1. Endodontics… Dr. Ashraf Refai BDS MSc DD HMD Lecturer of Endodontics Al-Azhar University / MIU

2. Endodontics… Endodontics What is it About?

4. Concerned with the:Morphology Physiology Pathology Pulp & Periradicular tissues

7. MICROBIOLOGY OF ENDODONTICS

8. PULP & PERIRADICULAR LESIONS

9. DIAGNOSTIC PROCEDURES

10. DAGNOSIS AND TREATMENT OF DENTAL PAIN

11. ENDODONTIC CAVITY PREPARATION

12. OBTURATION OF THE RADICULAR SPACE

13. ENDODONTIC SURGERY

14. RE-TREATMENT

15. TRAUMATIC INJURIES

16. BLEACHING OF DISCOLOURED TEETH

17. PEDIATRIC ENDODONTICS

18. PHARMACOLOGY OF ENDODONTICS

20. Pulp Space Morphology & Coronal Cavity Preparation

22. Pulp chamber

23. Pulp horn

24. Root canal

25. Apical foramen

26. Location

27. Percentage (17%-46%)

28. Accessory or Lateral canals

29. Location

32. Canal ConfigurationsClass I Class II Class III

33. Question #1: pulp space morphology & coronal cavity preparation The pulp is diseased the patient is in pain what do you do next?

34. Principles of Coronal Cavity Preparation pulp space morphology & coronal cavity preparation Coronal Cavity Preparation (Access Cavity) Radicular Cavity Preparation (Cleaning & Shaping) Outline form Convenience form Complete removal of caries & old fillings Toilet of the cavity

35. Message of the Day… pulp space morphology & coronal cavity preparation SLA

36. Objectives of Coronal Cavity Preparation pulp space morphology & coronal cavity preparation Straight line access (SLA) to apical foramen or to the initial curvature of the canal To locate all root canal orifices To conserve sound tooth structure

44. Principles of Coronal Cavity Preparation pulp space morphology & coronal cavity preparation Coronal Cavity Preparation (Access Cavity) Radicular Cavity Preparation (Cleaning & Shaping) Outline form Convenience form Complete removal of caries & old fillings Toilet of the cavity

45. Question #2: pulp space morphology & coronal cavity preparation We know how to get into the pulp but what is missing?

46. Principles of Coronal Cavity Preparation pulp space morphology & coronal cavity preparation You will never get from point A to point B consistently without a map Point A Point B

47. Pulp Space Morphology of Anterior Teeth pulp space morphology & coronal cavity preparation Upper Central Incisor Average Length: 23 mm Root Number & Form: 1 Canal Types: Type I Common Curvatures: Straight Labio-Lingual section Mesio-Distal section Cross-Sections Outline form

48. Pulp Space Morphology of Anterior Teeth pulp space morphology & coronal cavity preparation Upper Lateral Incisor Average Length: 22.5 mm Root Number & Form: 1 Canal Types: Type I Common Curvatures: Distal, Straight Labio-Lingual section Mesio-Distal section Cross-Sections Outline form

49. Pulp Space Morphology of Anterior Teeth pulp space morphology & coronal cavity preparation Upper Canine Average Length: 26 mm Root Number & Form: 1 Canal Types: Type I Common Curvatures: Straight, Distal Labio-Lingual section Mesio-Distal section Cross-Sections Outline form

50. Pulp Space Morphology of Anterior Teeth pulp space morphology & coronal cavity preparation Lower Central & Lateral Incisor Average Length: 21 mm Root Number & Form: 1 Canal Types: Type I 60% Type II 30% Type III 10% Common Curvatures: Straight, Distal Labio-Lingual section Mesio-Distal section Cross-Sections Outline form

51. Pulp Space Morphology of Anterior Teeth pulp space morphology & coronal cavity preparation Lower Canine Average Length: 25 mm Root Number & Form: 1 Canal Types: Type I 94% Type II or III 6% Common Curvatures: Straight Labio-Lingual section Mesio-Distal section Cross-Sections Outline form

52. Steps of Cavity Preparation for Anterior Teeth pulp space morphology & coronal cavity preparation

53. errors during Cavity Preparation of Anterior Teeth pulp space morphology & coronal cavity preparation Gouging Gouging Perforation Discoloration Narrow Access

54. pulp space morphology & coronal cavity preparation Revision of Anterior teeth

55. Pulp Space Morphology of Premolars pulp space morphology & coronal cavity preparation Maxillary First Premolar Average Length: 21 mm Root Number & Form: 2 roots 60% 3 roots 38% 1 root 2% Canal Types: 2 roots Type I each root 1 root Type III 70% Type II 20% Type I 10% Common Curvatures: Straight Labio-Lingual section Mesio-Distal section Cross-Sections Outline form

56. Pulp Space Morphology of Premolars pulp space morphology & coronal cavity preparation Maxillary Second Premolar Average Length: 21 mm Root Number & Form: 1 root 85% 2 roots 2% Canal Types: 1 root Type I 70% Type II 20% Type III 10% 2 roots Type I each root Common Curvatures: Straight, Distal Labio-Lingual section Mesio-Distal section Cross-Sections Outline form

57. Pulp Space Morphology of Premolars pulp space morphology & coronal cavity preparation Mandibular First Premolar Average Length: 22 mm Root Number & Form: 1 root Rarely 2 roots Canal Types: 1 root Type I 85% Type II&III 15% 2 roots Type I each root Common Curvatures: Straight Labio-Lingual section Mesio-Distal section Cross-Sections Outline form

58. Pulp Space Morphology of Premolars pulp space morphology & coronal cavity preparation Mandibular Second Premolar Average Length: 21.5 mm Root Number & Form: 1 root Rarely 2 roots Rarely 3 roots Canal Types: 1 root Type I 85% Type II&III 15% Type IV very rare 2 or 3 roots Type I each root Common Curvatures: Straight Labio-Lingual section Mesio-Distal section Cross-Sections Outline form

59. Steps of Cavity Preparation for Premolar Teeth pulp space morphology & coronal cavity preparation

60. errors during Cavity Preparation of Premolar Teeth pulp space morphology & coronal cavity preparation Gouging Overextension Narrow Access Missed Canal

61. pulp space morphology & coronal cavity preparation Revision of Premolars

62. Pulp Space Morphology of Molars pulp space morphology & coronal cavity preparation Maxillary First Molars Average Length: 20.5 mm Root Number & Form: 3 roots Mesio-Buccal (MB) Disto-Buccal (DB) Palatal (P) Canal Types: MB Type I 60% Type II&III 40% DB & P Type I Common Curvatures: MB Curves Distaly DB Curves Mesially P Curves Palataly Labio-Lingual section Mesio-Distal section

63. Pulp Space Morphology of Molars pulp space morphology & coronal cavity preparation Maxillary First Molars Cross-Section Outline form

64. Pulp Space Morphology of Molars pulp space morphology & coronal cavity preparation Maxillary Second Molars Average Length: 20 mm Root Number & Form: 3 roots 90% 2 & 4 roots 10% Canal Types: 3 roots like Maxillary First 2 roots (Buccal & lingual) Type I most frequent Type II less frequent Common Curvatures: Similar to Maxillary first Labio-Lingual section Mesio-Distal section

65. Pulp Space Morphology of Molars pulp space morphology & coronal cavity preparation Maxillary Second Molars Cross-Section Outline form

66. Pulp Space Morphology of Molars pulp space morphology & coronal cavity preparation Mandibular First Molars Average Length: 21 mm Root Number & Form: 2 roots Mesial Root Distal Root Canal Types: Mesial Root Type III 90% Type II 10% Distal Root Type I 60% Type II &III 40% Common Curvatures: Mesial root (distal or straight) Distal root (Straight, distal or mesial) Labio-Lingual section Mesio-Distal section

67. pulp space morphology & coronal cavity preparation Revision of Maxillary Molars

68. Pulp Space Morphology of Molars pulp space morphology & coronal cavity preparation Mandibular First Molars Cross-Section Outline form

69. Pulp Space Morphology of Molars pulp space morphology & coronal cavity preparation Mandibular Second Molars Average Length: 20 mm Root Number & Form: 2 roots Mesial Root Distal Root 3 roots rarely Canal Types: Mesial Root Type II & III frequent Type I rare Distal Root Type I frequent Type II & III rare Common Curvatures: Labio-Lingual section Mesio-Distal section

70. Pulp Space Morphology of Molars pulp space morphology & coronal cavity preparation Mandibular Second Molars Cross-Section Outline form

71. pulp space morphology & coronal cavity preparation Revision of Mandibular Molars

72. Steps of Cavity Preparation for Maxillary Molars pulp space morphology & coronal cavity preparation

73. Steps of Cavity Preparation for Mandibular Molars pulp space morphology & coronal cavity preparation

74. errors during Cavity Preparation of Molars pulp space morphology & coronal cavity preparation

76. Convenience form

77. Complete removal of caries & old fillings

78. Toilet of the cavityMorphology of Anterior teeth Morphology of Premolars Morphology of molars

79. Thank you Time for a break…