Endodontics

This is a learning resource about Endodontics which will focus on practical aspects. The project is a work in progress and any contributions or feedback is welcome. For encyclopedic coverage of the topic, see the Wikipedia articles:


 * Endodontics
 * Endodontic therapy

Treatment planning
It is sometimes said "Good surgeons know how to cut, better surgeons know when to cut, and the best Surgeons know when not to cut." Really, this adage can be applied to any irreversible treatment in medicine. Modern endodontic techniques mean that virtually any tooth can be root filled, but not everything that can be root filled should be root filled. Endodontic treatment takes time and effort for both operator and patient and should never be carried out in the absence of an evidence-based, overall restorative plan for the whole mouth.

Indications for RCT:
 * Irreversibly damaged or necrotic pulp +/- clinical and/or radiologic findings of apical periodontitis
 * Elective devitalization, e.g. prior to construction of a post crown, overdenture, doubtful pulp health prior to restorative procedures, likelihood of exposure when restoring a misaligned tooth, and prior to root resection or hemisection

Contra-indications for RCT:
 * Unrestorable and/or nonfunctioning teeth
 * Teeth with compromised periodontal status
 * Teeth with otherwise poor prognosis, uncooperative patients of persons in whom dental treatment cannot be carried out
 * Teeth of patients with poor oral condition that cannot be improved withing a reasonable time period

Frequently clinicians and patients are faced with the choice of either root canal treatment or dental extraction. This is a simplified version of an evidence-based decision making protocol to help with this decision (National Health Service, UK):

References and further reading
Access cavities table Resources
 * Manogue M, Patel S, Walker R, 2013 The Principles of Endodontics 2nd Edition; Oxford; Oxford University Press
 * Garg N, Garg A, 2010; Textbook of Endodontics 2nd Edition; Jaypee Brothers Medical Publishers
 * "Endo cheat sheet"