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What are the 4 types of pulpal diagnosis?
- 1. Normal (cold +, perc-, pulp-)
- 2. Reversible pulpitis
- 3. Irreversible pulpitis (symptomatic and asymptomatic
- 4. Necrosis
What constitutes a normal pulpal diagnosis?
- Cold (+)
- Percussion (-)
- Pulp (-)
Where does pulpal inflammation start?
Pulpal inflammation begins in the crown and travels apically with deep caries
How do you get pulpal necrosis?
Pulpal necrosis occurs with very sustained infection
Has evolution changed root canal anatomy?
what are the two components of a study design?
Radiographic analysis and a 3 dimensional study
What are the 2 x-rays for radiographic analysis
- Bucco-lingual view and mesio-distal view.
- -only BL can be taken clinically
what is a common cause of endodontic failure?
All of the organic tissue was not cleaned out (the entire working width)
How do we compensate for the extensive anatomy in pulp?
Use heavy irrigation for the canals ad Calcium Hydroxide
What are the characteristics of Computed tomography scans and micro-computed tomography scans?
- -up to 300 slices
- -can detect minute images
- -4-6 hours per scan
- -radiation exposure
What is the percentage of maxillary anteriors with one root and one canal?
100% of maxillary anteriors have 1 root and 1 canal
What is the incidence of Dens Invaginatus?
The incidence is 0.25% to 10%
Where is Dens Invaginatus (Dens in Dente) most prevalent?
- Most prevalent in Maxillary lateral incisors
- -maxillary centrals
- -mandibular incisors
- -posterior teeth with occlusal pits
How many canals can mandibular anteriors have?
- It can have 1 or two canals.
- 60% have 1 canal
- 40% have 2 canals
Which canal is often missed in mandibular incisors?
The lingual canal is missed due to inadequate access opening or the lingual shelf
How many mandibular canines have 2 canals?
1.7% incidence of mandibular canines with 2 canals
Which maxillary premolar has a higher incidence of a second canal?
The 1st premolar has a higher incidence of a second canal
What are the average percentages of 1, 2, and 3 canals in a maxillary first premolar?
- 1 Canal- 20%
- 2 Canals- 75%
- 3 Canals- 5%
What is the incidence of 1, 2, and 3 canals in a maxillary second premolar?
- 1 Canal- 65%
- 2 Canals- 34%
- 3 Canals- 1%
What are the incidences of 1, 2, and 3 canals in a mandibular 1st premolar?
- 1 canal- 75%
- 2 Canals- 24%
- 3 Canals- 1%
- A mandibular 1st premolar will have a classic tripod appearance with 3 canals
- -25% have 2+ canals
What are the incidences of 1, 2, and 3 canals in a mandibular 2nd premolar?
- 1 canal- 96%
- 2 Canals- 4%
- 3 Canals- NONE
Which root often occurs as the fourth root in a maxillary molar?
- The Mesiobuccal (MB2) second canal
- -the MB root itself is large, but the overall thickness is thin
What is a type III MB2 canal?
Type III MB2 canals have separate canals from oriface to apex
How often do we see an MB2 canal?
We see the MB2 canal 51.5%
What is unique about the palatal root on a maxillary molar?
The palatal canal often has an early exit from the root
What is the most often missed canal in mandibular molars?
The 2nd distal canal is most commonly missed. it is often the 4th canal
How often do we have 2 canals is a mandibular molar mesial root?
we ALWAYS have 2
What is the way to ensure the success of a root canal?
Biomechanical debridement will ensure the success of the canal