Endo Glossary Flashcards
abscess
localised colllection of pus within a tissue space
access cavity
opening prepared in a tooth to gain access to the root canal system for the purpose of cleaning, shaping and obturating
accessory canal
any branch of the main pulp canal or chamber that communicates with the external surface of the root
acute apical abscess
inflammatory reaction to pulpal infection and necrosis characterised by rapid onset, spontaneous pain, tenderness of tooth to pressure, pus formation and swelling of associated tissues
allodynia
pain resulting form a non-noxious stimulus to normal skin or mucosa
anaesthetic test
special investigation in which a tooth suspected of being the source of referred pain is anaesthetised with LA, if the pain is alleviated the suspected tooth may be the source of the pain
anatomic apex
tip of the root as determined by morphology
apex
tip/end of root
apex locator
an electronic device used as an aid in determining the root canal working length or perforation; operates on the principles of resistance, frequency or impedance
apexification
method to induce a calcified barrier in a root with an open apex or the continued apical development of an incompletely formed root in teeth with necrotic pulps
apexogenesis
vital pulp therapy procedure performed to encourage continued physiological development and formation of the root end
apical constriction
apical portion of the root canal having narrowest diameter; position may vary but it is usually 0.5-1.0mm short of the centre of the apical foramen
apical delta
pulp canal morphology in which the main canal divides into multiple accessory canals at or near the apex
apical gauging
measurement of the terminal diameter or shape of a canal after the initial crown-down shaping
apical patency (patency filing)
technique where the apical portion of the canal is maintained free of debris by instrumentation with a small file through apical foramen
apicetomy
see root-end resection
asymptomatic apical periodontitis
inflammation and destruction of apical periodontium that is of pulpal origin, appears as an apical radiolucent area and does not produce clinical symtoms
atypical odontalgia (phantom tooth pain)
pain with all the classic features of pulpagia usually following an extraction but not appearing to be of peripheral origin
austenitic phase
crystalline unstressed phase of stainless steel and nickel titanium alloy
backfiling
injection and/or compaction of GP into canal after creation of apical seal
balanced force technique
technique for cleaning and shaping the root canal system that allows opposing physical forces to guide each preparation instrument; uses clockwise rotation to engage dentine and counter-clockwise rotation whilst maintaining apical pressure to cut dentine
baradontalgia
tooth pain caused by a change in ambient pressure, often reported whilst flying or diving
bifurcation
anatomic area where roots of 2 rooted teeth divide
bioceramic
group of bioactive ceramic materials that are biocompatible with good physical and chemical properties used in endodontics as pulp capping or root end filing materials
biofilm
community of bacteria/fungi held together by an extracellular matric that adheres to a surface
bite test
diagnostic procedure in a which a tooth suspected of being cracked is subjected to differential occlusal forces on individual cusps in an attempt to replicate the reported discomfort; usually accomplished by having the pt bite on various plastic, wood or rubber objects
bleaching
use of a chemical agent to remove tooth discolouration
blunderbuss canal
term denotes an incompletely formed root in which the apical diameter of the pulp canal is greater than the coronal diameter
bony crypt
osseous cavity made or modified in bone during periradicular surgery
braiding technique
wrapping of multiple small files around an object in the root canal to aid in its removal
broach
thin, flexible, fragile usually tapered and pointed metal hand instruments with sharp projections curving backwords and obliquely
primarily use to remove pulp tissue or other easily engaged materials from the canal
buccal object rule
method of determining the relative location or objects that are superimposed on an intra-oral radiograph
Rule: when 2 different radiographs are made of a pair of objects, the image of the buccal object moves, relative to the image of the lingual object, in the opposite direction from which the X-ray beam is directed
C-shaped canal
pulp canal anatomy having the cross sectional shape of the letter ‘c’
found in the mandibular 7s in which mesio-buccal and distal canals communicate due to fusion of the mesial and distal roots
calcium hydroxide Ca(OH)2
odourless, strongly basic, frequently used as an intracanal medicament in nonsurgical endodontic procedures and also secondary to traumatic injuries; preparations appear to encourage calcification; different preparations may be used in pulp capping, pulpotomy, apexogenesis and apexification procedures in the secondary dentition; appears to inhibit inflammatory resorption and demonstrates anti-microbial activity.
canals
The space within the root of the tooth extending from the pulp chamber to the apical foramen; may be narrow, have lateral branches and/or exhibit irregular morphology.
carbamide peroxide (CH6N2O3)
Hydrogen peroxide coupled to urea; frequently marketed in an acidified, anhydrous glycerine base as a patient-applied extracoronal tooth-bleach system; breaks down into urea, ammonia, carbon dioxide (carbonic acid in saliva) and hydrogen peroxide.
cemental tear
complete or incomplete separation along the cementodentinal interface
type of root surface # typically seen in single rooted teeth
may present itself as a periapical or periodontal lesion
cementodentinal junction
The region at which the dentine and cementum are united; commonly used to denote the point at which the cemental surface terminates at or near the apex of a tooth; position can range from 0.5 to 3.0 mm from the anatomic apex.
cementoenamel junction
the region at which the enamel and cementum meet in the cervical region of the tooth; cementum may overlap the enamel; cementum and enamel may meet abruptly, or a gap may exist.
central sensitisation
increased synaptic efficacy established in somatosensory neurons in the dorsal horn of the spinal cord following intense peripheral noxious stimuli, tissue injury or nerve damage. This heightened synaptic transmission leads to a reduction in pain threshold, an amplification of pain responses and a spread of pain sensitivity to non-injured areas.
chelation
removal of inorganic ions from tooth structure by a chemical agent ususally disodium salt of EDTA
sometime used in an attempt to enlarge narrow canals or remove the smear layer after canal prepartion
chlorohexidine
Bis-biguanide antiseptic agent used to prevent colonization of microbes and to kill or inhibit microorganisms on surfaces; known for its substantivity.
chronic apical abscess
Inflammatory reaction to pulpal infection and necrosis characterized by gradual onset, little or no discomfort and the intermittent discharge of pus through an associated sinus tract.
circumferential filing
peripheral planing of all root canal walls equally during preparation
condensing osteitis
diffuse radiopaque lesion representing a localised bony reaction to a low-grade inflammatory stimulus, usually seen at apex of a tooth
cone beam-computed tomography CBCT
3D radiographic image from a cone shaped beam for evaluating teeth and supporting structures
CBCT reference planes: AXIAL
plane parallel to the ground
which separates the head from the feet
CBCT reference planes: SAGITTAL
plane from front to back
which divides the body into right and left
CBCT reference planes: CORONAL
plane from side to side
which divides the body into front and back
core build up
restoration used to replace missing coronal tooth structure in a root-filled tooth
cracked tooth
thin surface disruption of enamel and dentine and possible cementum, of unknown depth or extension
crow-down preparation
technique of canal prep involving early flaring with rotary instruments followed by incremental removal of canal debris and dentine from the orifice to the apical foramen
curettage
surgical procedure to remove diseased or reactive tissue and/or foreign material around the root
cyclic fatigue
instrument failure due to repetitive stress caused by work hardening and metal fatigue
divided into 2 stages starting with crack initiation in which microcracks form and start to grow preferentially along specific crystallographic planes or grain boundaries followed by crack propagation continuing until final fracture. Also known as flexural fatigue.
cyst
epithelium-lined pathologic cavity that may contain fluid, semi-solid material or cellular debris.
Below are only a selection of cystic lesions and consideration should be made of other diagnostic entities.
Lateral periodontal cyst - small odontogenic cyst of the periodontal ligament found most often in the mandibular canine and premolar areas; associated with a vital pulp and postulated to originate from the rests of Malassez, the rests of the dental lamina or a supernumerary tooth bud.
Periapical pocket cyst (bay cyst) - apical inflammatory cyst containing a sac-like, epithelium-lined cavity that is open to and continuous with the root canal.
Periradicular cyst (apical cyst, periapical cyst, radicular cyst) - an odontogenic cyst associated with a tooth with a necrotic pulp that develops within a periradicular inflammatory lesion; derives its epithelium from the cell rests of Malassez.
True cyst - apical inflammatory cyst with a distinct pathologic cavity; completely enclosed in an epithelial lining so that no communication to the root canal exists.
dens invaginatus (dens in dente)
Developmental defect resulting from infolding of the crown before calcification has occurred; may appear clinically as an accentuation of the lingual pit in anterior teeth; in its more severe form, gives a radiographic appearance of a tooth within a tooth, hence the term “dens in dente”; most common in the maxillary lateral incisors but may occur in any tooth of the dental arch.
dental dam
Latex or non-latex sheet used to isolate a tooth or teeth from the oral environment and to prevent migration of fluids or foreign objects into or out of the operative field; single or multiple holes punched through barrier allow placement around the tooth or allow teeth to be isolated; provides a dry, visible and clean operative field
dental dam clamp
metal device that is placed around a tooth at the level of the gingiva to secure a dental dam in position
available in varying configurations to fit different teeth
dental dam forceps
instrument used to spread a dental dam clamp allowing it to be placed around or removed from a tooth
dental dam frame
metal device used to stretch dental dam, hold it and secure its edge away from operative site
dental dam punch
device used to punch holes in dental dam
dental granuloma
Histologic term used to describe tissue formed adjacent to the apex of a tooth with pulp pathosis; characterized by chronic inflammatory cells such as macrophages, plasma cells and lymphocytes and sometimes a cluster of multinucleated giant cells; capillaries, fibroblasts and collagen fibers also present
dentinal fluid
Intratubular and extracellular fluid that is thought to be an ultrafiltrate of blood from the terminal pulpal capillaries. It diffuses through the space around the odontoblastic process and possibly through the intracellular structure of the odontoblast itself prior to entering the dentinal tubule and continuing a slow outward movement under a pressure gradient and eventually leaving the tooth through dentinal tubules
dentine
mineralized tissue that forms the bulk of the crown and root of the tooth, giving the root its characteristic form; surrounds coronal and radicular pulp, forming the walls of the pulp chamber and root canals;
composition is approximately 67% inorganic, 20% organic and 13% water
primary dentine
dentine formed during tooth development; exhibits well-organized pattern of tubules and cell processes.
secondary dentine
circumpulpal dentine formed by normal pulp function after tooth formation is complete; tubular pattern is regular, but number of tubules is less than that found in primary dentin; secondary dentin is separated from primary dentine histologically by a hyperchromatic line or demarcation zone.
tertiary dentine
dentine formed by external influences, including caries and attrition, and can range from regular tubular dentine that differs little from primary and secondary dentine (reactionary dentin), but can be very dysplastic and/or irregular, and atubular when there is odontoblast loss depending on the differentiation status of the formative cell.
reactionary dentine
tertiary dentine matrix secreted by surviving odontoblast cells in response to an appropriate stimulus.
reparative dentine
tertiary dentine matrix secreted by odontoblast-like cells in response to an appropriate stimulus after the death of odontoblasts; stimuli tend to be much stronger than those causing reactionary dentine formation.
sclerotic dentine
dentine characterised by calcification of the dentinal tubules as a result of injury or normal aging; it appears translucent in ground sections due to the difference in refractive indices of calcified dentinal tubules and adjacent normal tubules when examined by transmitted light.
dentine blush
red to pink discoloration of denitne due to pulpal haemorrhage, usually result of trauma or operative procedures
dentine bridge
Tertiary (reparative) dentine formation that provides closure of a previously exposed pulp or forms across the excised surface of a pulp after pulpotomy; can be irregular in structure, contains tunnel defects and is less calcified than secondary dentine; may be facilitated by chemical agents such as calcium hydroxide, mineral trioxide aggregate (MTA), or other bioceramic materials.
desensitise
eliminate or reduce painful dentinal response to irritating agents
diagnosis
science of detecting and distinguishing deviations from health and the cause and nature thereof
differential diagnosis
Process of identifying a condition by comparing the symptoms of all pathologic processes that may produce similar signs and symptoms
dilaceration
Deformity characterised by displacement of the root of a tooth from its normal alignment with the crown; may be a consequence of injury during tooth development. Common usage has extended the term to include sharply angular or deformed roots.
disinfection
Non-specific term implying the destruction of pathogenic microorganisms, but not necessarily of spores; usually by chemical agents.
down packing
Compaction of incremental segments of heat-softened gutta-percha to create an apical plug.
dysesthesia
Unpleasant abnormal sensation, whether spontaneous or evoked. Special cases of dysesthesia include hyperalgesia and allodynia. A dysesthesia should always be unpleasant and a paresthesia should not be unpleasant.
EDTA (ethylenediaminetetraacetic acid)
Odorless, white, crystalline solid whose various salts are soluble in water; disodium salt of ethylenediaminetetraacetic acid in a buffered aqueous solution is used as a chelating agent in root canal preparation; used to remove calcium, demineralize and soften dentine, and remove the smear layer.
elastic limit
point at which internal structure changes to prevent return to original form
elasticity
quality that allows a structure or material to return to its original form upon removal of an extreme force
elbow
narrow portion of a curved canal immediately coronal to a transportation or zip
endodontic/periodontal lesion
Process involving interaction of diseases of the pulp and periodontium.
endodontics
branch of dentistry 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 the biology of the normal pulp and the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.
endodontology
study of endo
enucleation
Removal of tissue lesion in its entirety; in endodontics, the term usually refers to the surgical removal of periradicular lesions.
envelope flap
Horizontal intrasulcular surgical flap with no vertical releasing incisions.
ethyl chloride
colourless, extremely volatile, flammamble liquid used in endo to apply cold as a pulp test
external bleaching
The use of a chemical agent on the outside of a tooth to remove discoloration from tooth structures; most frequently used agent is carbamide peroxide.
extrusion
Term used to describe when irrigants, gutta percha or endodontic sealers exit the apical foramen and contact the periodontal tissues.
fatigue
transitional weakening of a material due to cyclic loading and unloading characterised by frature below its ultimate tensile strength
fenestration
A window-like opening or defect in the alveolar plate of bone frequently exposing a portion of the root; usually located on the facial aspect of the alveolar process.
ferrule
band/ring of tooth structure surrounding the crown or root of a tooth to provide strength for the restorative material
file
tapered and pointed metal instrument with cutting edges used to enlarge the root canal by rotation or filing action; classified principally on activation method, alloy, cross-sectional shapes, taper, tip design and length of cutting flutes.
filing
Dynamic movement of a hand file to optimally effect canal debridement; predominantly a push- pull (rasping), rotational (reaming) movement or a combination of the two. Engine-driven filing motions can be rotary, reciprocating or oscillating.
surgical flap
Section of tissue, such as gingival mucosa, that has been partially detached from the underlying tissue but retains uninterrupted blood supply through an intact base; classified:
by position - apically positioned, lateral or vertical sliding;
by geometric shape - curved (semilunar), rectangular, scalloped, trapezoidal or triangular; or
by location of the incision - intrasulcular, submarginal or vertical.
flare-up
acute exacerbation of an asymptomatic pulpal and/or periradicular pathosis after the initiation or continuation of root canal treatment
fluctuant
Tactile sensation of fluid motion noted during palpation of a mass or swelling such as an abscess.
foramen
Openings in the root structure that communicate with the dental pulp and generally contain neural, vascular and connective elements..
Accessory foramen - orifice on the surface of a root communicating with a lateral or accessory canal.
Apical foramen - main apical opening of the root canal. Can be between 0 -3 mm from the radiographic apex
fracture
Split or break in tooth structure. A disruption of the enamel and/or dentine and/or cementum that is assumed to be of greater depth than a crack, of unknown depth or extension, visible or not visible clinically or radiographically, and with separated or unseparated segments.
Vertical root fracture - fracture in the root whereby the fractured segments are incompletely separated; it may occur buccal-lingually or mesial-distally; it may cause an isolated periodontal defect(s) or sinus tract; it may be radiographically evident.
Horizontal root fracture (oblique root fracture) - fracture due to traumatic injury confined to the root in a transverse plane separating the root into coronal and apical segments, with the fracture being confined either partially or completely within bone. The fracture can be buccal-lingually or obliquely oriented.
fremitus
palpable movement of a tooth when subject to occlusal forces
front surface mirror
mirror with reflective surface above backing reduces image distortion
full mucoperiosteal flap
Flap involving an intrasulcular horizontal incision and including epithelium, attached gingiva, alveolar mucosa and periosteum; triangular and rectangular flaps are examples.
furcation
anatomic area of a multi-rootes tooth where the roots diverge
furcation canal
accessory canal located in the furcation
gates-glidden drill
rotary, power-driven, flame-shaped bur with spiral inclined cutting edges mounted on a slender non cutting shaft and tipped with a guiding pilot point
gow gates mandibular nerve block
technique to administer local anaesthetic to the mandibular branch of the trigeminal nerve before it branches into the inferior alveolar nerve. The technique utilises extra-oral landmarks whereby the needle is directed at a higher puncture point, aiming for the vicinity of the mandibular condyle.
guided endodontic access
Utilization of cone beam computed tomography, specialized software and a digital impression 3-D scan to virtually plan the canal access preparation and produce a 3D-printed guide/template. This provides minimally invasive endodontic access preparations especially in calcified cases.
guided endodontic surgery
Utilization of cone beam computed tomography, specialized software and a digital impression 3-D scan to virtually plan endodontic surgeries and produce 3D-printed guides/templates to aid in endodontic (root end) surgical procedures
gutta percha
High molecular weight stereo-isomers of polyisoprene. Gutta-percha, 1-4 trans-polyisoprene, exists with its -CH2 groups on opposite sides of the double bond. Gutta-percha exists in two crystalline forms, the naturally occurring alpha form and the beta form found in most commercial formulations.
Dental gutta-percha points are reported to contain approximately 19–22% gutta-percha, 1–4% plasticizing waxes and resins, 59–75% zinc oxide, 1–17% metal sulphates for radiopacity and trace amounts of organic dyes for coloration. Since the late 1950s, material compounded for “gutta-percha” points has been made from balata, a nearly identical latex derived from the Mimusops Globsa tree of South America.
GP cone
pliable, radiopaque cone available in various sizes used to obturate root canals in conjunction with sealers.
H-type file (hedstrom)
file with spiral edges arranged as a buttress threaded screw so that cutting occurs only on a pulling stroke
hardness
mechanical property of resistance to surface indentation
heat test
Use of hot gutta-percha, hot water, a rotating rubber cup or commercial heating device to identify and reproduce a chief complaint of pain to heat upon application
hemisection (bicuspidsation)
Surgical separation of a multi-rooted tooth, usually a mandibular molar, through the furcation in such a way that a root and the associated portion of the crown may be removed or retained.
horn pulp
extension of pulp tissue into occlusal or incisal projection following cusp tips or developmental lobes
hydroynamic theory
A hypothesis that maintains that the inward or outward movement of fluid through the dentinal tubules activates sensory nerve fibers in the dentine or the pulp to produce pain; fluid movement can be in response to dehydration, osmotic changes, mechanical probing or thermal changes.
hyperaemia
increased volume of blood within dilated vessels in an organ/tissue
hyeralgesia
inc pain sensation or lower pain threshold that accompany an inflammatory reaction
hyperplastic pulpitis, chronic pulp polyp
form of chronic pulpal inflammation usually followingcarious or traumatic exposure;
characterised by proliferation of dental pulp tissue from the exposed pulp chamber, filling the cavity with pedunculated or sessile pinkish/red, fleshy mass; usually covered with epithelium
dentinal hypersensitivty
Short, exaggerated, sharp painful response elicited when exposed dentine is subjected to thermal, mechanical or chemical stimuli.
hypchlorite accident
Extrusion of sodium hypochlorite into the periradicular area during root canal irrigation, causing severe pain, swelling, ecchymosis and potential paraesthesia.
incision and drainage
Surgical opening created in soft tissue for the purpose of releasing purulent exudate.
informed consent
agreement by the pt to have tx rendered by the provider after the risk of tx, result of no tx, alternatives to tx and prognosis have been explained
infraction (craze line)
crack of enamel without loss of tooth structure
intrapulpal injection
Technique in which the anaesthetic solution is injected directly into the pulp under pressure.
periodontal ligament injection (intraligamentary, ligamentary, PDL) injection
Injection of local anaesthetic through the gingival sulcus into the periodontal ligament. The anaesthetic solution is actually forced into the alveolar bone and therefore the PDL injection is in essence an intra-osseous injection
instrumentation
cleaning and shaping of the root canal space using hand or engine driven instruments
internal bleaching
use of chemical oxidising agents, within the coronal portion of an endodontically treated tooth to remove tooth discolouration
intracanal medicament
chemical agent sealed within the root canal system; used between appointments as an anodyne and/or antimicrobial agent
irrigants
liquids used for intracanal irrigation e.g. sodium hypochlorite, EDTA
irrigation
Washing by a stream of fluid; intracanal irrigation facilitates physical removal of materials from the canal and introduction of chemicals for antimicrobial activity, demineralization, tissue dissolution, bleaching, deodorizing and hemorrhage control.
Active irrigation - use of mechanical or manual agitation to enhance physical and chemical debridement of canal contents.
Passive irrigation - gentle flushing of the canal to enhance chemical debridement, without application of energy.
Manual Dynamic Irrigation - simple, cost-effective technique to agitate irrigants inside the root canal system. A 2 mm in-and-out movement inside the irrigating solution is used with the master cone grasped 1 mm set back from the working length.
ISO (international standards organisation)
International non-governmental organization whose objective is the development of international standards; a committee, TC106-Dentistry, is responsible for the standardization of terminology, test methods and specifications for dental materials, instruments, appliances and equipment
isthmus
thin communication between 2 or more canals in the same root or between vascular elements in tissues
k-type file
file with tightly spiralled cutting edges that cut when pushed pulled or rotated; cross sectional configurations include diamond, square and triangular
lateral canal
accessory canal located in the coronal or middle third of the root, usually extending horizontally from the main canal space
ledge
deviation from the normal course of the root canal. which may make it difficult or impossible to reach the corrected working length
lingual (palatal) groove defect
A developmental groove occasionally present on the palatal surface of maxillary incisors; may be deep enough to communicate with the pulp, causing pulp necrosis due to the invasion of bacteria; may contribute to isolated periodontal defects due to loss of attachment in the area.
Ludwig’s angina
Severe, life-threatening infection, usually of odontogenic origin; arises if there is bilateral involvement of the submental, sublingual and submandibular spaces; is characterized by painful swelling of the floor of the mouth, tongue elevation, dysphagia, dysphonia and (at times) compromises the airway.
major apical diameter
area of the apical foramen where the walls are the farthest apart; usually located in the cementum
martensitic phase
Crystalline form of metal. In nickel titanium alloy, this more flexible form occurs as the result of thermal changes or the application of stress.
master apical file
largest file used to corrected working length of completely prep root canal
master point (master cone)
Largest gutta-percha point that can be placed either to full working length or to within a short distance of working length (usually 0.5 mm or less), of the completely prepared root canal prior to obturation by either lateral or vertical compaction.
medicament
agent used for medicinal value; commonly refers to intra-canal, inter-appointment agents used for pallative or antimicrobial purposes
mineral trioxide aggregates (MTA)
cement like material used as a root end filling material, for perforation repair and pulp capping and as a root end barrier in teeth with open apex
modified double flare technique
means of canal prep based upon initial coronal flaring using gates-glidden drills followed by working length determination and apical prep using step-back technique utilising K files
modulus of elasticity (Young’s modulus)
Measure of stiffness of an object, defined as the amount of strain resulting from applying a given stress.
negative pressure irrigation
Technique that uses a narrow vacuum tip placed apically into the canal to draw irrigant into the canal system.
nickel-titanium
Alloy of nickel and titanium, also known as “NiTi” or “nitinol,” with unique properties of flexibility and shape memory.
NiTi file
hand or rotary file manufactured with superelastic nickel-titanium alloy that is available in a variety of different designs.
non standardised instrument
Endodontic reamer, file or finger spreader that does not correspond to the appropriate ANSI/ADA or ISO/FDI specifications.
non standardised point/cone
Gutta-percha or paper point that does not conform to size and taper of standardized endodontic instruments; more tapered than standardized points, with fine apical diameters gradually increasing to larger coronal diameters than standardized points.
normal apical tissues
Teeth with normal periradicular tissues that are not sensitive to percussion or palpation testing. The lamina dura surrounding the root is intact, and the periodontal ligament space in uniform.
normal pulp
Clinical diagnostic category in which the pulp is symptom-free and normally responsive to pulp testing.
obturate
to fill the shaped and debrided canal space with temporary or permanent filling material
obturation technique
Method used to fill and seal a cleaned and shaped root canal using a root canal sealer and core filling material.
Carrier-based obturation - sealer is placed in the canal followed by a core carrier of metal, plastic or gutta-percha, which is coated with gutta- percha or other materials; the carrier device is heated prior to placement.
Continuous wave compaction technique - variation of warm vertical compaction in which a master point is placed in a sealer-lined canal and compacted by a prefitted, tip-heated electrical plugger. The softened point is vertically compacted, the plugger withdrawn and canal backfilled with thermoplasticized material.
Single cone technique – sealer is placed into the canal, and the master gutta-percha cone is used to agitate and move sealer apically and laterally within the canal. The master cone is seared at the level of the pulpal floor with compaction only to adapt gutta-percha to the orifice (not apically).
Lateral compaction — Sealer is placed in the canal followed by a fitted gutta-percha (or other material) master point compacted apically and laterally by a tapering spreader to make room for additional points. Silver point technique - sealer is placed in the canal followed by a fitted silver point. Historical.
Warm vertical compaction - sealer is placed in the canal followed by a fitted master cone, which is warmed and compacted vertically by a plugger to make room for additional warmed segments of filling.
odontalgia
pain originating from a tooth
odontogenic sinusitis
Sinusitis of dental aetiology. The pathological extension of any dental infection into the maxillary sinus causing symptomatic inflammation of the mucosal tissues of the maxillary sinus and potential involvement of other paranasal sinuses and nasal cavity. Symptoms from odontogenic sinusitis may include congestion, rhinorrhea, retro-rhinorrhea, facial pain, and/or foul odour.
orifice
opening leading from the pulp chamber into a root canal
orifice barrier
material placed to provide coronal seal to prevent re-contamination of the canal system e.g. RMGI
orifice barrier does not take the place of the final restoration
orifice opener (shaper)
A variety of hand- or power-driven instruments used to widen the canal orifice for easier introduction of cleaning and shaping instruments.
orthograde RCT
conventional approach through the crown of a tooth to access the root canal
osteoinduction
In bone regeneration procedures, material actively stimulates new bone formation
osteotomy
Surgical procedure involving the removal of bone, typically used to access the root-end.
outcomes
Root canal treatment should be assessed at least after one year and subsequently as required. Outcome will vary according to how strictly it is determined. Based upon the European Society of Endodontology quality guidelines:
Favourable - absence of pain, swelling and other symptoms, no sinus tract, no loss of function and radiological evidence of a normal periodontal ligament space around the root.
Uncertain - radiographs reveal that a lesion has remained the same size or has only diminished in size.
Unfavourable outcome - Tooth has associated signs and symptoms consistent with infection. Radiologic lesion has appeared subsequent to treatment, a pre-existing lesion has increased in size or a lesion has remained the same size or has only diminished in size during the 4-year assessment period. If root resorption is present this has continued. In these situations it is advised that the tooth requires further treatment. Healing by scar tissue formation – an extensive radiological lesion may heal but leave a locally visible, irregularly mineralized area. This defect may be scar tissue formation rather than a sign of persisting apical periodontitis. The tooth should continue to be assessed
Healing - teeth with a periradicular radiolucency, which are asymptomatic and functional, or teeth with or without radiographic periradicular radiolucency, which are symptomatic but whose intended function is not altered.
Functional - a treated tooth or root that is serving its intended purpose in the dentition.
over extension
A solid or semi-solid core root canal filling extending beyond the apical foramen, often the result of failure to create an apical stop during instrumentation.
over instrumentation
A solid or semi-solid core root canal filling extending beyond the apical foramen, often the result of failure to create an apical stop during instrumentation.
functional outcome
a treated tooth or root that is serving its intended purpose in the dentition.
healing outcome
teeth with a periradicular radiolucency, which are asymptomatic and functional, or teeth with or without radiographic periradicular radiolucency, which are symptomatic but whose intended function is not altered.
unfavourable outcome
tooth has associated signs and symptoms consistent with infection. Radiologic lesion has appeared subsequent to treatment, a pre-existing lesion has increased in size or a lesion has remained the same size or has only diminished in size during the 4-year assessment period. If root resorption is present this has continued. In these situations it is advised that the tooth requires further treatment. Healing by scar tissue formation – an extensive radiological lesion may heal but leave a locally visible, irregularly mineralized area. This defect may be scar tissue formation rather than a sign of persisting apical periodontitis. The tooth should continue to be assessed
favourable outcome
absence of pain, swelling and other symptoms, no sinus tract, no loss of function and radiological evidence of a normal periodontal ligament space around the root.
uncertain outcome
radiographs reveal that a lesion has remained the same size or has only diminished in size.
pain
multifactorial noxious experience that involves not only the sensory response but also modification by cognitive, emotional and motivational influences related to past experience.
paper point (cone)
A tapered cylinder of paper used to dry root canals.
palpation
use of the sense of touch to examine tissue for diagnostic reasons, such as to determine texture, rigidity and tenderness
paresthesia
Sensation such as burning, prickling or partial numbness caused by neural injury; sometimes follows acute traumatic injuries or infection to the teeth and jaws, root-end resection or overfilling of the root canal with impingement upon a nerve.
partial pulpotomy (Cvek pulpotomy)
Removal of a small portion of the vital coronal pulp as a means of preserving the remaining coronal and radicular pulp tissues.
parulis
nodule at the site where a draining sinus tract reaches the surface
patency filing
Maintaining the communication between the root canal and the peri radicular tissues, by passing a small file (8,10 K file) carefully, just beyond the apical constriction.
pathfinder
small diameter instrument used to intially negotiate canal
percussion
diagnostic procedure used to assess a tooth by means of tapping painful response may indicate periradicular inflammation; variations in sound may indicate changes in attachment such as ankylosis.
perforation
Mechanical or pathologic communication between the root canal system and the external tooth surface.
Apical perforation – perforation in the apical one-third of the root.
Furcation perforation –perforation in the furcal area of the tooth.
Strip perforation - complete penetration of a root canal wall due to excessive lateral tooth structure removal during canal preparation; usually occurs in curved roots or roots with surface invaginations.
periapex
anatomic site situated at and around the apical portion of a root
periapical index
scoring system for registration of apical periodontitis in radiographs
periodontitis
inflammation of periodontitium
peripheral sensitisation
Sensitisation from a primary hyperalgesia where the presence of allogenic substances cause a lowered pain threshold. This lowering of pain thresholds is related to a lowering of the stimulus needed to excite an action potential.
peridontium
The tissues that surround and support teeth, attaching them to the alveolar bone; includes bone, connective tissue, vascular and neuronal elements.
periradicular surgery
Surgical procedure normally incorporating raising a flap, bone removal and root end resection, retrograde root filling, hemi section or root resection
phantom tooth pain
Regional pain that continues in an area after tooth extraction, similar to phantom limb pain; pathophysiology includes deafferentation, nerve sprouting, neuroma formation and sympathetic efferent activity.
plugger
smooth flat ended and slightly tapered metal instrument designed to compact materials vertically within a prepared root canal
post
custom or preformed rod that is fitted and cemented into the root canal of an endodontically tx tooth for core retention
canal preparation
Procedures involved in cleaning and shaping the canal system prior to obturation.
Biomechanical preparation - use of rotary/reciprocating and/or hand instruments to expose, clean, enlarge and shape the pulp canal space, usually in conjunction with irrigants.
Chemomechanical preparation - use of chemicals for irrigation of the root canal, demineralization of dentine, dissolution of pulp tissue and neutralization of bacterial products and toxins; used in conjunction with biomechanical preparation
previously initiated therapy
Clinical diagnostic category indicating that the tooth has been previously treated by partial endodontic therapy (eg, pulpotomy, pulpectomy).
previously treated
Clinical diagnostic category indicating that the tooth has been endodontically treated and the canals are obturated with various filling materials other than intracanal medicaments.
prognosis
The prospect of recovery as anticipated from the usual course of disease or peculiarities of the case. In endodontics this can be classified as unfavourable, questionable or favourable. Alternatively can be expressed in percentage terms.
pulp abscess
localised collection of clinically visible pus within the pulp of the tooth
pulp canal obliteration PCO
radiographic evidence of increased dentine production primarily in response to trauma. The end result of this process is a calcified canal and is not necessarily indicative of a diseased pulp.
pulp chamber
portion of the pulp space within the anatomic crown of teh tooth
pulp cap
treatment of an exposed vital pulp by sealing the pulpal wound with a dental material such as calcium hydroxide or mineral trioxide aggregate to facilitate the formation of reparative dentine and maintenance of a vital pulp.
Direct pulp cap - a dental material placed directly on a mechanical or traumatic vital pulp exposure.
Indirect pulp cap - a material is placed on a thin partition of remaining carious dentine that, if removed, might expose the pulp in immature permanent teeth.
pulp exposure
Opening in dentine that uncovers pulp. Carious pulp exposure - pulp exposure resulting from the progressive destruction of tooth structure by acids and proteolytic enzymes elaborated through microbial activity; underlying pulp is inflamed to a varying and unknown extent, due to the progression of dental caries.
Mechanical pulp exposure - accidental exposure of the pulp by hand- or engine-driven dental instruments in the absence of dental caries; if aseptic conditions are maintained, the underlying pulp is usually not inflamed.
Traumatic pulp exposure - pulp exposure due to a fracture of the tooth.
pulp necrosis
clinical diagnostic category indicating death of the dental pulp
pulp is usually non responsive to pulp testing
pulp regeneration
ability to recreate lost or damaged pulp tissue
pulp space
cavity within the tooth that houses the dental pulp system
pulp stone
calcified mass occurring within the pulp or attached to the pulp space walls
pulp sensibility test
A diagnostic procedure to determine pulpal status; can be performed with electrical, mechanical or thermal methodologies to assess the pulp’s response to the stimulus.
Electric pulp test (EPT) - pulp test that utilises an electrical current to stimulate sensory nerves of the dental pulp.
Thermal pulp test - pulp test using a hot or cold stimulus to induce dentinal tubule fluid movement and resultant stimulation of sensory receptor elements within the pulp.
Cold test - usually conducted with a cotton pellet sprayed with 1,1,1,2 tetrafluoroethane.
Heat test - usually conducted with hot liquid.
Test cavity - diagnostic procedure in which a small cavity is prepared without anaesthesia into the dentine to test for pulpal responsiveness.
pulp vitality test
Diagnostic procedure to determine pulpal status by the assessment of blood supply to the tooth.
Laser Doppler flowmetry - pulp test that assesses pulpal blood flow by the detection of light scatter generated by moving erythrocytes; effective in young traumatized pulps and large pulps that do not respond dependably to other forms of sensibility testing.
Pulse oximetry - pulp test to assess vascular integrity by measuring the oxygenation of blood.
pulp
Richly vascularized and innervated specialized connective tissue of ectomesenchymal origin; contained in the central space of a tooth, surrounded by the dentine, with inductive, formative, nutritive, sensory and protective functions.
pulp extomy/extirpation
complete removal of the vital dental pulp
pulpitis
Clinical and histologic term denoting inflammation of the dental pulp; clinically described as reversible or irreversible and histologically described as acute, chronic or hyperplastic.
Asymptomatic irreversible pulpitis - clinical diagnosis based on subjective and objective findings indicating that the vital inflamed pulp is incapable of healing. Additional descriptors: no clinical symptoms but inflammation produced by caries, caries excavation, trauma.
Reversible pulpitis - clinical diagnosis based on subjective and objective findings indicating that the inflammation should resolve and the pulp return to normal.
Symptomatic irreversible pulpitis - clinical diagnosis based on subjective and objective findings indicating that the vital inflamed pulp is incapable of healing. Additional descriptors: lingering thermal pain, spontaneous pain, referred pain.
pulpotomy
Removal of the coronal portion of a vital pulp as a means of preserving the vitality of the remaining radicular portion; may be performed as emergency procedure for temporary relief of symptoms or therapeutic measure, as in the instance of a Cvek pulpotomy (trauma).
radial land
peripheral portion of a rotary instrument that is flat and smooth designed to centre the instrument in the canal space
radicular
pertaining to the root of the tooth
radiograph
image produced by the action of x-rays. Working length radiograph - periapical radiograph taken during a root treatment procedure to determine the correct working length. Usually taken with at least a size 15 K file in situ at the estimated working length Cone fit radiograph - periapical radiograph taken during a root treatment procedure to determine the correct working length has been achieved and that preparation of the canal system is adequate. Taken with a GP cone ( a number of GP cones) in situ.
radiographic apex
Tip of the root as determined radiographically; its location can vary from the anatomic apex due to root morphology and distortion of the radiographic image
radiolucency
Area of darkness on a radiograph indicating that an object of low density is allowing complete or partial penetration by x-rays
radiopacity
Area of lightness on a radiograph indicating that the density of an object is preventing penetration by x-rays.
radix entomolares
supernumerary root on a mandibular molar, located distolingually
radix paramolares
supernumerary root on a mandibular molar, located mesiobucally
reamer
tapered metal instrument with spiral cutting edges used to enlarge root canals by rotary action; differs from a file primarily in having fewer spirals or twists (flutes) per unit length of cutting blade; is not effective in a push-pull motion.
reanubf
typically a continuous clockwise rotation of a reamer for canal debridement
recapitulation
A file working motion consisting of a counter-clockwise (cutting direction) and a clockwise motion (release of the instrument) whereby the angle of the counter-clockwise direction is greater than the angle of the reverse direction.
rectangular flap
intrasulcular incision with 2 vertical releasing incisions
referred pain
Pain that is interpreted to originate in a part of the body other than the actual site of origin.
regenerative endodontics
Biologically-based procedures designed to physiologically replace damaged tooth structures, including dentine and root structures, as well as cells of the pulp-dentine complex.
tooth replantation
Return of a tooth to its alveolus. Intentional replantation - insertion of a tooth into its alveolus after the tooth has been extracted for the purpose of performing treatment, such as root-end filling(s) or perforation repair.
resorption
Condition associated with either a physiologic or a pathologic process resulting in a loss of dentine, cementum and/or bone.
Cervical resorption External resorption Inflammatory resorption Internal resorption Replacement resorption (ankylosis) Transient apical breakdown
transient apical breakdown
response to tooth luxation consisting of radiographic apical bone and root resorption that resolves spontaneously without intervening treatment.
replacement resorption (ankylosis)
pathologic loss of cementum, dentine and periodontal ligament with subsequent replacement of such structures by bone, resulting in fusion of bone and tooth.
internal resorption
inflammatory process initiated within the pulp space with loss of dentine and possible invasion of the cementum.
inflammatory resorption
internal or external pathologic loss of tooth structure and possibly bone, resulting in a defect; occurs as the result of microbial infection; characterized radiographically by radiolucent areas along the root.
external resorption
resorption initiated in the periodontium and initially affecting the external surfaces of a tooth; may be further classified as surface, inflammatory or replacement, or by location as cervical, lateral or apical; may or may not invade the dental pulp space.
cervical resorption
type of external resorption that occurs in the coronal third of the root.
retreatment
Procedure to remove root canal filling materials from the tooth, followed by cleaning, shaping and obturating the canals.
retrograde root filling
placement of restorative material into resected root end, during a periradicular surgery procedure
revascularisation
restoration of blood supply
root canal debridement
elimination of organic and inorganic material as well as microorganisms from the root canal by mechanical and/or chemical means
root amputation
Surgical removal of all of the root and adherent soft tissues leaving the crown of the tooth intact and supported by remaining root(s).
root canal filling
Any material or combination of materials placed inside a root canal for the purpose of obturating and sealing the canal spac
root canal system
space containing the dental pup inside the crown and root of a tooth
root canal filling retoration
restorative material placed in the root-end preparation during periradicular surgery or intentional replantation; designed to enhance the seal of the root canal where orthograde obturation has been less than optimal.
root end preparation
Cavity created to receive a root-end filling during periradicular surgery or intentional replantation; may be accomplished using rotary or ultrasonic instrumentation.
root end resection
Surgical removal of the apical portion of a root and adherent soft tissues; may be performed in advance of root-end preparation for a root-end filling or as a definitive treatment.
root canal sealer
Radiopaque dental cement used, usually in combination with a solid or semi-solid core material, to fill voids and to seal root canals during obturation; included are bioceramics, resins, calcium hydroxide, zinc oxide-eugenol, glass ionomer and others.
selective caries removal
Excavation of peripheral carious tissues in teeth with vital, asymptomatic pulps. Carious tissues in close proximity to the pulp are left in place, and a restoration is placed.
senstisation
heightened sense of preception to noxious stimulation
sinus tract
Pathway from an enclosed area of infection to an epithelial surface; opening or stoma may be intraoral or extraoral and represents an orifice through which pressure is discharged; usually disappears spontaneously with elimination of the causative factor by endodontic treatment.
smear layer
Surface film of debris retained on dentine and other surfaces after instrumentation with either rotary instruments or endodontic files; consists of dentine particles, remnants of vital or necrotic pulp tissue, bacterial components and retained irrigant.
sodium hypochlorite solution (NaOCl)
Clear, pale, greenish-yellow, strongly alkaline liquid with a strong chlorine odour; has a solvent action on organic tissue and is a potent antimicrobial agent; used for irrigating root canals either in full strength or diluted solutions
sonic instumentation
Preparation of the root canal system with a transversely oscillating file at a frequency within the audible range of perception vibration created by means of compressed air activating a rotor-shaft assembly in a handpiece
spreader
smooth, pointed, slightly-tapered metal instrument designed to compact materials within a prepared root canal; available in a variety of designs that include hand held, finger held or rotary driven.
standardised instrument
Endodontic instrument that conforms to the applicable ANSI/ADA or ISO/FDI specifications, for diameter, length, taper, torsional properties, tip design, and other related factors.
standardised point/cone
Gutta-percha, silver or paper point manufactured to conform to the size and taper of a standardised endodontic instrument.
step back technique
Method of canal preparation using smaller, more flexible files in the apical one-third, followed by files sequentially larger than the master apical file at incremental lengths of 0.5 to 1 mm short of working length. eg size 30 file to CWL of 21mm, then size 35 to 20 mm, size 40 to 19 mm and so on until the coronal flare is met.
submarginal flap
Flap with the horizontal incision in attached gingiva; may have two vertical releasing incisions; generally rectangular or trapezoidal in shape; indicated when crowns are present on anterior teeth and an adequate zone of healthy attached gingiva is present.
substantivity
Binding of disinfectant to dentine and soft tissues with prolonged release. Chlorhexidine possesses this characteristic.
surgical repair of root resorption
the treatment of resorptive defects, which may include exposure of the affected resorptive area, debridement of the area affected by the resorption, and placement of a biological and esthetic restoration on the root surface. Does not include placement of a permanent restoration.
symptomatic apical periodontitis
Inflammation usually of the apical periodontium, producing clinical symptoms including a painful response to biting and/or percussion or palpation. It might or might not be associated with an apical radiolucent area.
taurodontism
Dental morphologic variation in which the body of the tooth is enlarged, and the roots are reduced in size; results in taurodont teeth with large pulp chambers and apically positioned furcations.
torque
force that produces or tends to produce twisting or rotation within a structure such as a rotary file
torsional fatigue
The passage of a beam of light through a tooth or other tissue for diagnostic purposes especially in defining fractures. Also used to help locate canal orifices
transillumination
The passage of a beam of light through a tooth or other tissue for diagnostic purposes especially in defining fractures. Also used to help locate canal orifice
transportation
removal of canal wall structure on the outside curve of the apical half of the canal due to the tendency of files to restore themselves to their original linear shape during canal prep; may leads to ledge formation and possible perforations
triangular flap
intrasulcular incision with one vertical releasing incision
triple antibiotic paste
combination of 3 antibiotics (metronidazole, monocylcine and ciprofloxacin) used to disinfect canals typically for regenerative endo
tugback
slight frictional resistance of a master point to withdrawal when seated indicates a relative degree of adaptation , at least 2 dimensions
ultrasonic instrumentation
Preparation of the root canal system with a transversely oscillating diamond or file at a frequency above the audible range of perception (18,000 to 40,000 Hz); instruments activated by electrical current passing through arrangement of lamellar metal plates, creating alternating attractive and repulsive forces transformed into mechanical vibratory movement.
underfilling
incomplete obturation of the root canal space with resultant voids
vital pulp therapy
tx aimed at preserving and maintaining pulp tissue that has been compromised by trauma, caries, or restorative procedures in a healthy state
walking bleach
a form of internal bleaching in which oxidising agents are sealed into the pulp chamber for a limited period of time, usually a few days
watch winding
Backward and forward oscillatory motion (30 then 60 degrees)of a small hand instrument whilst applying a light apical pressure. Used for passing small instruments through canals in the early phases of instrumentation of the canal.
working length
Distance from a coronal reference point to the point at which canal preparation and obturation should terminate.
Estimated working length - the estimated length of the root canal from a fixed coronal reference point to the radiographic apex minus 1 mm.
Corrected working length - actual length (or apical limit to which preparation is confined) to which the root canal is prepared to, after confirmation with a working length radiograph or use of an electronic apex locator.
zinc oxide ZnO
Fine, odorless, amorphous, white or yellowish powder used in combination with eugenol in various sealers and temporary cements; the principal component by weight in gutta-percha
zip
Tear-drop shape that may be formed in the apical foramen during preparation of a curved canal when a file extends through the apical foramen and subsequently transports that outer wall; a procedural error that complicates cleaning and obturation.
