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$Incomplete tooth fracture â proposal for a new definition$

I <strong>special</strong> _ advancements in endodonticsFig. 11a_Annotated 3-D model of alower molar that illustrates complexpulpal anatomy.Fig. 11b_Endodontic therapy thatillustrates the respect for the naturalpulpal anatomy present.Fig. 12a_Post-op image of the abilityto seal complicated pulpal anatomy.Fig. 12b_Healing observed whenobjectives for successful endodontictherapy are accomplished.Fig. 11aFig. 11bFig. 12aFig. 12bFig. 13_Illustration of the objectiveto have continual seal of the entireroot-canal system from the apex tothe cavo-surface.Further advancement in our ability to visualiseroot-canal systems and the surrounding structuresin 3-D will continue to revolutionise our capacity todiagnose and treat endodontic disease. The quality ofendodontic therapy provided will increase as thescience of CBCT develops. Future advancement in thisscience will focus on our ability to more clearly renderand manipulate these images. Figure 11a is an annotated3-D model of a lower molar that illustrates pulpalanatomy that is encountered in clinical practice. 46Figure 11b displays the endodontic outcomes possiblewhen such natural complexities are respected.There are many exciting advancements on thehorizon to aid in our pursuit of higher levels of disinfection.Further exploration into the potential toshape individual pulpal anatomy on a 3-D basis willcontinue. The science of irrigation may one day takeus from disinfection to sterilisation. Figures 12a and billustrate the successful outcome that can be accomplishedwhen intricate areas of an infected root-canalsystem can be disinfected and sealed.Future advancement in the pursuit of a precisecoronal seal will be in the form of products and devicesthat aid in the technique-sensitive procedure of placingdeep dentinal bonding. Figure 13 illustrates thisobjective of a continuous seal of the entire root-canalsystem from the apex to the cavo-surface.Fig. 13These advances in endodontic treatment modalitieswill undoubtedly have a significant impact on ourability to attain greater success rates. However, the futureof our profession is in the hands of skilled andcommitted clinicians who strive to move our professionforward. Progressive exploration into the areasdiscussed in this article will keep endodontic therapyat the forefront of treatment options available forpatients._26 Iroots4_2010
AD_References1. Doyle SL, Hodges JS, Pesun IJ, Baisden MK, Bowles WR.Factors affecting outcomes for single-tooth implants andendodontic restorations. J Endod. 2007 Apr;33(4):399–402.2.Iqbal MK, Kim S. For teeth requiring endodontic treatment, whatare the differences in outcomes of restored endo donticallytreated teeth compared to implant-supported restorations? IntJ Oral Maxillofac Implants. 2007;22 Suppl: 96–116.3. Estrela C, Bueno MR, Leles CR, Azevedo B, Azevedo JR.Accuracy of cone beam computed tomography and panoramicand periapical radiography for detection of apical periodontitis.J Endod. 2008 Mar;34(3):273–9.4. Patel S, Dawood A, Mannocci F, Wilson R, Pitt Ford T. Detectionof periapical bone defects in human jaws using cone beamcomputed tomography and intraoral radiography. Int Endod J2009 Jun;42(6):507–15.5. Tyndall DA, Rathore S. Cone-beam CT diagnostic applications:caries, periodontal bone assessment, and endodontic applications.Dent Clin North Am. 2008 Oct;52(4):825–41, vii.6. Stavropoulos A, Wenzel A. Accuracy of cone beam dentalCT, intraoral digital and conventional film radiography for thedetection of periapical lesions. An ex vivo study in pig jaws. ClinOral Investig. 2007 Mar;11(1):101–6.7. Patel S. New dimensions in endodontic imaging: Part 2. Cone beamcomputed tomography. Int Endod J. 2009 Jun; 42(6): 463–75.8. Low KM, Dula K, Bürgin W, von Arx T. Comparison of PeriapicalRadiography and Limited Cone-Beam Tomography in PosteriorMaxillary Teeth Referred for Apical Surgery. J Endod.2008;34(5):557–62.9. Cotton TP, Geisler TM, Holden DT, Schwartz SA, Schindler WG.Endodontic applications of cone-beam volumetric tomography.J Endod. 2007 Sep;33(9):1121–32.10. Schilder H. Filling root canals in three dimensions. Dent ClinNorth Am. 1967 Nov:723–44.11. Schilder H. Canal debridement and disinfection. In Pathwaysof the Pulp. 1 st Ed., St. Louis: Mosby Co., 1976:111–33.12. Byström A, Sundqvist G. Bacteriologic evaluation of the efficacyof mechanical root canal instrumentation in endodontictherapy. Scand J Dent Res. 1981 Aug;89(4):321–8.13. West JD. The relationship between three-dimensional endo -dontic seal and endodontic failure. Master Thesis. Boston:Boston University, 1975.14. Matherne RP, Angelopoulos C, Kulild JC, Tira D. Use of conebeamcomputed tomography to identify root canal systemsin vitro. J Endod. 2008 Jan;34(1):87–9.15. Hockett JL, Dommisch JK, Johnson JD, Cohenca N. Antimicrobialefficacy of two irrigation techniques in tapered andnontapered canal preparations: an in vitro study. J Endod.2008 Nov;34(11):1374–7.16. Brito PR, Souza LC, Machado de Oliveira JC, Alves FR, De-DeusG, Lopes HP, Siqueira JF Jr. Comparison of the effectivenessof three irrigation techniques in reducing intracanal Enterococcusfaecalis populations: an in vitro study. J Endod. 2009Oct;35(10):1422–7.17. Miller TA, Baumgartner JC. Comparison of the antimicrobialefficacy of irrigation using the EndoVac to endodontic needledelivery. J Endod. 2010 Mar;36(3):509–11. You can also subscribe viawww.oemus.com/abo✂I hereby agree to receive a free trial subscription of (4 issues per year). I would like to subscribe to for € 44 includingshipping and VAT for German customers, € 46 including shipping and VAT for customers outsideof Germany, unless a written cancellation is sent within 14 days of the receipt of the trial subscription.The subscription will be renewed automatically every year until a written cancellationis sent to OEMUS MEDIA AG, Holbeinstr. 29, 04229 Leipzig, Germany, six weeks prior to therenewal date.Reply via Fax +49 341 48474-290 to OEMUS MEDIA AG or per E-mail to:grasse@oemus-media.deLast NameFirst NameCompanyStreetZIP/City/CountyE-MailSignatureNotice of revocation: I am able to revoke the subscription within 14 days after my order by sendinga written cancellation to OEMUS MEDIA AG, Holbeinstr. 29, 04229 Leipzig, Germany.UnterschriftOEMUS MEDIA AGHolbeinstraße 29, 04229 LeipzigTel.: +49 341 48474-0Fax: +49 341 48474-290E-Mail: grasse@oemus-media.de
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