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Essential Endodontology : Prevention and Treatment of Apical Periodontitis.

By: Material type: TextTextPublisher: Newark : John Wiley & Sons, Incorporated, 2020Copyright date: ©2020Edition: 3rd edDescription: 1 online resource (410 pages)Content type:
  • text
Media type:
  • computer
Carrier type:
  • online resource
ISBN:
  • 9781119271970
Subject(s): Genre/Form: Additional physical formats: Print version:: Essential EndodontologyDDC classification:
  • 617.6/32
LOC classification:
  • RK351 .E874 2020
Online resources:
Contents:
Cover -- Title Page -- Copyright Page -- Contents -- Foreword -- List of Contributors -- About the Companion Website -- Chapter 1 Apical Periodontitis: Microbial Infection and Host Responses -- 1.1 Introduction -- 1.2 Terminology -- 1.3 Pulp Infection and Periapical Inflammation -- 1.4 Biological and Clinical Significance of Apical Periodontitis -- 1.4.1 Apical Periodontitis as an Infection -- 1.4.2 Infection Control -- 1.4.3 Microbial Specificity and Host Defense -- 1.4.4 Endodontic Infection and General Health -- 1.4.5 Tooth Loss and Replacement -- 1.5 Concluding Remarks -- References -- Chapter 2 Dentin-Pulp and Periodontal Anatomy and Physiology -- 2.1 Introduction -- 2.2 Dentin -- 2.2.1 Dentin Formation -- 2.2.2 Dentin Structure -- 2.2.3 Dentinal Fluid -- 2.3 Pulp Tissue and its Homeostasis -- 2.3.1 Pulp Cells -- 2.3.2 Blood and Lymph Vessels -- 2.3.3 Nerves -- 2.3.4 Pulp Stones -- 2.4 Pulp Inflammation -- 2.4.1 Immune Cells in Pulp -- 2.4.2 Odontoblasts as Immunological Cells -- 2.5 Pulp Nociception and Hypersensitivity -- 2.6 Age-related Changes in Dentin-pulp Complex -- 2.6.1 Age-related Changes in Dentin -- 2.6.2 Caries-affected Dentin -- 2.7 The Periodontium -- 2.8 The Periodontal Ligament (PDL) -- 2.8.1 Cells of the PDL -- 2.8.2 Epithelial Cell Remnants -- 2.8.3 Turnover -- 2.8.4 Circulation in the PDL -- 2.8.5 Innervation of PDL -- 2.9 Cementum -- 2.9.1 Cement Structure and Formation -- 2.10 Alveolar Bone -- 2.10.1 Alveolar Bone Structure -- References -- Chapter 3 Etiology and Pathogenesis of Pulpitis and Apical Periodontitis -- 3.1 Introduction -- 3.2 Etiology of Pulpitis and Apical Periodontitis -- 3.3 Inflammation Versus Infection of the Pulp and Periapical Tissues -- 3.3.1 Bacterial Irritation and Invasion of the Dental Pulp -- 3.4 The Dental Pulp -- 3.4.1 The Defense System in the Dental Pulp -- 3.4.2 Classification of Pulpitis.
3.4.3 Histological and Molecular Evaluation of Pulpitis -- 3.5 The Periapical Tissues -- 3.5.1 The Defense System in the Periapical Tissues -- 3.5.2 Classification of Apical Periodontitis -- 3.5.3 Modulation of the Immune Response and Bone Resorption in Apical Periodontitis -- 3.5.4 Healing of Apical Periodontitis -- 3.6 Concluding Remarks -- References -- Chapter 4 Microbiology of Apical Periodontitis -- 4.1 Introduction -- 4.2 Microbial Causation of Apical Periodontitis -- 4.3 Endodontic Biofilms and the Community-as-Pathogen Concept -- 4.3.1 Structure -- 4.3.2 Bacterial Interactions and Intercommunication in Biofilms -- 4.3.3 Community-as-Pathogen Concept -- 4.3.4 Biofilms in Teeth with Apical Periodontitis -- 4.3.5 Dynamics of Endodontic Biofilm Formation - a Theory -- 4.3.6 Apical Periodontitis is a Disease Caused by Biofilms -- 4.3.7 Requirements for an Endodontic Pathogenic Community -- 4.4 Mechanisms of Bacterial Pathogenicity -- 4.4.1 Bacterial Virulence Factors Released in the Canal Milieu -- 4.5 Microbial Ecology and the Root Canal Ecosystem -- 4.5.1 Ecological Determinants -- 4.5.2 Ecology of the Endodontic Biofilm Community -- 4.6 Types of Endodontic Infections -- 4.6.1 Intraradicular Infection -- 4.6.1.2 Secondary Intraradicular Infection -- 4.6.2 Extraradicular Infection -- 4.7 Identification of Endodontic Bacteria -- 4.7.1 Taxonomy of Endodontic Infections -- 4.7.2 As-yet-Uncultivated Phylotypes -- 4.8 Endodontic Biofilm Community Profiles -- 4.9 Microbiota in the Apical Root Canal -- 4.10 Symptomatic Infections -- 4.10.1 Factors Influencing the Development of Symptoms -- 4.10.2 Shift in the Microbiota Before Symptom Appearance -- 4.11 Persistent/Secondary Endodontic Infections -- 4.12 Extraradicular Infections -- 4.13 Other Microorganisms in Endodontic Infections -- 4.13.1 Fungi -- 4.13.2 Archaea -- 4.13.3 Viruses -- References.
Chapter 5 Epidemiology, Treatment Outcome, and Risk Factors for Apical Periodontitis -- 5.1 Introduction -- 5.2 General Aspects of Epidemiology -- 5.2.1 Prevalence -- 5.2.2 Incidence -- 5.2.3 Prognosis -- 5.2.4 Prevalence Versus Incidence -- 5.3 Elements of an Epidemiologic Study -- 5.4 Evaluation of Epidemiologic Data -- 5.4.1 Data Structure -- 5.4.2 Adjustment for Confounding in Observational Studies -- 5.4.3 Regression Models -- 5.5 Factors and Conditions Associated with Treatment Outcome -- 5.5.1 Treatment Outcome -- 5.5.2 Person-specific Risk Factors -- 5.5.3 Tooth-Specific Risk Factors -- 5.5.4 Concluding Remarks -- References -- Chapter 6 Radiology of Apical Periodontitis -- 6.1 Introduction -- 6.2 Normal Apical Periodontium -- 6.2.1 Root Apex and Pulp Canal Foramen -- 6.2.2 Cementum -- 6.2.3 Periodontal Ligament Space -- 6.2.4 Lamina Dura -- 6.2.5 Cortical Bone -- 6.2.6 Cancellous Bone -- 6.2.7 Neighboring Anatomical Structures -- 6.3 Radiographic Appearance of Apical Periodontitis -- 6.3.1 Conventional Radiographic Appearance -- 6.3.2 Incipient Apical Periodontitis on Conventional Radiographs -- 6.3.3 Established Apical Periodontitis on Conventional Radiographs -- 6.3.4 Appearance of Apical Periodontitis on CBCT -- 6.3.5 Apical Periodontitis Associated with Root‐filled Teeth -- 6.4 Healing Characteristics -- 6.4.1 Healing of Apical Periodontitis After Non‐surgical Root Canal Treatment -- 6.4.2 Healing after Endodontic Surgery -- 6.5 Conventional Radiography for Assessment of Apical Periodontitis -- 6.6 Advanced Radiographic Techniques for Endodontic Diagnosis -- 6.7 Differential Diagnosis -- 6.7.1 Concomitant Periodontal Disease -- 6.7.2 Vertical Root Fracture -- 6.7.3 Osteomyelitis -- 6.7.4 Occlusal Trauma -- 6.7.5 Odontogenic Cysts -- 6.7.6 Non-odontogenic Cysts and Tumors -- 6.7.7 Bone-related Lesions -- 6.7.8 Tumors.
6.8 CBCT for Assessment of AP -- 6.8.1 Diagnosis -- 6.8.2 Treatment Outcome -- 6.9 Concluding Remarks -- References -- Chapter 7 Clinical Manifestations and Diagnosis -- 7.1 Introduction -- 7.2 Pulpal Diagnostic Terms -- 7.2.1 Healthy Pulp -- 7.2.2 Reversible Pulpitis -- 7.2.3 Symptomatic Irreversible Pulpitis -- 7.2.4 Asymptomatic Irreversible Pulpitis -- 7.2.5 Necrotic Pulp -- 7.2.6 Infected Pulp/Infected Pulpal Space -- 7.3 Symptomatology of Pulpal Disease -- 7.3.1 Presenting Symptoms -- 7.3.2 History of the Presenting Symptoms -- 7.4 Clinical Findings -- 7.4.1 Carious Pulpal Exposure -- 7.4.2 Age-related Changes -- 7.4.3 Periodontal Disease -- 7.4.4 Previous Pulpal Insults -- 7.5 Diagnostic Testing -- 7.5.1 Sensibility Tests -- 7.5.2 Mechanical Tests -- 7.5.3 Radiographic Examination -- 7.5.4 Experimental Testing Methods -- 7.6 Formulation of a Pulpal Diagnosis -- 7.6.1 Key Factors -- 7.6.2 Related Factors -- 7.6.3 Treatment Planning -- 7.7 Periapical Diagnosis -- 7.7.1 Normal Apical Tissues -- 7.8 Symptomatology of Periapical Disease -- 7.8.1 Symptomatic Apical Periodontitis (SAP) -- 7.8.2 Asymptomatic Apical Periodontitis -- 7.8.3 Acute Periodontitis with Abscess -- 7.8.4 Chronic Apical Abscess -- 7.8.5 Condensing Osteitis -- 7.9 Formulation of a Periapical Diagnosis -- 7.9.1 Key Factors -- 7.9.2 Related Factors -- 7.10 Future of Pulpal and Periapical Diagnosis -- References -- Chapter 8 Biological Basis for Endodontic Repair and Regeneration -- 8.1 Principles of Regeneration and Repair -- 8.1.1 Pulp and Periapical Regeneration Processes -- 8.2 Vital Pulp Therapy -- 8.2.1 Bioactive Materials -- 8.3 Cell Types Involved in Pulp Healing -- 8.3.1 Tertiary Dentine -- 8.3.2 Stem Cells: Sources and Activation -- 8.3.3 Neurovascular Components in Regeneration -- 8.4 The Role of Inflammation -- 8.4.1 Pulp Responses to Bacterial Challenges.
8.4.2 The Link between Inflammation and Regeneration -- 8.5 Signaling Molecules in Dentine -- 8.6 Tissue Engineering Approaches to Dental Pulp Regeneration -- References -- Chapter 9 Prevention: Treatment of the Exposed Dentine Pulp Complex -- 9.1 Diagnostic Challenges of Deep Caries and Traumatic Pulp Exposure -- 9.1.1 Deep Caries as an Endodontic Problem -- 9.2 Discerning Pulpal Diagnosis -- 9.2.1 The Penetration Depths of Carious Lesions -- 9.2.2 Pulp Inflammation - a Two-edged Sword -- 9.2.3 Untreated Caries a Model to Understand Reparative Dentine -- 9.3 The Pulp Biology Associated with Pulp Capping -- 9.3.1 Hard Tissue Formation -- 9.3.2 Stimuli Causing Tertiary Dentine and Origin of Dentinal Repair Cells -- 9.3.3 Hemostasis -- 9.3.4 The Pulp-capping Materials -- 9.4 Criteria for Assessing Success of Vital Pulp Therapies -- 9.5 Indirect Pulp Capping and Stepwise Excavation -- 9.6 Pulp Capping of the Uninflamed Pulp (Class I) -- 9.7 Pulp Capping of the Cariously Involved Pulp (Class II) -- 9.8 Partial Pulpotomy -- 9.9 Pulpotomy -- 9.10 Treatment Details for Pulp-preserving Techniques -- 9.11 The Available Evidence for Relative Merit of Treatment Procedures for Vital Pulps -- 9.11.1 Scenarios for Multiple Outcomes and Follow‐up Treatment -- 9.11.2 Strategies for Obtaining Optimal Clinical Evidence -- 9.11.3 Lack of Standardization in Clinical Trials -- 9.11.4 Choice of Capping Materials -- 9.11.5 Status of Current Clinical Evidence -- 9.12 Future Perspectives of More Advanced Biological Approaches -- References -- Chapter 10 Vital Pulp Extirpation -- 10.1 Introduction -- 10.2 Pulpectomy - Definition and Rationale -- 10.3 The Challenge of Effective Local Anesthesia -- 10.4 Principles of Effective Pulpectomy -- 10.4.1 The Aseptic Working Environment -- 10.4.2 Tissue-preserving Access -- 10.4.3 Pulp Tissue Resection and Elimination.
10.5 Canal Shaping.
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Cover -- Title Page -- Copyright Page -- Contents -- Foreword -- List of Contributors -- About the Companion Website -- Chapter 1 Apical Periodontitis: Microbial Infection and Host Responses -- 1.1 Introduction -- 1.2 Terminology -- 1.3 Pulp Infection and Periapical Inflammation -- 1.4 Biological and Clinical Significance of Apical Periodontitis -- 1.4.1 Apical Periodontitis as an Infection -- 1.4.2 Infection Control -- 1.4.3 Microbial Specificity and Host Defense -- 1.4.4 Endodontic Infection and General Health -- 1.4.5 Tooth Loss and Replacement -- 1.5 Concluding Remarks -- References -- Chapter 2 Dentin-Pulp and Periodontal Anatomy and Physiology -- 2.1 Introduction -- 2.2 Dentin -- 2.2.1 Dentin Formation -- 2.2.2 Dentin Structure -- 2.2.3 Dentinal Fluid -- 2.3 Pulp Tissue and its Homeostasis -- 2.3.1 Pulp Cells -- 2.3.2 Blood and Lymph Vessels -- 2.3.3 Nerves -- 2.3.4 Pulp Stones -- 2.4 Pulp Inflammation -- 2.4.1 Immune Cells in Pulp -- 2.4.2 Odontoblasts as Immunological Cells -- 2.5 Pulp Nociception and Hypersensitivity -- 2.6 Age-related Changes in Dentin-pulp Complex -- 2.6.1 Age-related Changes in Dentin -- 2.6.2 Caries-affected Dentin -- 2.7 The Periodontium -- 2.8 The Periodontal Ligament (PDL) -- 2.8.1 Cells of the PDL -- 2.8.2 Epithelial Cell Remnants -- 2.8.3 Turnover -- 2.8.4 Circulation in the PDL -- 2.8.5 Innervation of PDL -- 2.9 Cementum -- 2.9.1 Cement Structure and Formation -- 2.10 Alveolar Bone -- 2.10.1 Alveolar Bone Structure -- References -- Chapter 3 Etiology and Pathogenesis of Pulpitis and Apical Periodontitis -- 3.1 Introduction -- 3.2 Etiology of Pulpitis and Apical Periodontitis -- 3.3 Inflammation Versus Infection of the Pulp and Periapical Tissues -- 3.3.1 Bacterial Irritation and Invasion of the Dental Pulp -- 3.4 The Dental Pulp -- 3.4.1 The Defense System in the Dental Pulp -- 3.4.2 Classification of Pulpitis.

3.4.3 Histological and Molecular Evaluation of Pulpitis -- 3.5 The Periapical Tissues -- 3.5.1 The Defense System in the Periapical Tissues -- 3.5.2 Classification of Apical Periodontitis -- 3.5.3 Modulation of the Immune Response and Bone Resorption in Apical Periodontitis -- 3.5.4 Healing of Apical Periodontitis -- 3.6 Concluding Remarks -- References -- Chapter 4 Microbiology of Apical Periodontitis -- 4.1 Introduction -- 4.2 Microbial Causation of Apical Periodontitis -- 4.3 Endodontic Biofilms and the Community-as-Pathogen Concept -- 4.3.1 Structure -- 4.3.2 Bacterial Interactions and Intercommunication in Biofilms -- 4.3.3 Community-as-Pathogen Concept -- 4.3.4 Biofilms in Teeth with Apical Periodontitis -- 4.3.5 Dynamics of Endodontic Biofilm Formation - a Theory -- 4.3.6 Apical Periodontitis is a Disease Caused by Biofilms -- 4.3.7 Requirements for an Endodontic Pathogenic Community -- 4.4 Mechanisms of Bacterial Pathogenicity -- 4.4.1 Bacterial Virulence Factors Released in the Canal Milieu -- 4.5 Microbial Ecology and the Root Canal Ecosystem -- 4.5.1 Ecological Determinants -- 4.5.2 Ecology of the Endodontic Biofilm Community -- 4.6 Types of Endodontic Infections -- 4.6.1 Intraradicular Infection -- 4.6.1.2 Secondary Intraradicular Infection -- 4.6.2 Extraradicular Infection -- 4.7 Identification of Endodontic Bacteria -- 4.7.1 Taxonomy of Endodontic Infections -- 4.7.2 As-yet-Uncultivated Phylotypes -- 4.8 Endodontic Biofilm Community Profiles -- 4.9 Microbiota in the Apical Root Canal -- 4.10 Symptomatic Infections -- 4.10.1 Factors Influencing the Development of Symptoms -- 4.10.2 Shift in the Microbiota Before Symptom Appearance -- 4.11 Persistent/Secondary Endodontic Infections -- 4.12 Extraradicular Infections -- 4.13 Other Microorganisms in Endodontic Infections -- 4.13.1 Fungi -- 4.13.2 Archaea -- 4.13.3 Viruses -- References.

Chapter 5 Epidemiology, Treatment Outcome, and Risk Factors for Apical Periodontitis -- 5.1 Introduction -- 5.2 General Aspects of Epidemiology -- 5.2.1 Prevalence -- 5.2.2 Incidence -- 5.2.3 Prognosis -- 5.2.4 Prevalence Versus Incidence -- 5.3 Elements of an Epidemiologic Study -- 5.4 Evaluation of Epidemiologic Data -- 5.4.1 Data Structure -- 5.4.2 Adjustment for Confounding in Observational Studies -- 5.4.3 Regression Models -- 5.5 Factors and Conditions Associated with Treatment Outcome -- 5.5.1 Treatment Outcome -- 5.5.2 Person-specific Risk Factors -- 5.5.3 Tooth-Specific Risk Factors -- 5.5.4 Concluding Remarks -- References -- Chapter 6 Radiology of Apical Periodontitis -- 6.1 Introduction -- 6.2 Normal Apical Periodontium -- 6.2.1 Root Apex and Pulp Canal Foramen -- 6.2.2 Cementum -- 6.2.3 Periodontal Ligament Space -- 6.2.4 Lamina Dura -- 6.2.5 Cortical Bone -- 6.2.6 Cancellous Bone -- 6.2.7 Neighboring Anatomical Structures -- 6.3 Radiographic Appearance of Apical Periodontitis -- 6.3.1 Conventional Radiographic Appearance -- 6.3.2 Incipient Apical Periodontitis on Conventional Radiographs -- 6.3.3 Established Apical Periodontitis on Conventional Radiographs -- 6.3.4 Appearance of Apical Periodontitis on CBCT -- 6.3.5 Apical Periodontitis Associated with Root‐filled Teeth -- 6.4 Healing Characteristics -- 6.4.1 Healing of Apical Periodontitis After Non‐surgical Root Canal Treatment -- 6.4.2 Healing after Endodontic Surgery -- 6.5 Conventional Radiography for Assessment of Apical Periodontitis -- 6.6 Advanced Radiographic Techniques for Endodontic Diagnosis -- 6.7 Differential Diagnosis -- 6.7.1 Concomitant Periodontal Disease -- 6.7.2 Vertical Root Fracture -- 6.7.3 Osteomyelitis -- 6.7.4 Occlusal Trauma -- 6.7.5 Odontogenic Cysts -- 6.7.6 Non-odontogenic Cysts and Tumors -- 6.7.7 Bone-related Lesions -- 6.7.8 Tumors.

6.8 CBCT for Assessment of AP -- 6.8.1 Diagnosis -- 6.8.2 Treatment Outcome -- 6.9 Concluding Remarks -- References -- Chapter 7 Clinical Manifestations and Diagnosis -- 7.1 Introduction -- 7.2 Pulpal Diagnostic Terms -- 7.2.1 Healthy Pulp -- 7.2.2 Reversible Pulpitis -- 7.2.3 Symptomatic Irreversible Pulpitis -- 7.2.4 Asymptomatic Irreversible Pulpitis -- 7.2.5 Necrotic Pulp -- 7.2.6 Infected Pulp/Infected Pulpal Space -- 7.3 Symptomatology of Pulpal Disease -- 7.3.1 Presenting Symptoms -- 7.3.2 History of the Presenting Symptoms -- 7.4 Clinical Findings -- 7.4.1 Carious Pulpal Exposure -- 7.4.2 Age-related Changes -- 7.4.3 Periodontal Disease -- 7.4.4 Previous Pulpal Insults -- 7.5 Diagnostic Testing -- 7.5.1 Sensibility Tests -- 7.5.2 Mechanical Tests -- 7.5.3 Radiographic Examination -- 7.5.4 Experimental Testing Methods -- 7.6 Formulation of a Pulpal Diagnosis -- 7.6.1 Key Factors -- 7.6.2 Related Factors -- 7.6.3 Treatment Planning -- 7.7 Periapical Diagnosis -- 7.7.1 Normal Apical Tissues -- 7.8 Symptomatology of Periapical Disease -- 7.8.1 Symptomatic Apical Periodontitis (SAP) -- 7.8.2 Asymptomatic Apical Periodontitis -- 7.8.3 Acute Periodontitis with Abscess -- 7.8.4 Chronic Apical Abscess -- 7.8.5 Condensing Osteitis -- 7.9 Formulation of a Periapical Diagnosis -- 7.9.1 Key Factors -- 7.9.2 Related Factors -- 7.10 Future of Pulpal and Periapical Diagnosis -- References -- Chapter 8 Biological Basis for Endodontic Repair and Regeneration -- 8.1 Principles of Regeneration and Repair -- 8.1.1 Pulp and Periapical Regeneration Processes -- 8.2 Vital Pulp Therapy -- 8.2.1 Bioactive Materials -- 8.3 Cell Types Involved in Pulp Healing -- 8.3.1 Tertiary Dentine -- 8.3.2 Stem Cells: Sources and Activation -- 8.3.3 Neurovascular Components in Regeneration -- 8.4 The Role of Inflammation -- 8.4.1 Pulp Responses to Bacterial Challenges.

8.4.2 The Link between Inflammation and Regeneration -- 8.5 Signaling Molecules in Dentine -- 8.6 Tissue Engineering Approaches to Dental Pulp Regeneration -- References -- Chapter 9 Prevention: Treatment of the Exposed Dentine Pulp Complex -- 9.1 Diagnostic Challenges of Deep Caries and Traumatic Pulp Exposure -- 9.1.1 Deep Caries as an Endodontic Problem -- 9.2 Discerning Pulpal Diagnosis -- 9.2.1 The Penetration Depths of Carious Lesions -- 9.2.2 Pulp Inflammation - a Two-edged Sword -- 9.2.3 Untreated Caries a Model to Understand Reparative Dentine -- 9.3 The Pulp Biology Associated with Pulp Capping -- 9.3.1 Hard Tissue Formation -- 9.3.2 Stimuli Causing Tertiary Dentine and Origin of Dentinal Repair Cells -- 9.3.3 Hemostasis -- 9.3.4 The Pulp-capping Materials -- 9.4 Criteria for Assessing Success of Vital Pulp Therapies -- 9.5 Indirect Pulp Capping and Stepwise Excavation -- 9.6 Pulp Capping of the Uninflamed Pulp (Class I) -- 9.7 Pulp Capping of the Cariously Involved Pulp (Class II) -- 9.8 Partial Pulpotomy -- 9.9 Pulpotomy -- 9.10 Treatment Details for Pulp-preserving Techniques -- 9.11 The Available Evidence for Relative Merit of Treatment Procedures for Vital Pulps -- 9.11.1 Scenarios for Multiple Outcomes and Follow‐up Treatment -- 9.11.2 Strategies for Obtaining Optimal Clinical Evidence -- 9.11.3 Lack of Standardization in Clinical Trials -- 9.11.4 Choice of Capping Materials -- 9.11.5 Status of Current Clinical Evidence -- 9.12 Future Perspectives of More Advanced Biological Approaches -- References -- Chapter 10 Vital Pulp Extirpation -- 10.1 Introduction -- 10.2 Pulpectomy - Definition and Rationale -- 10.3 The Challenge of Effective Local Anesthesia -- 10.4 Principles of Effective Pulpectomy -- 10.4.1 The Aseptic Working Environment -- 10.4.2 Tissue-preserving Access -- 10.4.3 Pulp Tissue Resection and Elimination.

10.5 Canal Shaping.

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