A dental dam or rubber dam is a thin, 6-inch (150 mm) square sheet, usually latex or nitrile, used in dentistry to isolate the operative site from the rest of the mouth. Sometimes termed "Kofferdam", it was designed in the United States in 1864 by Sanford Christie Barnum. It is used mainly in endodontic, fixed prosthodontic and general restorative treatments. Its purpose is both to prevent saliva interfering with the dental work, and to prevent instruments and materials from being inhaled, swallowed or damaging the mouth. In dentistry, use of a rubber dam is sometimes referred to as isolation or moisture control.
A root canal is the naturally occurring anatomic space within the root of a tooth. It consists of the pulp chamber, the main canal(s), and more intricate anatomical branches that may connect the root canals to each other or to the surface of the root.
Endodontics is the dental specialty concerned with the study and treatment of the dental pulp.
Dental instruments are tools that dental professionals use to provide dental treatment. They include tools to examine, manipulate, treat, restore, and remove teeth and surrounding oral structures.
Dens invaginatus (DI), also known as tooth within a tooth, is a rare dental malformation and a developmental anomaly where there is an infolding of enamel into dentin. The prevalence of this condition is 0.3 - 10%, affecting males more frequently than females. The condition presents in two forms, coronal involving tooth crown and radicular involving tooth root, with the former being more common.
Microsurgical endodontics is that aspect of endodontics which evolved after the introduction of the Surgical Operating Microscope (SOM) to endodontics in the early 1990s. The recent addition of SOM's to endodontic therapy can allow better visualization and management of the surgical field by endodontists during endodontic procedures through magnification and greatly improved high intensity lighting. SOM's typically magnify in the 4X to 25X range. The other commonly used magnification aide, through lens eyeglass mounted surgical telescopes, provide 2.5X to 4.5X magnification. Surgical operating microscopes have a steep learning curve and require training, as well as patience and practice to master.
Root canal treatment is a treatment sequence for the infected pulp of a tooth which is intended to result in the elimination of infection and the protection of the decontaminated tooth from future microbial invasion. Root canals, and their associated pulp chamber, are the physical hollows within a tooth that are naturally inhabited by nerve tissue, blood vessels and other cellular entities. Together, these items constitute the dental pulp.
Apical periodontitis is typically the body's defense response to the threat of microbial invasion from the root canal. Primary among the members of the host defense mechanism is the polymorphonuclear leukocyte, otherwise known as the neutrophil. The task of the neutrophil is to locate and destroy microbes that intrude into the body – anywhere in the body – and they represent the hallmark of acute inflammation.
Mineral trioxide aggregate (MTA) was developed for use as a dental root repair material by Mahmoud Torabinejad. It is formulated from commercial Portland cement, combined with bismuth oxide powder for radio-opacity. MTA is used for creating apical plugs during apexification, repairing root perforations during root canal therapy, and treating internal root resorption. This can be used for root-end filling material and as pulp capping material. Originally, MTA was dark gray in color, but white versions have been on the market since 2002.
Pulpotomy is a minimally invasive procedure performed in children on a primary tooth with extensive caries but without evidence of root pathology. The minimally invasive endodontic techniques of vital pulp therapy (VPT) are based on improved understanding of the capacity of pulp (nerve) tissues to heal and regenerate plus the availability of advanced endodontic materials. During the caries removal, this results in a carious or mechanical pulp exposure (bleeding) from the cavity. During pulpotomy, the inflamed/diseased pulp tissue is removed from the coronal pulp chamber of the tooth leaving healthy pulp tissue which is dressed with a long-term clinically successful medicament that maintains the survival of the pulp and promotes repair. There are various types of medicament placed above the vital pulp such as Buckley's Solution of formocresol, ferric sulfate, calcium hydroxide or mineral trioxide aggregate (MTA). MTA is a more recent material used for pulpotomies with a high rate of success, better than formocresol or ferric sulfate. It is also recommended to be the preferred pulpotomy agent in the future. After the coronal pulp chamber is filled, the tooth is restored with a filling material that seals the tooth from microleakage, such as a stainless steel crown which is the most effective long-term restoration. However, if there is sufficient remaining supporting tooth structure, other filling materials such as amalgam or composite resin can provide a functional alternative when the primary tooth has a life span of two years or less. The medium- to long-term treatment outcomes of pulpotomy in symptomatic permanent teeth with caries, especially in young people, indicate that pulpotomy can be a potential alternative to root canal therapy (RCT).
In dentistry, the smear layer is a layer found on root canal walls after root canal instrumentation. It consists of microcrystalline and organic particle debris. It was first described in 1975 and research has been performed since then to evaluate its importance in bacteria penetration into the dentinal tubules and its effects on endodontic treatment. More broadly, it is the organic layer found over all hard tooth surfaces.
Holistic dentistry, also called biological dentistry, biologic dentistry, alternative dentistry, unconventional dentistry, or biocompatible dentistry, is the equivalent of complementary and alternative medicine for dentistry. Although the holistic dental community is diverse in its practices and approaches, common threads include strong opposition to the use of amalgam in dental fillings, nonsurgical approaches to gum disease, and the belief that root canal treatments may endanger systemic health of the patient through the spread of trapped dental bacteria to the body. Many dentists who use these terms also regard water fluoridation unfavorably.
Regenerative endodontic procedures is defined as biologically based procedures designed to replace damaged structures such as dentin, root structures, and cells of the pulp-dentin complex. This new treatment modality aims to promote normal function of the pulp. It has become an alternative to heal apical periodontitis. Regenerative endodontics is the extension of root canal therapy. Conventional root canal therapy cleans and fills the pulp chamber with biologically inert material after destruction of the pulp due to dental caries, congenital deformity or trauma. Regenerative endodontics instead seeks to replace live tissue in the pulp chamber. The ultimate goal of regenerative endodontic procedures is to regenerate the tissues and the normal function of the dentin-pulp complex.
Pulp capping is a technique used in dental restorations to prevent the dental pulp from necrosis, after being exposed, or nearly exposed during a cavity preparation, from a traumatic injury, or by a deep cavity that reaches the center of the tooth causing the pulp to die. When dental caries is removed from a tooth, all or most of the infected and softened enamel and dentin are removed. This can lead to the pulp of the tooth either being exposed or nearly exposed which causes pulpitis (inflammation). Pulpitis, in turn, can become irreversible, leading to pain and pulp necrosis, and necessitating either root canal treatment or extraction. The ultimate goal of pulp capping or stepwise caries removal is to protect a healthy dental pulp and avoid the need for root canal therapy.
Actinomyces radicidentis is a species in the genus Actinomyces, first isolated from infected root canals of teeth. Once characterized, it has since been found to be present in failed root canal treatments. Its pathogenicity has been suggested to be due to an ability to form cell aggregates, held together by embedding in an extracellular matrix in host tissues. Like other pathogenic Actinomyces, by collectively finding itself in a protected biofilm environment can evade elimination by host defenses, including phagocytosis.
José Freitas Siqueira Jr. was born in Miracema, Rio de Janeiro, Brazil, in October 1967. He received his DDS from Gama Filho University, Rio de Janeiro in 1989, and his endodontic certificate from Federal University of Rio de Janeiro in 1991. In 1996, he received his master's degree in microbiology and immunology from Federal University of Rio de Janeiro. He concluded his PhD in microbiology and immunology in 1998 at Federal University of Rio de Janeiro. Since 2002, Siqueira is the chairman of endodontics, director of the postgraduate program in endodontics and head of the molecular microbiology laboratory at Estácio de Sá University, in Rio de Janeiro, Brazil.
In the dental specialty of endodontics, periradicular surgery is surgery to the external root surface. Examples of periradicular surgery include apicoectomy, root resection, repair of root perforation or resorption defects, removal of broken fragments of the tooth or a filling material, and exploratory surgery to look for root fractures.
Periapical granuloma, also sometimes referred to as a radicular granuloma or apical granuloma, is an inflammation at the tip of a dead (nonvital) tooth. It is a lesion or mass that typically starts out as an epithelial lined cyst, and undergoes an inward curvature that results in inflammation of granulation tissue at the root tips of a dead tooth. This is usually due to dental caries or a bacterial infection of the dental pulp. Periapical granuloma is an infrequent disorder that has an occurrence rate between 9.3 to 87.1 percent. Periapical granuloma is not a true granuloma due to the fact that it does not contain granulomatous inflammation; however, periapical granuloma is a common term used.
Apexification is a method of dental treatment to induce a calcific barrier in a root with incomplete formation or open apex of a tooth with necrotic pulp. Pulpal involvement usually occurs as a consequence of trauma or caries involvement of young or immature permanent teeth. As a sequelae of untreated pulp involvement, loss of pulp vitality or necrotic pulp took place for the involved teeth.
Root resection or root amputation is a type of periradicular surgery in which an entire root of a multiroot tooth is removed. It contrasts with an apicoectomy, where only the tip of the root is removed, and hemisection, where a root and its overlying portion of the crown are separated from the rest of the tooth, and optionally removed.
