© Springer International Publishing AG 2018 Thomas Kvist (ed.)Apical Periodontitis in Root-Filled Teethhttps://doi.org/10.1007/978-3-319-57250-5_4 4. Consequences Fredrik Frisk1, 2 and Thomas Kvist2 (1) Department of Endodontology, Institute for Postgraduate Dental Education, Jönköping, Sweden (2) Department of Endodontology,…
Disease Illness Sickness Phenomena studied Pathophysiological, histological, microbiological, and radiographic events Pain, swelling, or other symptoms present now or in the future Criteria for classification and grading of disease…
Fig. 4.1 Nonrestorable roots of a mandibular second molar with a fragment in the apical third of the distal root. Tooth extraction is the treatment of choice in this case…
Fig. 7.1 (a) Preoperative radiograph. (b) Fractured instrument in the apical third of the curved distal root of a first mandibular molar. (c) Root perforation and creation of “iatrogenic” canal…
Factors affecting intracanal instrument fracture Operator related Skill, proficiency, judgment Anatomy related Access cavity Root canal anatomy Instrument related Material Design Manufacturing process and errors Technique/use related Motors operating parameters…
Fig. 1.1 Fragments of various endodontic instruments Fig. 1.2 (a) Fragment of an irrigation needle in the mesiobuccal root canal of a maxillary molar. (b) Fragment of the notched end…
Fig. 3.1 Image showing H-files discarded after clinical use due to plastic deformation of the cutting tip Fig. 3.2 Distribution of fractured and plastically deformed instruments within different ISO sizes…
Study Lesiona No lesion Healing (%) Effect on healing Strindberg (1956) 2/4 9/11 11/15 (73%) Overall 19% reduction (although lower when lesion is present) Grahnén and Hansson (1961) NR NR…
Fig. 5.1 (a) Preoperative radiograph of a mandibular right first molar with a fragment in the middle third of the mesial root. (b, c) Operative microscope photographs of the pulp…
Steps Procedure First Ten vigorous strokes in a scouring sponge soaked in 0.2% chlorhexidine solution Second 30-min presoak in an enzymatic cleaning solution Third 15-min ultrasonication in the same solution…
Author(s) Study design and sample size Methods, devices, instruments, techniques, and protocol used Microscope Definition of success Success rate Shiyakov and Vasileva (2014) In vivo (n = 26) Ultrasonics Yes…
Fig. 4.1 Large MODB pin-retained amalgam restoration. The loss of original occlusal anatomy landmarks and pulp canal space calcification will make this a more challenging tooth to access for root…
Fig. 10.1 Anatomic relationship between pulp and periodontium In case of endodontic lesions, the pathway of inflammation is through the apical foramen, furcation canals, and lateral accessory canals to the…
Fig. 6.1 (a) Micro-computed tomography axial section of a tooth with the root canals filled. The material appears in black color and shows a good filling of the root canals….
Fig. 7.1 NaOCl extrusion (Courtesy of Dr. Daniel OTT) 7.2.2 Probable Aetiological Factors 1. Wide apical foramina 2. If the apical constriction is destroyed probably during root canal instrumentation…
Medical/Dental history Past/recent treatment, drugs Chief complaint (if any) How long, symptoms, duration of pain, location, onset, stimuli, relief, referred, medications Clinical exam Facial symmetry, sinus tract, soft tissue, periodontal…
Fig. 2.1 Periapical radiographic images obtained by intraoral solid-state sensors, used for diagnosis, odontometry, and follow-up 2.2 Digital Radiography Digital intraoral receptors have several advantages compared to conventional film-based imaging,…
Fig. 3.1 Indirect view of palate where 4% articaine with 1:80,000 adrenaline was administered. Sloughing following vasoconstrictor induced ischemia is a more likely reason than the anesthetic per se When…
Fig. 11.1 (a, b) Male patient, 70 years old, no systemic problem, strong attrition, secondary dentine formation and calcifications in pulp chamber, and vertical dimensional loss. This sort of clinical…
