Endodontic diagnosis Requirements of a diagnostician, Clinical examinations, Clinical endodontic tests, Factors influencing prognosis

History:
1-Thereplacementofmissingtoothstructurehasbeenpracticedbyvariousculturesforthousandsofyears:Talmud(AD352-457)……..asupportingwire.
2-Franks(AD200-737)……...awoodendowel.
3-PierreFauchard,in1747,gavethefirstdocumentedprocedureof‘pivotingteeth’,heusedpostsfabricatedofgoldorsilverthatwereheldinplacewiththeheat-softenedadhesivecalled“mastic”.Inthe1870’s,RichmondCrown(integrateddowelcrown)givenbyT.W.Richmond.
4-Inthe1960’s….changeoverfromthesingleporcelaincrown…..separate,well-retainedcomponent,‘thecore’.
5-Inthe1970’s,compositeandamalgamwereintroducedasdirectcorebuildupmaterials.Pinretainedcompositeandamalgamrestorationsasalternativestopostandcorebegantobepracticed.
6-In1980,ArunNayyardescribedtheamalgamcoronal–radiculardowelandcoresystem.

7-In1990,Duretetalintroducedanon-metallicpost,basedoncarbon-fiberreinforcementprinciples,whichshowedhightensilestrengthandmodulusofelasticitysimilartodentin.8-In1994,SandhausandPascheintroducedtheprefabricatedzirconiaceramicendodonticpostandsuggesteduseofzirconiaceramiccorebuildup.Thus,over200yearsofresearchbyvariouscliniciansandinvestigatorshasincreasedthelongevityandserviceabilityofendodonticallytreatedteeth..

Endo is a Greek word for "lnside" and Odontis Greek word for "Tooth" Endodontic treatment treats inside of the tooth Endodontics is the branch of clinical dentistry associated with the prevention, diagnosis and treatment of the pathosisof the dental pulp and peri-radicular tissue. That is, the main aim of the endodontic therapy involves to:
1-Maintain vitalitYof the PulP .
2-Preserve and restore the tooth with damaged and necrotic pulp.
3-Preserve and restore the teeth which have failed to the previous endodontic therapy to allow the tooth to remain functional in the dental arch



Backgroundandaims:
Toothacheresultingfrominfectionofthedentalpulpisacauseofseveresuffering.Theinfectionoftenoccursasaresultof:
1-dentalcaries.
2-Pulpalinfectionscanalsooccurinnon-cariousteethbycracksorfractures,duetoexternaltraumaorinheavilyrestoredteeth.
Thepurposeofrootcanaltreatmentbyrootfillingofteeth(endodontics)istopreventandtreatpulpalinfectionsandtherebysymptomssuchastoothacheandswellingbecauseofsuppuration,andforfunctionalandasymptomatictooth,withoutsignsofresidualrootcanalinfection,includinglossofboneattherootapex.

A.Set-up:
B.Charting:examination,diagnosisandtreatmentplan
1.Takingofmedicalhistory:Chiefcomplaint,presentillness,pastmedicalhistory,healthformincludingmedication,allergiesandotherrelevantinformation.
2.Examination;clinicalandradiographical.
3.Diagnosis4.Treatmentplan,informedconsentandcostoftreatment.
C.Preparationofthetooth:
6.Preparativemeasures;pre-endodonticbuild-up,localanaesthesia,accesscavitypreparation,rubberdamisolation.
D.Aseptictreatment:
7.Startlocatingandnegotiatingtherootcanal(s).
8.Decideworkinglengthwithelectronicapexlocator.
9.Workinglengthradiographtakenwithaparallelingtechnique.
10.Radiographicverificationorcorrectionofworkinglength.
11.ChooseReciproc-file.
12.Routinecanalinstrumentation.
13.Canalinstrumentationdeviantfromnormalroutine.
14.Temporarycanaldressing.
15.Masterpointradiograph.
16.CanalobturationE.Finalizationprocedures.
17.Coronalcanalplug.
18.Coronalrestoration,temporaryorpermanent.
19.Reflectuponanddecicionoftreatmentprognosis.
F. Retreatment.