An overview of the dental pulp: its functions and responses to injury
The dental pulp is a unique tissue and its importance in the long-term prognosis of the tooth is often ignored by clinicians. It is unique in that it resides in a rigid chamber which provides strong mechanical support and protection from the microbial rich oral environment. If this rigid shell loses its structural integrity, the pulp is under the threat of the adverse stimuli from the mouth, such as caries, cracks, fractures and open restoration margins, all of which provide pathways for micro-organisms and their toxins to enter the pulp.
| C Yu
PV Abbott |
A clinical classification of the status of the pulp and the root canal system
Many different classification systems have been advocated for pulp diseases. However, most of them are based on histopathological findings rather than clinical findings which leads to confusion since there is little correlation between them. Most classifications mix clinical and histological terms resulting in misleading terminology and diagnoses. This in turn leads to further confusion and uncertainty in clinical practice when a rational treatment plan needs to be established in order to manage a specific pathological entity. A simple, yet practical classification of pulp diseases which uses terminology related to clinical findings is proposed.
| PV Abbott
C Yu |
Treatment planning the endodontic case
Following a definitive diagnosis of the need for root canal treatment, the treatment planning stage should be straightforward if a logical sequence of decision-making is followed. Very few contra-indications exist for providing root canal treatment, but the planning must include several aspects.
| T Yeng
HH Messer
P Parashos |
A big role for the very small — understanding the endodontic microbial flora
Apical periodontitis, an inflammatory process around the apex of a tooth root, is primarily a sequel to microbial infection of the pulp space. The microbial flora is composed of a restricted group of the total oral flora, selected by environmental pressures of anaerobiosis, nutrition and competition with other species and inhabits the root canal as a biofilm of coaggregated communities in an extracellular matrix. The untreated infected canal is generally composed of a polymicrobial mix with approximately equal proportions of Gram-positive and Gram-negative species, dominated by obligate anaerobes.
| D Figdor
G Sundqvist |
The principles of techniques for cleaning root canals
This paper reviews the biologic principles of preparing root canals with an emphasis on correct use of current rotary NiTi instrumentation techniques and systems. The role and properties of contemporary root canal irrigants is also discussed.
| GR Young
P Parashos
HH Messer |
The use of calcium hydroxide, antibiotics and biocides as antimicrobial medicaments in endodontics
Bacteria have been implicated in the pathogenesis and progression of pulp and periapical diseases. The primary aim of endodontic treatment is to remove as many bacteria as possible from the root canal system and then to create an environment in which any remaining organisms cannot survive. This can only be achieved through the use of a combination of aseptic treatment techniques, chemomechanical preparation of the root canal, antimicrobial irrigating solutions and intracanal medicaments.
| B Athanassiadis
PV Abbott
LJ Walsh |
Interim and temporary restoration of teeth during endodontic treatment
The purposes of this article are to review the literature regarding the use of interim and temporary restorations, and to provide recommendations regarding such restorations for clinicians to follow when providing endodontic treatment.
| A-L Jensen
PV Abbott
J Castro Salgado |
The differential diagnosis of toothache from other orofacial pains in clinical practice
Teeth are a common and obvious source of orofacial pain. There is a risk that endodontic treatment may be initiated in patients that do not have pulp or periapical pathosis.
| J Linn
I Trantor
N Teo
R Thanigaivel
AN Goss |
Management of tooth resorption
A correct diagnosis and an understanding of the aetiology and dynamics of the processes involved in tooth resorption is critical to effective management. Tooth resorptions can be classified as: (1) trauma induced; (2) infection induced; or (3) hyperplastic invasive.
| GS Heithersay |
The endodontic management of traumatized permanent anterior teeth: a review
Despite the many journal articles and reviews that have been published regarding the treatment of trauma to teeth, the endodontic management of these injuries is often still not fully understood. The purpose of this review is to establish clear and up-to-date guidelines for practitioners who are faced with treating dental injuries on a day-to-day basis, based on an assessment of current available scientific information relating to the endodontic management of these injuries.
| AJ Moule
CA Moule |
Implant or the natural tooth – a contemporary treatment planning dilemma?
An assessment of whether to rehabilitate a tooth requiring endodontic treatment or to replace it with a dental implant can often involve a challenging and complex decision-making process. This paper reviews the literature pertaining to both treatment modalities and identifies key issues that need careful consideration in planning the most appropriate course of care in a given clinical situation. A need to appreciate advances across both disciplines is highlighted, allowing the development of effective interdisciplinary evidence-based treatment strategies to maximize treatment outcome.
| V John
S Chen
P Parashos |