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2015 | OriginalPaper | Hoofdstuk

5. Endodontic Access Considerations Based on Root Canal Morphology

Auteur: Peter Murray

Gepubliceerd in: A Concise Guide to Endodontic Procedures

Uitgeverij: Springer Berlin Heidelberg

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Abstract

The odontoblast cells within dental pulp create the roots of teeth through a process of dentinogenesis during tooth development. Dental pulp initially occupies the root canal space within each root of a tooth. The root canal space containing dental pulp reduces in volume throughout life, because of dentinogenesis, which is the continual calcification and mineralization process of odontoblasts. As a patient gets older their root canals become more calcified and narrower, in old age the root canals of teeth can be completely calcified with no apparent dental pulp remaining. These continuing mineralization processes within the root canals of teeth give rise to alterations in root canal morphology which can present challenges for the ideal position of the endodontic access. The goal of the access is to locate and provide the direct access of files and instruments into the root canals of the tooth. The position and design of the access is determined by the size of the pulp chamber, the age of the tooth, previous restorative efforts, the long axis of the tooth, and root curvature. The location and design of the access cavity is dictated by the pulp chamber morphology of the tooth being treated. Achieving adequate access to the root canal is the key to accomplishing endodontic success. In order to remove the dental pulp the location of the coronal pulp chamber and the pulp within the roots must be visualized. To help visualize the location of the dental pulp, there are laws to be used to help position the access and find the orifices to root canals:Root canal centrality, Root canal concentricity, Dentin color change, Symmetry 1 and 2, and Orifice location 1 and 2. If the access is not adequate for endodontic treatment, it could compromise the cleaning, shaping and obturation of the root canals which could increase the risk of treatment failure.
Literatuur
1.
go back to reference Spasser HF, Kahn FH. Access–the cornerstone of endodontic success. N Y State Dent J. 1968;34:471–8. PubMed Spasser HF, Kahn FH. Access–the cornerstone of endodontic success. N Y State Dent J. 1968;34:471–8. PubMed
2.
go back to reference Bevelander G, Johnson PL. Odontoblasts and dentinogenesis (a histochemical study). J Dent Res. 1946;25:381–5. PubMedCrossRef Bevelander G, Johnson PL. Odontoblasts and dentinogenesis (a histochemical study). J Dent Res. 1946;25:381–5. PubMedCrossRef
3.
go back to reference Murray PE, Stanley HR, Matthews JB, Sloan AJ, Smith AJ. Age-related odontometric changes of human teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93:474–82. PubMedCrossRef Murray PE, Stanley HR, Matthews JB, Sloan AJ, Smith AJ. Age-related odontometric changes of human teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93:474–82. PubMedCrossRef
4.
go back to reference Allen PF, Whitworth JM. Endodontic considerations in the elderly. Gerodontology. 2004;21:185–94. PubMedCrossRef Allen PF, Whitworth JM. Endodontic considerations in the elderly. Gerodontology. 2004;21:185–94. PubMedCrossRef
6.
go back to reference Fonzar F, Fonzar A, Buttolo P, Worthington HV, Esposito M. The prognosis of root canal therapy: a 10-year retrospective cohort study on 411 patients with 1175 endodontically treated teeth. Eur J Oral Implantol. 2009;2:201–8. PubMed Fonzar F, Fonzar A, Buttolo P, Worthington HV, Esposito M. The prognosis of root canal therapy: a 10-year retrospective cohort study on 411 patients with 1175 endodontically treated teeth. Eur J Oral Implantol. 2009;2:201–8. PubMed
7.
go back to reference Garcia-Godoy F, Murray PE. Recommendations for using regenerative endodontic procedures in permanent immature traumatized teeth. Dent Traumatol. 2012;28:33–41. PubMedCrossRef Garcia-Godoy F, Murray PE. Recommendations for using regenerative endodontic procedures in permanent immature traumatized teeth. Dent Traumatol. 2012;28:33–41. PubMedCrossRef
10.
go back to reference American Association of Endodontists. Colleagues for excellence. Access opening and canal location. Chicago: American Association of Endodontists; 2010. American Association of Endodontists. Colleagues for excellence. Access opening and canal location. Chicago: American Association of Endodontists; 2010.
11.
go back to reference Raturi P, Girija S, Subash TS, Mangala TM. Unravelling the mysteries of pulp chamber. J Endodontology 2007;19:23–29. Raturi P, Girija S, Subash TS, Mangala TM. Unravelling the mysteries of pulp chamber. J Endodontology 2007;19:23–29.
12.
go back to reference Vertucci FJ, Haddix JE, Britto LR. Tooth morphology and access cavity preparation. In: Cohen S, Hargreaves KM, editors. Pathways of the pulp. 9th ed. St Louis: CV Mosby; 2006. p. 149–232. Vertucci FJ, Haddix JE, Britto LR. Tooth morphology and access cavity preparation. In: Cohen S, Hargreaves KM, editors. Pathways of the pulp. 9th ed. St Louis: CV Mosby; 2006. p. 149–232.
13.
go back to reference Deutsch AS. Pulp chamber morphology: basic research leads to clinical technique. Dent Today. 2005;24:124, 126–7. PubMed Deutsch AS. Pulp chamber morphology: basic research leads to clinical technique. Dent Today. 2005;24:124, 126–7. PubMed
14.
go back to reference Patel S, Rhodes J. A practical guide to endodontic access cavity preparation in molar teeth. Br Dent J. 2007;203:133–40. PubMedCrossRef Patel S, Rhodes J. A practical guide to endodontic access cavity preparation in molar teeth. Br Dent J. 2007;203:133–40. PubMedCrossRef
15.
go back to reference Zelikow R, Cozzarelli-Moldauer G, Keiner S, Hardigan PC. A method to minimize complications in endodontic access cavity preparation. Todays FDA. 2008;20:17–20. PubMed Zelikow R, Cozzarelli-Moldauer G, Keiner S, Hardigan PC. A method to minimize complications in endodontic access cavity preparation. Todays FDA. 2008;20:17–20. PubMed
Metagegevens
Titel
Endodontic Access Considerations Based on Root Canal Morphology
Auteur
Peter Murray
Copyright
2015
Uitgeverij
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-662-43730-8_5