Clinical endodontics: a textbook PDF
Preview Clinical endodontics: a textbook
ThiemeVerlag Sommer-Druck Tronstad WN013628/01/03 16.7.2008 HerrSchabert Feuchtwangen ClinicalEndodontics TN768103 Titelei ThiemeVerlag Sommer-Druck Tronstad WN013628/01/03 16.7.2008 HerrSchabert Feuchtwangen ClinicalEndodontics TN768103 Titelei ThiemeVerlag Sommer-Druck Tronstad WN013628/01/03 16.7.2008 HerrSchabert Feuchtwangen ClinicalEndodontics TN768103 Titelei Clinical Endodontics A Textbook 3rd edition Leif Tronstad, LDS, DMD, MS, PhD ProfessorEmeritus UniversityofOslo FacultyofDentistry Oslo,Norway 572illustrations Thieme Stuttgart·NewYork ThiemeVerlag Sommer-Druck Tronstad WN013628/01/03 16.7.2008 HerrSchabert Feuchtwangen ClinicalEndodontics TN768103 Titelei LibraryofCongressCataloging-in-PublicationData Important note: Medicine is an ever-changing science undergoing continual development. Researchand clinical Tronstad,Leif. experience are continually expanding our knowledge, in Clinicalendodontics:atextbook/LeifTronstad.—3rdrev.ed. particular our knowledge of proper treatment and drug p.;cm. therapy.Insofarasthisbookmentionsanydosageorappli- Includesbibliographicalreferencesandindex. cation,readersmayrestassuredthattheauthors,editors, ISBN978-3-13-768103-8(alk.paper) andpublishershavemadeeveryefforttoensurethatsuch 1.Endodontics-Textbooks.I. Title. referencesareinaccordancewiththestateofknowledge [DNLM:1.DentalPulpDiseases–therapy. atthetimeofproductionofthebook. 2.Endodontics–methods.WU230T854c2008] Nevertheless, this does not involve, imply, or express RK351.T762008 anyguaranteeorresponsibilityonthepartofthepublish- 617.6’342–dc22 ersinrespecttoanydosageinstructionsandformsofap- plicationsstatedinthebook.Everyuserisrequestedto examinecarefullythemanufacturers’leafletsaccompany- ing each drug and to check, if necessary in consultation withaphysicianorspecialist,whetherthedosagesched- ulesmentionedthereinorthecontraindicationsstatedby themanufacturersdifferfromthestatementsmadeinthe presentbook.Suchexaminationisparticularlyimportant withdrugsthatareeitherrarelyusedorhavebeennewly released on the market. Every dosage schedule or every formofapplicationusedisentirelyattheuser’sownrisk and responsibility. The authors and publishers request everyusertoreporttothepublishersanydiscrepanciesor inaccuraciesnoticed.Iferrorsinthisworkarefoundafter publication,erratawillbepostedatwww.thieme.comon theproductdescriptionpage. Someoftheproductnames,patents,andregisteredde- signsreferredtointhisbookareinfactregisteredtrade- marksorproprietarynameseventhoughspecificreference tothisfactisnotalwaysmadeinthetext.Therefore,the appearanceofanamewithoutdesignationasproprietary isnottobeconstruedasarepresentationbythepublisher thatitisinthepublicdomain. 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Coverdesign:ThiemePublishingGroup TypesettingbySommerDruck,Feuchtwangen PrintedinGermanybyGraphischesCentrumCunoGmbH, Calbe(Saale) ISBN 978-3-13-768103-8 123456 ThiemeVerlag Sommer-Druck Tronstad WN013628/01/03 16.7.2008 HerrSchabert Feuchtwangen ClinicalEndodontics TN768103 Titelei To Anne-Grethe andtoNora,Greger,Ulrik,Andrea,Kristin, andKarl-Henrik ThiemeVerlag Sommer-Druck Tronstad WN013628/01/03 16.7.2008 HerrSchabert Feuchtwangen ClinicalEndodontics TN768103 Titelei VI Preface to the Third Edition ThescopeofthethirdeditionofClinicalEndodontics treatment are discussed, and main endodontic isasbeforetobeasimple,yetcomprehensivetext- techniques are described. The format of the pre- bookinendodonticsthatservesasanintroductory viouseditionshasbeenkept,andnewrelevantin- textfordentalstudentsandasasuitablerefresher formationhasbeenaddedtothetext.Thelistsof source for general practitioners, postdoctoral stu- references following each chapter have been up- dents,andendodontists.Withthisconceptinmind, dated.Iagainextendmythankstofriendsandcol- ClinicalEndodonticssummarizesthebiologyofthe leagueswhohavecontributedillustrationalmate- endodontium and the apical periodontium and rialtothebook. dealswiththeetiologyandpathogenesisofendo- donticdiseases.Examinationmethods,diagnoses, Oslo,Summer2008 LeifTronstad treatmentprinciples,andprognosisofendodontic ThiemeVerlag Sommer-Druck Tronstad WN013628/01/03 16.7.2008 HerrSchabert Feuchtwangen ClinicalEndodontics TN768103 Titelei VII Table of Contents 1 TheEndodontium .................... 1 ProvocationTests ................... 78 Structure ............................... 1 AnesthesiaTest ..................... 78 TheDentin .......................... 1 OpticalTests ....................... 79 TheDentalPulp...................... 5 RadiographicExamination................ 79 ReactionPatterns ........................ 9 TentativeDiagnosis ..................... 79 Pulpitis ............................. 9 ClinicalDiagnosis ....................... 81 PathogenesisofPulpitis ............... 11 FurtherReading ........................ 82 SystemicInfluences .................. 24 PulpNecrosis........................ 25 5 TreatmentofTeethwithVitalPulp ..... 84 RepairinthePulp .................... 26 EndodonticAspectsofRestorativeProcedures 84 FurtherReading ......................... 29 CavityandCrownPreparation ......... 84 CavityCleansingandDrying .......... 85 2 TheApicalPeriodontium .............. 31 ImpressionMethods ................. 85 Structure ............................... 31 PulpProtection ..................... 86 ReactionPatterns ........................ 32 MarginalLeakage ................... 87 ApicalPeriodontitis .................. 32 PulpCapping ........................... 88 EtiologyofApicalPeriodontitis ......... 32 Indications ......................... 88 PathogenesisofApicalPeriodontitis ..... 41 WoundDressingandTissueReactions .. 89 RadiographicAppearanceandDifferential PulpalSeal ......................... 90 Diagnosis ........................... 54 Follow-upExaminationandPrognosis .. 91 FurtherReading ......................... 62 CappingoftheInflamedPulp ......... 93 Pulpotony ............................. 94 3 EndodonticSymptomatology .......... 65 Indications ......................... 94 PulpalPain.............................. 65 WoundDressingandTissueReactions .. 96 DentalHypersensitivity ............... 65 ClinicalConsiderations............... 96 SymptomaticPulpitis ................. 66 Follow-upExaminationsandPrognosis . 96 PeriapicalPain........................... 68 Pulpectomy ............................ 96 SymptomaticApicalPeriodontitis....... 68 Indications ......................... 97 OralandPerioralPainofEndodonticInterest . 69 TreatmentPrinciples ................ 97 PeriodontalDiseases.................. 69 ClinicalConsiderations............... 101 InfectionofCystsandSalivaryGlands ... 70 Follow-upExaminationsandPrognosis . 102 Sinusitis ............................ 70 FurtherReading ........................ 102 TemporomandibularJointDysfunction Syndrome........................... 71 6 TreatmentofNonvitalTeeth .......... 104 TrigeminalNeuritis................... 72 ConservativeEndodonticTreatment........ 105 ChronicNeurogenicPain .............. 73 Indications ......................... 105 Referredpain ........................ 74 TreatmentPrinciples ................ 105 FurtherReading ......................... 74 ClinicalConsiderations............... 112 Follow-upExaminationsandPrognosis . 114 4 EndodonticExaminationandDiagnosis .. 76 ApicalPeriodontitisRefractoryto History ................................. 76 EndodonticTreatment ................... 116 ClinicalExamination ..................... 76 SystemicAntibioticTreatment ........ 117 PercussionandPalpationTests ......... 76 SurgicalTreatment .................. 118 SensitivityTests...................... 77 Prognosis .......................... 119 ThiemeVerlag Sommer-Druck Tronstad WN013628/01/03 16.7.2008 HerrSchabert Feuchtwangen ClinicalEndodontics TN768103 Titelei VIII TableofContents TreatmentofImmatureNonvitalTeeth ..... 120 MaterialswithAssumedTherapeutic Apexification ....................... 120 Effect ..............................173 Follow-upExaminationsandPrognosis . 121 RetrogradeFillingMaterials............175 EndodonticTreatmentofRoot-Fractured FurtherReading .........................177 Teeth ................................. 123 EndodonticTreatmentofEndo–PerioLesions 125 11 EndodonticTechniques............... 178 Surgical–EndodonticTreatment ........... 127 PreparationforTreatment ................ 179 Indications ......................... 127 AccessCavity ....................... 179 Asepsis ............................ 132 RubberDam........................ 181 FlapDesignandSurgicalAccess ....... 133 RootCanalInstrumentation .............. 183 MicrobiologicalandMicroscopic Step-BackPreparation ............... 184 Examination ....................... 134 ApicalBoxPreparation ............... 185 ResorptionLacunaeandPerforation CrownDownPreparation............. 187 Defects ............................ 134 InstrumentationofCurvedRootCanals . 188 Apicoectomy ....................... 137 RootCanalObturationwithSilverPoints .... 189 IntentionalReplantation ............. 137 RootCanalObturationwithGutta-Percha Aftercare .......................... 138 Points ................................. 190 Follow-upExaminationandPrognosis .. 138 TheDippingTechnique............... 190 FurtherReading ........................ 139 ThermoplasticizedGutta-Percha Techniques......................... 191 7 EndodonticEmergencyTreatment ..... 141 LateralCondensationTechnique ....... 194 EmergencyTreatmentofVitalTeeth ....... 141 StandardizedEndodonticTechnique.... 195 TeethwithSymptomaticPulpitis ...... 141 Two-StepandOtherTechniques ....... 197 CrownFractures .................... 142 RootCanalObturationwithAdhesive DentalHypersensitivity .............. 142 Technique ............................. 199 TraumaticOcclusion ................. 143 RootCanalObturationwithPastes ......... 200 EmergencyTreatmentofNonvitalTeeth .... 143 RegenerativeEndodontics ................ 201 SymptomaticApicalPeriodontitis...... 143 FurtherReading ........................ 201 FurtherReading ........................ 145 12 DentalMorphologyandTreatment 8 EndodonticAspectsofRootResorption . 146 Guidelines ......................... 203 InternalRootResorption ................. 149 MaxillaryCentralIncisor ................. 203 CervicalRootResorption ................. 150 TreatmentGuidelines ................ 203 ExternalInflammatoryRootResorption..... 152 MaxillaryLateralIncisor ................. 204 ReplacementResorption ................. 155 TreatmentGuidelines ................ 204 FurtherReading ........................ 156 MaxillaryCanine........................ 205 TreatmentGuidelines ................ 205 9 EndodonticInstruments.............. 158 MaxillaryFirstPremolar ................. 205 RootCanalInstrumentation .............. 158 TreatmentGuidelines ................ 206 HandInstruments ................... 158 MaxillarySecondPremolar ............... 206 Engine-DrivenInstruments ........... 161 TreatmentGuidelines ................ 206 RootCanalObturation ................... 163 MaxillaryMolars........................ 207 HandInstruments ................... 163 MaxillaryFirstMolar ................ 207 Gutta-PerchaGuns .................. 163 MaxillarySecondMolar .............. 207 SurgicalInstruments .................... 164 MesiobuccalRootofMaxillaryMolars .. 207 FurtherReading ........................ 166 DistobuccalRootofMaxillaryMolars ... 208 PalatalRootofMaxillaryMolars ....... 208 10 EndodonticMaterials ................ 167 TreatmentGuidelines ................ 208 TemporaryFillingMaterials............... 167 MaxillaryThirdMolar ............... 209 RootCanalFillingMaterials............... 168 MandibularIncisors ..................... 209 CoreMaterials ...................... 168 TreatmentGuidelines ................ 210 RootCanalSealers................... 171 MandibularCanine ...................... 210 ThiemeVerlag Sommer-Druck Tronstad WN013628/01/03 16.7.2008 HerrSchabert Feuchtwangen ClinicalEndodontics TN768103 Titelei TableofContents IX TreatmentGuidelines ................ 210 RootFilledTeethwithNormalApical MandibularFirstPremolar................ 211 Periodontium ...................... 231 TreatmentGuidelines ................ 211 Retreatment ........................... 232 MandibularSecondPremolars ............ 212 Treatment-ResistantCases............ 232 TreatmentGuidelines ................ 212 SurgicalRetreatment ................ 233 MandibularMolars...................... 212 FurtherReading ........................ 234 MandibularFirstMolar .............. 212 MandibularSecondMolar ............ 213 15 BleachingofDiscoloredTeeth ......... 236 MesialRootofMandibularMolars ..... 213 DiscolorationofTeeth ................... 236 DistalRootofMandibularMolars ...... 213 VitalTeeth ......................... 236 TreatmentGuidelines ................ 213 NonvitalTeeth ...................... 237 MandibularThirdMolar.............. 214 BleachingofEndodonticallyTreatedTeeth .. 238 FurtherReading ........................ 214 PreparationforBleaching............. 238 BleachingAgents.................... 239 13 EndodonticComplications ............ 215 BleachingProcedures ................ 239 IncompleteAnalgesia .................... 215 RestorationoftheBleachedTooth...... 240 AccessCavity........................... 215 BleachingofVitalTeeth .................. 240 PerforationsfromthePulpChamber ....... 216 BleachingofTeethwithEnamelDefects. 240 RootPerforations ....................... 217 BleachingofTeethwithDentin ApicalPerforations .................. 217 Discolorations ...................... 240 LateralPerforations.................. 220 FurtherReading ........................ 241 PostPerforations .................... 221 ObliteratedRootCanal ................... 222 16 RestorationofEndodonticallyTreated FractureofanInstrument ................ 223 Teeth ............................. 242 AdverseReactionstoMedicaments ........ 226 StrengtheningofEndodonticallyTreated LocalTissueIrritation ................ 226 Teeth ................................. 242 NeurotoxicReactions ................ 226 IntracoronalRestorations............. 242 AllergicReactions ................... 227 CoronalRestorations................. 244 OverfillingoftheRootCanal .............. 227 RetentionofProstheticAppliancesin VerticalRootFractures................... 228 EndodonticallyTreatedTeeth ............. 244 FurtherReading ........................ 229 PreparationofRootCanalPostSpace ... 246 CementationofRootCanalPosts....... 246 14 EndodonticRetreatment ............. 230 FurtherReading ........................ 246 IndicationsforRetreatment............... 230 RootFilledTeethwithApical 17 PrognosisofEndodonticTreatment .... 247 Periodontitis ....................... 230 FurtherReading ........................ 249
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