Definition of endodontics

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Definition of endodontics
•Richard Bence defines
Endodontics as the specialty of
dentistry concerned with the
diagnosis and treatment of
diseases and injuries of the pulp
and periapical tissue.

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•The American Association of
Endodontists defines this field as
that branch of dentistry concerned
with the morphology, physiology,
and pathology of the human
dental pulp and periradicular
tissues.
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BASIC PHASES OF
ENDODONTIC THERAPY
a) the diagnostic phase, in which
the cause of the disease is
identified and the treatment plan
is prepared;

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b) the preparatory phase, in
which, by cleaning and shaping
the root canal, the root canal
contents are removed and the
root canal space itself is shaped
to receive a three-dimensional
filling; and

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c) the obturation phase, in which
the root canal system is filled with
an inert material to ensure a tight
seal.

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Anatomy & access
cavities
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Pulpal floor
Pulpal roof
Dentin
Enamel
Pulp horn
Pulp chamber
Bifurcation canal
Lateral canal
Canal orifice
Pulp canal
Apical delta
Apical foramen
Major anatomic components of the root canal system.

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Endodontic terminology:
Apical delta:
When the main canal branches
apically into two small canals i.e
there will be 2 apical foramina for
the same canal
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Apical ramifications:
When the main canal branches
apically into more than two
branches i.e there will be more
than 2 apical foramina for the
same canal.

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Dentino-cemental junction is
also called the ( apical
constriction, minor apical
diameter ). It is the area where
cememntum meets dentin near
the apex of the root.
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Dentino-cemental junction
( apical constriction )

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Lateral canal:
It is a lateral branching of the
main canal . It connects the main
canal with the periodontal
membrane.
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Vertucci Classification
Vertucci Classification
1 canal 1 orifice
2 canals join then 1 orifice
1 two 1

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Vertucci Classification-
Two canals at the apex
2 canals 2 orifices
1 two
2 one 2
1 two 1 two
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Vertucci Classification
3 canals 3 orifices

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A successful outcome in
endodontic treatment essentially
depends on three factors:
1) cleaning and shaping
2) disinfection
3) three-dimensional obturation of
the root canal system.
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Access cavity permits:
•localization,
•cleaning,
•shaping,
•disinfection, and
•three-dimensional obturation of
the root canal system.

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REQUIREMENTS OF THE ACCESS
CAVITY
1)Permit the removal of all the
chamber contents
All the roof of the chamber should
be removed. It should include
both the mesio-distal and buccolingual
width of the pulp chamber.
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2) Permit complete, direct vision
of the floor of the pulp chamber
and canal openings.
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•To meet this second requirement,
the access cavity must
sometimes be slightly modified to
give it the so-called “convenient
shape”.
•This gives the walls a slight
anterior inclination that facilitates
inspection of the floor and thus
localization of the canal openings.

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3) Facilitate the introduction of
canal instruments into the root
canal openings
•Access should allow instruments
to slide in the canal.

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4) Provide access as direct as
possible to the apical one third of
the canal for both preparation
instruments and canal filling
instruments.
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5) Provide a positive support for
temporary fillings
6) Always have four walls

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GENERAL PRINCIPLES FOR THE
PREPARATION OF THE ACCESS
CAVITY
Regardless of the tooth, there are
three phases in the preparation of
the access cavity:
•penetration,
•enlarging, and
•finishing.
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1-Penetration phase
•This phase is performed using a
round diamond bur mounted on a
high-speed handpiece.
•The objective of this phase is to
“penetrate” the pulp chamber by
breaking through the roof with the
bur.

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If the pulp chamber is wide
enough, there is a sensation of
“falling into a vacuum” when the
roof is penetrated.
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2-Enlargement phase
•This phase is performed with a
round bur mounted on a low-speed
handpiece.
•Its diameter should be slightly
smaller than that of the preceding
bur, and it should have a long shaft
for improved penetration and
visibility.

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3-Finishing and flaring phase
•This phase requires a non-endcutting
diamond bur, also called
self-guiding bur, or Batt’s bur or
endo Z bur mounted on a highspeed
handpiece.

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