Endodontics

ENDODONTICS:

 Endodontics is the branch of dentistry which is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.

What are Dental Endodontic Materials?

Endodontic materials are used in cleaning, shaping and filling of the root canals during root canal system. Pulp devitalization , Endodontic files, root canal irrigants, intracanal medicaments , obturation materials and root canal sealers have so far made endodontics more interesting , riveting , efficient, competent , economical & efficacious.

1.Endo diagnosis

Diagnosing endodontic problems is a challenging part of the treatment process. 

It's an art and science of recognizing disease by means of signs, symptoms and tests.

The clinical evaluation consists of several basic tests, palpation, percussion, periodontal probing, thermal/electrical testing, biting and release. 

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The choices available at Dentalkart:

Pulp tester- it checks the vitality of pulp using electrical stimulation by stimulating the intradental nerves, and creating a response after it

Endo frost - non toxic frost for freezing pellets to temperature of -50 degrees celsius 

Icy spray - non toxic frost for freezing pellets to temperature of -50/ -58 degrees celsius

2.CAVITY ACCESS

Cavity access is defined as achieving unobstructed canal patency and  attaining a straight line access to the apical foramen. Well designed access preparation is essential for a good endodontic result.

Main objective:

Creating a smooth, straight line access to the canal system and the apex and to conserve sound tooth structure.

Ideal access preparation 

1- unobstructed view into the canal.

2- file should paas into the canal without touching the access cavity.

3- no remaining caries should be left

4- obturating material should pass into the canal without any obstruction.

Endodontic burs such as carbide round burs (which is used for initial preparation), carbide long tapered burs (should be then used to even the internal walls and pulp chamber), and endodontic access kits are available to gain entry into tooth. These instruments are usually used at a speed ranging from 60,000-1,20,000 pm.

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The choices available at Dentalkart are:

1- endodontic access burs

2- endodontic access kits

3- devitalizers  (pulp devitalizer)

3.CLEANING AND SHAPING

Primary aim of cleaning and shaping is notably the removal of infected canal contents and shaping adequately for 3D filling of the root canal spaces. 

Objectives of biomechanical preparation of canal

1- completely debrid the pulp space of pulp tissue, microorganisms, and endotoxins.

2- the canals should be continuously tapered

3- the original anatomy of the canals should be maintained.

4- the position of apical foramen should be maintained.

5-apical foramen should be as small as possible.

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The choices available at Dentalkart:

Endodontic instruments-Play a very important role in the success of root canal treatments.

Barbed broaches can be used to extirpate the pulp and remove the foreign debris. It should not be mistaken as canal enlarging instrument.

Smooth Broach- sometimes used as a pathfinder

Gates Glidden drills (GG drills) and Peeso Reamers, hand reamers with non cutting guide tip are used to pre-enlarge and straighten the coronal part of the canal for greater access to the canal for cleaning and obturation.

K-files, H-files, Flexi files, are used for canal negotiation, consistent shaping and recapitulation of the root canals. 

NiTi hand and rotary files- technical advances have led to improvements in the ability to shape root canals with fewer procedural complications.

C-files, D-Finders are used for severely curved and calcified canals.

Materials such as EDTA act as chelating agents assists in negotiating calcified canals.

4.INTRACANAL MEDICAMENTS

• Intracanal medicaments have been used to disinfect root canals between appointments and reduce interappointment pain

FUNCTIONS OF INTRACANAL MEDICAMENT:

• Disinfect Root Canals
• Prevents & reduce the growth of micro-organisms
• Pevention & control of post operative pain
• Control of persistent periapical abscess - in weeping canals

IDEAL REQUIREMENTS OF INTRA CANAL MEDICAMENT:

• Potent antibacterial & antifungal agent
• Potent pulp tissue solvent
• Non irritant to periapical tissue
• Long duration of action
• Have  low surface tension
• No hypersensitivity or allergic reaction
• No interference with repair of periapical tissues
• Active in presence of blood, abscess or protein derivatives of the tissue
• Should be stable & should have longer shelf life
• Capable of inactivation in culture medium
• Economic, easily available

TYPES OF INTRACANAL MEDICAMENTS:

I.Phenols

• Eugenol
• CMCP
• Parachlorophenol
• Camphorated parachlorophenol
• Cresol
• Thymol

II.Aldehydes:

• Formacresol
• Glutaraldehyde

III. Halides:

• Iodine  - Potassium iodine
• Sodium Hypochlorite
• Chloramine T

1. Steroids:
2. Calcium hydroxide

5.POST & CORE material is a dental restoration used to sufficiently build-up tooth structure for future restoration i.e crown when there's not enough tooth structure to properly retain the crown. 

Retention and resistance form of the restoration depends on:

Post length

Post diameter

Surface texture

Luting agent

Steps in tooth preparation-

• Removal of RC filling material
• Enlargement of the canal
• Preparation of the coronal tooth structure 

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The choices available at Dentalkart:

• Fiber post ( carbon fiber post, glass fiber post)

• Metal screw post

• Cast metal post

• Fiber reinforced post

• Parapost 

• Post & drill

• Intraradicular post

• Restoration retention system

• Core build-up material

6.OBTURATION 

Obturation is defined as the three dimensional filling of the entire root canal system as close as possible to cementoenamel junction.

Purposes of obturation:

• To prevent microorganisms from entering the root canal system
• To isolate the remaining microorganisms in the root canal from outer fluids and nutrients

When to obturate?

• When there are no signs of pain and swelling
• No signs of pus, fistula or abscess
• The canal is dry and free from necrotic tissues and pus.

The available obturation materials-

Gutta-percha

MTA

Hydrophilic polymer

Resilon 

After the root canal has been completely debrided and made free from any microorganisms, it is dried and then sealed with an obturating material using root canal sealer and gutta percha/ mta.  Modifications in dentistry has made obturation techniques quite simpler with the use of gun & pen systems, MTA carrier, endodontic heat sources, irrigation gels, carriers.

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The choices available at Dentalkart:

• Gutta-percha points ( for various tapers, and protaper)

• Gutta-percha cutter 

• Root canal sealers (calcium hydroxide with iodoform root canal sealer, calcium hydroxide, ZOE root canal sealer, MTA, resin based root canal sealer)

• Root canal irrigation gel

• Paper points

• Endodontic heat source ( touch & heat model)

• Obturation system (obturation gun & pen system, cordless obturation system, motor driven obturation unit)

• Root canal filling remover -(methylene chloride) in cases of re- root canal treatment

• Lentulo spirals (paste carriers )

7.TEMPORARY FILLING MATERIAL

A temporary material is placed for various reasons that may include emergency care, or a temporary replacement for permanent restoration until infection subsides, and/or to allow for further evaluation of the tooth, or sometimes after a root canal treatment before the final restoration/crown can be placed, extensive decay that requires immediate restoration of tooth.

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The choices available at Dentalkart:

• temporary filling material

• Temporary cement

• Eugenol

• Intermediate restorative material

8.ACCESSORIES

Miscellaneous endodontic items that are necessary for dental practice.

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The choices available at Dentalkart:

• Rubber dam kit, rubber dam clamps.

• Endodontic box

• Endo finger gauge ring, endo file cleaner, endo file organizer, endo guard hand, endo calibration

• Cheek and lip retractor

9.BLEACHING PRODUCTS

DENTAL AESTHETICS

In today's world, people are getting more aware and conscious about their dental aesthetics, hence trying to get treatments that would enhance their overall facial appearance. This special branch of dentistry  focuses on improvement in color, shape, and size, alignment and overall smile appearance. Prosthodontics, Orthodontics and Conservative & Endodontics are three branches that predominantly work on dental aesthetics.

Treatments that improves dental aesthetics-

1. Bleaching of tooth, laser whitening, gums depigmentation
2. Orthodontics
3. Veneers, dental laminates
4. Gingivectomy, enameloplasty
5. crowns, gum grafts
   

BLEACHING

Bleaching is mainly done to upgrade tooth discoloration due to extrinsic and intrinsic causes. 

Variety of bleaching products are available, hence the most commonly used are-

• Hydrogen peroxide
• Sodium perborate
• Carbamide peroxide

In- office bleaching concentration- 25%-38% hydrogen peroxide

At-home bleaching concentration- 3%-7.5% 

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The choices available at Dentalkart: In- office bleaching agents

• Gingival barrier

• At home bleaching agent (bleaching gel, bleaching kit, tooth whitening gel)

10. RE-TREATMENT

A procedure that is done to remove root canal filling materials from the tooth, followed by cleaning, shaping and obturating the canal.

CAUSES OF FAILURE OF ROOT CANAL TREATMENT

Pre-operative causes:

Sinus tract, periodontal problems, misinterpretation of radiographs, inadequate sterilization of instruments, failure to achieve complete biomechanical objectives, over and underextended preparation, ledge formation, defective obturation, missing out on lateral and accessory canals etc. 

Post-operative causes:

Trauma, impaired periapical healing, poor post endodontic restoration, foreign body reaction etc

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The choices available at Dentalkart:

• Gutta-percha solvent

• Universal retreatment rotary files 

• H files, k files

WHY SHOULD WE BUY ENDODONTIC PRODUCTS FROM DENTALKART?

1. All Being Dental Products on a single platform-Dentalkart.com

2. Wide range of endodontic products necessary for endodontic diagnosis, cavity access, biomechanical preparation, intracanal medicaments, obturating materials, post & cores, temporary filling materials, bleaching products, and for root canal retreatment and many more products formulated and engineered by both premium and economical brands are easily obtainable in a few simple steps and available at the best Price in India are offered.
3. Strict and Stringent monitoring at every step (We procure directly from the manufacturer and our products are made to go through various quality tests to ensure that only the best product reaches you)
4. All various types of endodontic products and instruments available on Dentalkart are genuine and authentic.
5. Having varied forms of payment including credit and debit cards, net banking and cash on delivery (CoD).
6. Fastest Delivery with 10-days replacement policy.

GUIDANCE ON MAINTENANCE OF  ENDODONTIC MATERIALS 

• After hand or ultrasonic cleaning, the instruments should be cleaned and dried
• The cutting/sharpened instruments should be kept separate from other instruments during cleaning and sterilization procedures
• Use of rust-inhibitor detergents for cleaning process is advised

Sterilization

• Sterilization of endodontic files can be carried out by various methods such as dry heat sterilization, autoclave, ethylene oxide gas, glass bead sterilizer and hot salt sterilizer.
• However, complete sterilization from microorganisms are achieved by autoclaving the files at 121 degree Celsius for 15 minutes under the pressure of 15 pounds. 
• On the other hand, sterilization by glass bead showed sterilization upto 90%.The endodontic files sterilized by immersing in glutaraldehyde for 24 hours showed sterilization up to only 80%.

BRANDS AVAILABLE IAT DENTALKART:

Materials used in endodontics manufactured by over 50 brands are available on the website providing comprehensive catalogue products to choose from.Diverse range of high end endodontic products brands are available at one platform such as Anabond Stedman, AAA, Angelus, API,  Ammdent, Biodinamica, Cerkamed, Chinese, Coltene, Dentobizz, Detax, Dentsply, Denext, Deor, DMG, D-Tech, Diadent, Dental Avenue, DPI, Eighteenth, E-Dental, Endostar, GDC, GC, Hagen- Werken Filay Dent, Indian, Itena, Ivoclar Vivadent, J-Morita, Kerr, Maarc, Marathon, Mani, Mothers International Australia, Medicept, Meta Biomed, Micro-mega, Neo-endo, Nexobio, Nordin, Neolix, Prevest Denpro, Pyrax, Pulpdent, Prima Dental, Premier Dental PD, SS-White, Septodont, Sybron Endo, SuperEndo, Satelec,  Tri-Hawk, Tokuyama, Thomas, Tehno-Dent, Voco, Vdw, Vishal DentoCare, Ultradent, Waldent, Woodpecker, 3M Espe, 3A Medes.