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Edition History

Blackwell Munksgaard (1e, 2003); Blackwell Publishing Ltd (2e, 2010)

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Library of Congress Cataloging-in-Publication Data

Names: Bjørndal, Lars, 1963- editor. | Kirkevang, Lise-Lotte, 1970- editor. |

Whitworth, John M., editor.

Title: Textbook of endodontology / edited by Lars Bjørndal, Lise-Lotte Kirkevang,

John Whitworth.

Other titles: Textbook of endodontology (Bergenholtz)

Description: Third edition. | Hoboken, NJ : Wiley, 2018. | Preceded by

Textbook of endodontology / edited by Gunnar Bergenholtz, Preben

Hørsted-Bindslev, Claes Reit. 2nd ed. 2010. | Includes bibliographical

references and index. |

Identifiers: LCCN 2018000530 (print) | LCCN 2018001339 (ebook) |

ISBN 9781119057321 (pdf) | ISBN 9781119057369 (epub) | ISBN 9781119057314 (hardback)

Subjects: | MESH: Dental Pulp Diseases--therapy | Periapical Diseases--therapy

Classification: LCC RK351 (ebook) | LCC RK351 (print) | NLM WU 230 | DDC 617.6/342--dc23

LC record available at https://lccn.loc.gov/2018000530

Cover images: © Lars Bjørndal

Cover design by Wiley

CONTENTS

List of contributors

Foreword

Preface

About the companion website

Chapter 1 Introduction to endodontology

Endodontology
The objective of endodontic treatment
Clinical problems and solutions
The diagnostic dilemma
The outcome dilemma
The tools of treatment
References

Part 1 The Vital Pulp

Chapter 2 The dentin–pulp complex: structure, functions, threats, and response to external injury
1. Introduction
2. The odontoblast and the dentin–pulp complex
3. The dental pulp
4. Immune responses in the dentin–pulp complex
5. Responses of the healthy dentin–pulp complex to nondestructive stimuli
6. The dentin–pulp complex and responses to external injuries
7. Summary
8. References
Chapter 3 Dentinal and pulpal pain
1. Introduction
2. Classification of nerve fibers
3. Morphology of intradental sensory innervation
4. Function of intradental sensory nerves
5. Sensitivity of dentin: hydrodynamic mechanism in pulpal A-fiber activation
6. Responses of intradental nerves to tissue injury and inflammation
7. Local control of pulpal nociceptor activation
8. Dentin hypersensitivity
9. Pain symptoms and pulpal diagnosis
10. References
Chapter 4 Clinical pulp diagnosis and decision-making
1. Introduction
2. Evaluation of diagnostic information
3. Diagnostic accuracy
4. Diagnostic strategy
5. Clinical manifestations of pulpal and periapical inflammation
6. Collecting diagnostic information
7. Diagnostic methodology: assessment of pulp vitality
8. Diagnostic methodology: evaluation of reported pain
9. Diagnostic methodology: provocation/inhibition of pain
10. Diagnostic methodology: evaluation of tooth discolorations
11. Diagnostic classification
12. References
Chapter 5 Caries pathology and management in deep stages of lesion formation
1. Enamel lesions without clinical cavitation
2. Progressive stages of enamel–dentin lesions without surface cavitation and exposure of dentin to the oral environment
3. Cavitation of the dentin lesion
4. Concluding remarks on the natural history of dental caries
5. Strategies for the management of deep caries
6. Detailed treatment protocol for deep caries management
7. References
Chapter 6 Treatment of vital pulp conditions
1. Introduction
2. Indications and treatment concepts for preserving vital pulp functions
3. Protocols for treatments aiming to preserve the vitality of the exposed pulp
4. Factors of importance in preserving vital pulp functions
5. Capping materials and healing patterns
6. Tissue–biomaterial interaction and pulp healing
7. Pulp-preserving treatments – a controversial treatment?
8. Indications and treatment concepts for treating the irreversibly inflamed vital pulp (pulpectomy)
9. Postoperative considerations
10. Choosing between pulp-preserving vital pulp therapies and pulpectomy
11. Concluding remarks on the avoidance of pulpectomy by vital pulp therapies
12. Revitalization and/or regenerative endodontic procedures
13. References

Part 2 The Infected Necrotic Pulp and Apical Periodontitis

Chapter 7 Apical periodontitis
1. Introduction
2. The nature of apical periodontitis
3. Interactions with the infecting microbiota
4. Treatment and healing of periapical lesions
5. Persistence of periapical lesions
6. Clinical manifestations and diagnostic terminology
7. References
Chapter 8 Microbiology of the inflamed and necrotic pulp
1. Introduction
2. Historical background
3. Clinical evidence
4. Infections in root-filled teeth with persistent apical periodontitis
5. Microbial pathogenesis of apical periodontitis
6. Association of signs and symptoms with specific bacteria
7. Biological evidence
8. Extraradicular biofilms
9. Ecological determinants for microbial growth in root canals
10. Microbial interactions in biofilms
11. Microbial resistance to antimicrobials
12. Antibiofilm strategies
13. Concluding remarks
14. References
Chapter 9 Clinical diagnosis of pulp necrosis and apical periodontitis
1. Introduction
2. Clinical features of pulp necrosis and root canal infections
3. Radiographic features of apical periodontitis
4. A strategy for the formulation of a periapical diagnosis
5. Diagnostic challenges during treatment
6. Special cases of endodontic infections
7. An integrated approach to endodontic diagnosis
8. References

Part 3 Endodontic Treatment Procedures

Chapter 10 Endodontic emergencies
1. Introduction
2. General diagnostic considerations and emergency principles
3. The etiology and pathogenesis behind emergency scenarios
4. Non-endodontic tooth pain – conditions of differential diagnostic interest
5. Management of patients with acute dental pain
6. References
Chapter 11 Controlling the environment – the aseptic working field
1. Background
2. Preparing teeth for rubber dam isolation and the development of an aseptic working field
3. Rubber dam isolation
4. Application of the rubber dam
5. Disinfection of the working field
6. Aseptic working procedures
7. References
Chapter 12 Access and canal negotiation: the first key procedural steps for successful endodontic treatment
1. Introduction
2. Principles of tooth development and tooth anatomy
3. Individual analysis of the tooth, preoperative radiographs, and additional CBCT scans in complex cases
4. Rubber dam isolation
5. Access cavity preparation
6. Canal negotiation
7. References
Chapter 13 Root canal instrumentation
1. Introduction
2. Principles of root canal instrumentation
3. Root canal system anatomy
4. Anatomical variations in teeth
5. Procedural steps
6. Endodontic instruments
7. Instrumentation techniques
8. Limitations of root canal instrumentation
9. Preventing procedural mishaps
10. References
Chapter 14 Irrigation and disinfection
1. Introduction
2. Eradication of microorganisms from the root canal system
3. Microbial reduction by instrumentation
4. Root canal irrigation
5. The apical root canal – a special challenge for irrigation
6. Activation of irrigant flow
7. Use of lasers in irrigation
8. Wide-spectrum sound energy for cleaning the root canal system
9. Intracanal medicaments
10. Concluding remarks
11. References
Chapter 15 Root canal filling
Chapter 15.1 Root canal filling materials
1. Introduction
2. Requirements
3. Evaluation of specific materials
4. References
Chapter 15.2 Root canal filling techniques
1. Introduction
2. Clinical objectives and in vitro investigations
3. The root canal filling–dentin interface
4. Root canal filling techniques
5. Concluding remarks
6. References

Part 4 The Endodontically Treated Tooth

Chapter 16 The root canal-treated tooth in prosthodontic reconstruction
1. Introduction
2. Fracture predilection of root-treated teeth
3. Occlusal loading
4. Root canal-treated teeth as abutments
5. Distribution of remaining tooth structure and restorability
6. Principles of restoration of root-treated teeth
7. Timing of restoration after endodontic treatment
8. Approach to restoration of anterior teeth
9. Characteristics of posts
10. Preparation of the post space
11. Approach to restoration of posterior teeth
12. Core materials
13. Modes of restoration failure in root canal-treated teeth
14. Conclusions
15. References
Chapter 17 Clinical epidemiology: measuring endodontic disease and treatment outcome
1. Introduction
2. Defining a “successful” outcome
3. Study designs commonly used in endodontic research
4. Treatment outcome and risk factors
5. Concluding remarks
6. References
Chapter 18 Endodontic retreatment – the decision-making process
1. Introduction
2. Why might the initial treatment be unsuccessful?
3. When may further intervention be considered?
4. Decision-making – the dentist's perspective
5. Decision-making – the patient's perspective
6. References
Chapter 19 Nonsurgical retreatment
1. Introduction
2. Indications
3. Instrumentation of the root canal
4. Summary
5. References
Chapter 20 Surgical endodontics
1. Introduction
2. General outline of the procedure
3. Local anesthesia
4. Flap design, incision, and raising the flap – general considerations
5. Access to the root tip
6. Root-end resection
7. Curettage of the soft-tissue lesion
8. Management of bleeding
9. Root-end preparation
10. Root-end filling
11. Repositioning and suturing of the flap
12. Postoperative measures
13. Follow-up after surgery
14. References

Part 5 Additional Considerations

Chapter 21 Local anesthetic considerations
1. Introduction
2. Fundamentals of local anesthetic action
3. Common local anesthetic agents in endodontics
4. Standard methods of local anesthesia for endodontics
5. Failure to secure anesthesia
6. Why may teeth be difficult to anesthetize?
7. Measures to preempt or overcome challenging local anesthesia
8. Supplementary injections
9. Sedation
10. Complications of local anesthesia
11. References
Chapter 22 Complex orofacial pain conditions
1. Introduction
2. Overview of pain mechanisms
3. Diagnostic process
4. Complex orofacial pain conditions
5. Painful posttraumatic trigeminal neuropathy
6. Persistent idiopathic facial pain
7. Atypical odontalgia/persistent dentoalveolar pain
8. Trigeminal neuralgia
9. Trigeminal autonomic cephalalgias
10. Migraine/neurovascular orofacial pain
11. Temporomandibular disorder pain – referred pain
12. Summary
13. References
Chapter 23 Endodontic complications after trauma
1. Introduction
2. Common dental injuries
3. Dental trauma and its consequences
4. Consequences of pulp breakdown and infection after trauma
5. General considerations in the management of dental trauma
6. Diagnostic quandaries: to remove or review the pulp after trauma?
7. References
Chapter 24 Medicolegal considerations
1. Introduction
2. Ethical considerations – the concepts of beneficence and nonmaleficence
3. Defining best practice
4. Endodontic procedures as complex interventions with scope for imperfection, oversight and error
5. Examples of errors and accidents
6. Do errors always lead to legal action?
7. Professional indemnity/malpractice insurance
8. Managing risks
9. Conclusion
10. References
Chapter 25 Emergencies in need of urgent referral
1. Introduction
2. Neurological injuries resulting from endodontic procedures and materials
3. Neurological injuries resulting from periapical inflammation
4. Chemical tissue trauma
5. Severe odontogenic infections that may compromise systemic health
6. Suspicion of locally aggressive or neoplastic lesions
7. Severe or persistent pain
8. Inhalation or aspiration of dental instruments or materials
9. Allergic responses that may compromise systemic health
10. Reporting adverse events
11. Summary
12. References
Chapter 26 The transition to independent practice
1. Introduction
2. The challenge of transition
3. Learning: explanations and strategies
4. Conclusion
5. Acknowledgment
6. References

Index

End User License Agreement

Textbook of Endodontology

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