustment 114
curved canals 120-1 working length Quantec series 2000 instrumentation
deep preparation 131 T 1 40
dentin removal 119 determination 111 radiographic determination 108-9
end-point 107 l oss 112-13 T cells, radicular cysts 34 radiographic distortion 111
entrance enlargement 97 radiograph 108 T-helper cells 30 radiographic measurement 117
extirpation 118 , oot fracture 176, 255, 257 T-suppressor cells 30 resistance measurement 116
fully automated 194-5 ,ubber dam 77 tetracycline 284 step-down technique 125
funnel formation 126 bow technique 81 Thermafill technique 137, 183 wound healing 254
glass ionomer cement 92 clamp first technique 85 thermocatalytic bleaching 286
impression making 92 clamps 79, 81, 86 thermoplastic injection technique 184-5 X-ray alignment 41
instrumentation 106, 110, 112, 113, forceps 80 tissue remnant removal 145 XeCl laser 72
118, 119, 127 frames 80, 86 titanium alloy instruments 62-3
apical periodontitis 148 function 77 titanium-aluminium alloy 62 Z
bacterial control 147 insertion phases 81 tooth
bacterial elimination 156 Ivory punch 77, 78 zinc phosphate cement 273, 279
balanced force technique 176 latex allergy 78 developmental defects 289 ZOE-EBA cement 232
Canalfinder 144 l ubricants 78 examination 39
deciduous teeth 202 material 78 tooth discoloration 283
endodontic failure 215, 217 operating field disinfection 85 causes 283, 284
engine-driven 134-5 placement 81-5 iatrogenic 285
H files 128 punches 78 tooth fracture
K files 129 radiography 86 coronal restoration 272
Lightspeed 142-3 root canal preparation 109 endodontic access cavity 270
maxillary molars 132-3 rubber first procedure 84 MOD amalgam retorations 271
midcanal 144 tray 80 prevention 281
periapical lesion 150 wing technique 82-3 protection 271
problems 126-7 risk 270
Profile 04 136-7 S tooth injuries
pulpotomy in mixed dentition 205 classification 256-7
Quantec series 2000 140-1 S files 61 complicated fracture 256
rat-tail files 129 Sealapex 169, 170, 173 cracks 264-6
smear layer formation 154 sealer 169, 170 l uxation with avulsion 257
step-down technique 176 pulp necrosis 257
surgical microscope 130-1 apical 177 replanting 257
Tri Auto ZX 138-9 materials 268 stable fixation 257
ultrasonic irrigation 152 post-core 279 traumatic 255
i nstruments 94 root canal wall coating 172 uncomplicated fracture 256
prebending 126 Selenomonas sputigena 23 Touch'n-heat probe 188, 190
interim restorations 92-3 sensitivity test 12, 38 trepanation 130
irrigation 110, 119, 148-9 Shaper instrument 66
shaping, root canal filling 118-19
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