Submitted by DR - Amithbabu.C.B

Submitted by
DR.AMITHBABU.C.B
1YEAR ENDODONTICS
 ANATOMY OF TOOTH
 MORPHOLOGY OF TOOTH
 VARIATIONS OF TOOTH
 ANOMALIES OF TOOTH
 ENDODONTIC CORELATION
 FIRST EVIDENCE OF
CALCIFICATION= 3-4 months
 CROWN COMPLETION=4-5 YEARS
 ERUPTION=6-7 YEARS
 ROOT COMPLETION=9YEARS
It helps in diagnosis and treatment
planning.
It differs between young and adult
patients.
Open apex
apexification apexogenesis
Non vital teeth Vital root

therapy
REVERSIBLE IRREVERSIBLE PULPITIS
PULPITIS NECROTIC PULP
APEXOGENESIS CLOSED OPEN

APEX APEX
PULPCAPPING OR
RCT APEXIFICATION
PULPOTOMY
&
OBTURATION
Arch traits
Crown
 Narrower MD
 Greater height / width proportion
 Smaller MD / LL proportion
Root
 Smaller MD / LL proportion
 Generally oblong in x-section
Type traits (arch trait)
 Nearly equal in size & dimensions
MANDIBULAR
CENTRAL
INCISOR
MESIAL VIEW
 LABIAL ASPECT
The narrowest MD of all incisors
Bilaterally symmetrical (type trait)
3 mamelons
Mesial and distal mamelons are of
equal prominence
TOOTH ANATOMY
90 º MI & DI angles and are at same level
Both HOCs are within the incisal third
M & D outlines are almost straight line CEJ
convex cervically
Root is narrow & conical
Lingual aspect
Shallow fossa & less prominent cingulum

& marginal ridges
CEJ summit in the centre
 Mesial aspect
Labial HOC within cervical third
From HOC toward incisal edge labial
Outline is straight
Root Broad & flat
A shallow depression in the mid
portion
Ovoid in x-section
Distal aspect
CEJ is less curved
LL and narrow MD
Incisal aspect
 Triangular
 Labial surface is flat compared to
maxincisors
 Seldom labial lobe groove
 Long axis of incisal edge is perpendicular
to LL line (type trait)
 Mesial outline = distal outline in length
Pulp
Broad LL and narrow MD
ANATOMIC RELATIONSHIP
IN SITU
 Mandibular alveolar process is thin in
labiolingual direction
 Roots broad in labiolingual direction
 Alveolar socket of anterior teeth is in

spongy bone close to incisive canal
PULP CHAMBER
 Smallest tooth in the arch
 Pulp chamber is small and flat mesiodistally
 Three distinct pulp horns present in a recently
erupted tooth become calcified and disappear in
life due to constant masticatory forces
 Labiolingually the pulp chamber is wide and ovoid
in cross-section in the cervical third of the crown
and tapers gradually
ROOT CANAL
MORPHOLOGY
 Root is broad labiolingualy & narrow
mesiodistally
 Canal is ovoid in labiolingual direction in the
cervical third of root ribbon shape in middle
third round in apical third
 Ribbon shape in the middle third is an area
where bifurcation occurs and where perforation
can occur due to over instrumentation
ROOT CROSS SECTION
ovoid
RIBBON SHAPE
ROUND
DIMENSIONS
 AVERAGE LENGTH=21.5mm
 AVERAGE CROWN LENGTH=9mm
 AVERAGE ROOT LENGTH=12.5mm
 IMPORTANCE;
in determining the working

length. In better assumption of the
radiograph
ACCESS OPENING
CONSIDERATIONS
 Small fissure burs and no;2 round burs are used
 Labial perforation are common it can be
avoided if the clinician remembers that it is
nearly impossible to perforate in the lingual
direction because of the bur shank contacting
the incisal edge
 Proper access enables one to determine whether
a second root canal is present
OVOID
ACCESS OPENING
EXACT
CENTRE OF
LINGUAL
SURFACE
Working from
inside the chamber Thin long
to the outside tapering
fissuring
ACCESS OPENING
The access is quite high on

This view
The lingual side.
shows the
This gives the clinician a
Access view
Straight down the canal
extendingTo
and Minimize theperforation
the incisal
On the facial side
edge
ACCESS OPENING
INCORRECT
CORRECT TECHNIQUE THE
BUR IS DIRECTED
TO LABIOLINGUAL
DIRECTION
.PERFORATION
CORRECT-SWEEPING MOTION IN A
SLIGHTLY LINGUAL TO LABIAL
DIRECTION UNTIL THE CHAMBER IS
ENGAGED TO OBTAIN ACCESS TO
LINGUAL CANAL
importance
the access opening is made, in the
lingual surface, there is always a risk
that the lingual canal is missed unless it
is specifically looked for with a pre-
curved file.
For the same reason there is a risk of
unsymmetrical preparation of the labial
side of the root canal.
The canal(s) of the lower central incisor
is almost always straight unlike in the
lower lateral incisor, where the root tip
and canal often curve sharply distally
ACCESS OPENING
NOTE:
proper access enables one to

explore the cervical third of the
root to determine whether a
second root canal is present
ROOT CANAL
CONFIGRATION
 ROOT IS STRAIGHT-60%
 DISTAL CURVATURE-23%
 LABIAL CURVATURE-13%
ROOT CANAL
CONFIGRATION
 1 CANAL IN 1 APICAL FORAMEN-70%
 1 CANAL BIFURCATING INTO 2
CANALS AND EXITING INTO 1APICAL
FORAMEN-22%
Precurving the files and using the
balance force technique
Will reduce ledging and better
cleaning and shaping of the
Root canal
ADVANTAGE OF PRECURVING
OF FILES
The tip of
correcting file
should be severely
curved
To by pass the
ledge to hug the
inside wall of the
curve
Large instrument into a curved

Canal-ledge
ACCESS CAVITY & ROOT
CANAL
OUTLINE SHAPE -OVOID
THE LINGUAL EDGE OF
DENTINE REMAINS
DEFLECTING THE FILE
TOWARDS THE LABIAL
WALL AS A RESULT
PORTION OF LINGUAL
WILL NOT BE SHAPED AND
CLEANED
REMOVAL OF THE
LINGUAL LEDGE
GIVES A STRAIGHT LINE
ACCESS
ERROR IN ACCESS OPENING
PERFORATION
ROOT CANAL
The typical error in access on a

mandibular incisor
is to perforate toward the facial
(white dot). The clinician had
already "located" the canal but
bypassed it while continuing to
drill down and to the facial.
NOTE:
 The lingual canal is often missed in teeth with
two canals because the access cavity if placed
too far lingually restricts straight line access.
 Over preparation will weaken the tooth
unnecessarily and may result in strip perforation
 The apices of mandibular incisors are often
reclined lingually and access for endodontic
surgery is often can be extremely difficult
MANDIBULAR
INCISOR WITH TWO
CANALS WITH ONE
APICAL FORAMINA
Care should be taken while

obturating the canal ,two
gutta purcha points should
be inserted alternatively to
confirm the canal
configration
IN CALCIFIED CANAL
While searching for a calcified

LINGUAL
canal, clinicians tend to drill in INCLINATION
an apical direction but TO THE BUR
neglect to take into account the
natural angulations of the
mandibular incisor, resulting in
buccal perforation.
CALCIFIED CANALS
 In calcified canal if the bur does not easily drop
into the pulp chamber .the clinician should
change into a smaller bur keeping the long axis
in mind direct the cutting action in apical
lingual
 If still do not find remove the bur ,place it in
access cavity ,expose radiograph, the resultant
will reveal the depth and angulation from
mesial to distal
ATTRITED AND ROTATED TEETH
BUCCAL
LINGUAL
I n this attrited and

rotated incisor with two
canals,
an incisor access greatly
facilitated location of the
lingual canal.
ANOMALIES
 A few anomalies were reported includes
 Two canals two separate foramina
 Dens invaginatus
 Fusion
 Gemination
 Talon cusp
GEMINATION
Incomplete division of
a single tooth bud
Bifid crown with a
single pulp chamber
Endodontic treatment is just

like treating a Tooth with
large pulp chamber
FUSION
Dentinal union of two

embryologically developing
Teeth
Hence they will have separate
root canals and pulp
Chamber
So endodontic treatment will
be like treating two
teeth
ROOT CANAL VARIATIONS
VARIATIONS
All the studies shows that majority of central

incisor to have single canal
Two canals were found in 26% .
Three or more canals were quote rare
Even when two canals were found the majority
join in single foramen
ROOT CANAL VARIATIONS
MANDIBULAR CENTRAL
INCISOR WITH 2CANAL
2APICAL FOAMINA
Labial and lingual canals are

discovered by exploration
With a fine curved file into to
both labial and lingual canals
It is important to check for
the possibility of labial &
Lingual canals in anterior
teeth
CASE REPORT
 A 7 year old girl was referred to the faculty
of dentistry at haceppte university .her
parents complained of abnormal shape to
one of her tooth .pt medical history was
normal .the patient was in the early mixed
dentition period with good oral hygiene .a
prominent lingual talon cusp in the right
mandibular central incisor was noticed.
tongue irritation during speech and
mastication was noticed.
 Radiographic examination , a radio opaque v
shaped appearance of a tubercle like structure
originating from the cervical third of the
crown no signs of periapical pathology was
noted
 Treatment
 Prevent Caries in developmental grooves
 Eliminating tongue irritation
 Surface grinding
 Sealing with flowable composites

bonding acid etching
 On follow up patient did not had any
complaints
REFERENCES
 ENDODONTIC PRACTICE –GROSSMAN
 PATHWAYS OF PULP-COHEN
 INGLE-ENDODONTICS
 ENDODONTICS CLINICAL PROBLEM
SOLVING
 COLOUR ATLAS OF ENDODONTICS-
WILLIAM T JOHNSON
 WWW.WICKIPEDIA.COM
 BRITISH DENTAL JOURNAL
THANK YOU

Submitted by DR - Amithbabu.C.B

Uploaded by

Copyright:

Available Formats

Submitted by DR - Amithbabu.C.B

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Submitted by DR - Amithbabu.C.B

Uploaded by

Copyright:

Available Formats

Submitted by

Non vital teeth Vital root

APEXOGENESIS CLOSED OPEN

Shallow fossa & less prominent cingulum

 Alveolar socket of anterior teeth is in

 AVERAGE ROOT LENGTH=12.5mm

in determining the working

The access is quite high on

proper access enables one to

Large instrument into a curved

The typical error in access on a

Care should be taken while

While searching for a calcified

I n this attrited and

Endodontic treatment is just

Dentinal union of two

All the studies shows that majority of central

Labial and lingual canals are

 Sealing with flowable composites

You might also like