Weine Endodontic Therapy Pdf 32
Weine Endodontic Therapy Pdf 32
endodontic therapy is aimed at strengthening the tooth structure, maintaining or improving the function of the tooth, providing a satisfactory aesthetic outcome and controlling inflammation. root canal treatment is the most common treatment of teeth with pulpal and/or periradicular disease. the endodontic treatment of choice for teeth with pulp necrosis and apical periodontitis is the pulpotomy procedure. the method of choice for treating large periradicular lesions is root-end resection. as a result of complex variations in morphology, a number of different techniques may be used for root canal treatment [ 15 ]. even with careful technique, pain will often occur during the procedure. intraoperative procedures, such as the placement of a temporary filling or an obturating material, may cause additional pain. postoperative pain may be a result of many factors: the type of anesthesia used, the type of filling or obturation material used, the tightness of the access cavity, and the number of visits. the degree of preoperative pain may be related to the size of the lesion. the success of endodontic treatment is highly dependent on the quality of the treatment performed; the result of the treatment may be affected by the operator's skill, the anatomy of the tooth, the presence of an inflammatory process and periodontal disease [ 16 ]. the remaining tooth structure, the condition of the periodontium and the patient's cooperation are the most important factors in determining the prognosis of endodontic treatment.
the mandibular first molar is the most commonly afflicted molar in the primary and permanent dentitions. it is important to have an understanding of the complexities of the anatomy of the root canal system in order to make correct diagnosis and to achieve successful treatment. it is essential to understand the three-dimensional anatomy of the root canal system in the mandibular first molar to achieve successful endodontic treatment. several anatomical variations in the canal system of the mandibular first molar are described. the main variations of canal configuration in the mandibular first molar are: the presence of two canals, the single canal with two foramina, the single canal with one foramen, and the single canal with no foramina [ 1 ]. the roots of mandibular first molars are longer and broader than the roots of mandibular second molars and have an oval-shaped crown. the lingual and distal root canals are located in the same root. the root canal is oval in shape and usually lies in a mesio-distal orientation. the root canal is directed toward the lingual or distal foramen. a single-rooted first molar typically has one apical foramen on its mesial root and one or two on the distal root [ 3 ].
the root canal anatomy of mandibular second premolars is variable. one factor that may increase the difficulty of endodontic treatment is the presence of a single canals in the middle third of the root. this is particularly challenging because it is difficult to reach the middle third of the root with the working length of the canal. one unique feature of the root canal anatomy of mandibular second premolars is that there is an accessory canal in almost 70% of cases that is located in the middle third of the root [ 31 ]. the accessory canal may be a single canal (type i) or two separate canals (type ii) [ 37 ].
endodontic treatment of the maxillary molar is the most difficult of all endodontic procedures. the mesiobuccal root canal is a unique case in that it is usually a ribbon of tissue, and ends in 1, 2, or 3 separate foramina. in many cases, it is impossible to treat the entire length of the root canal because of the complexity of the anatomy. it is recommended that these teeth be treated on an individual basis, due to the unpredictability of the anatomy of the mesiobuccal root canal.1 due to the difficulty in treating the maxillary molar, a significant amount of literature has been published regarding the steps in the endodontic treatment of the mesiobuccal root canal. weine et al, for example, described the prevalence of the additional canal and the use of diagnostic aids to aid in the endodontic treatment of the mesiobuccal root canal.2 the primary canal of the maxillary first molar may have 2, 3, or 4 separate openings, with the incidence of the additional canals ranging from 25% to 95%.3 the frequency of these additional canals also varies from tooth to tooth. some of the additional canals may be calcified or filled. in general, the additional canals run parallel to the long axis of the root. the prevalence of the additional canals of the maxillary molar is approximately 30% to 50%.