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Hai bệnh nhiễm trùng ảnh hưởng đến sự tồn tại của răng: mô nướu nha chu và mô quanh răng đỉnh. Đau và mất chức năng đi kèm với các dạng nghiêm trọng của một trong hai bệnh cũng có thể làm giảm chất lượng cuộc sống của những người bị ảnh hưởng nghiêm trọng. Nhiễm trùng tủy răng và các mô quanh răng thuộc lĩnh vực nội nha. Trong khi các tình trạng và bệnh lý khác là một phần quan trọng của kỷ luật, thì điều trị răng bị viêm tủy răng hoặc viêm nha chu đỉnh bằng cách trám răng hoặc phẫu thuật chóp lại là phần quan trọng nhất cho đến nay. Nội nha thiết yếu tìm cách tích hợp kiến thức cơ bản, sinh học và vi sinh về bệnh viêm nha chu đỉnh với thực hành chẩn đoán và điều trị. Điểm nhấn của cuốn sách vẫn như trước. Nó tập trung vào đặc điểm sinh học và lâm sàng của căn bệnh quan trọng nhất của nội nha theo thứ tự để thúc đẩy các phương pháp tiếp cận tốt hơn bao giờ hết để chẩn đoán, phòng ngừa và điều trị. Người ta có thể hỏi liệu có còn nhu cầu về sách giáo khoa kiểu này không. Bất kỳ sinh viên hoặc học viên nào cũng có thể tiếp cận các kỹ thuật và phương pháp tiên tiến, mới nhất, cũng như các ấn phẩm khoa học, trực tiếp trên phương tiện truyền thông xã hội hoặc từ cơ sở dữ liệu công cộng. Tuy nhiên, người ta có thể tranh luận rằng ngày nay nhu cầu về văn bản cơ bản, nâng cao hơn thậm chí còn lớn hơn trước đây. Hình minh họa sự bùng nổ về số lượng các ấn phẩm liên quan đến nội nha trong những năm gần đây. Trong thập kỷ trước khi xuất bản lần thứ hai vào năm 2008, số lượng các ấn phẩm nội nha mới đã tăng 38% so với thập kỷ trước. Trong 10 năm tiếp theo, mức tăng là 125 phần trăm, với tổng số 14.685 ấn phẩm. Rõ ràng là tổng số đóng góp khoa học cho ngành học hiện nay vượt xa những gì mà bất kỳ nhà nghiên cứu, nhà khoa học hoặc bác sĩ lâm sàng nào có thể đọc hoặc tiếp thu. Một người mới trong lĩnh vực này cũng không thể điều hướng trong một khu vực mà chất lượng của thông tin có sẵn sẽ rất khác nhau. Do đó, nền tảng kiến thức được nén do các chuyên gia trong lĩnh vực của họ cung cấp là điều cần thiết làm điểm khởi đầu cho các nghiên cứu sâu hơn và cung cấp nền tảng kiến thức và hiểu biết sâu sắc. Đối tượng mục tiêu của cuốn sách vẫn là sinh viên sau đại học, giáo viên và các nhà nghiên cứu tập trung vào lĩnh vực nội nha. Nội nha thiết yếu cũng sẽ phục vụ như một phần bổ sung cho sinh viên đại học về nội nha. Ấn bản năm 2008 chưa được một năm để in trước khi người đồng biên tập của cả hai ấn bản trước, Thomas R. Pitt Ford, qua đời. Những đóng góp của ông cho hai lần xuất bản trước là rất thiếu sót cho sự hoàn thiện của chúng, và các phẩm chất chuyên môn và cá nhân của ông đã bị thiếu sót trong quá trình chuẩn bị cho lần xuất bản thứ ba này. Tôi hy vọng rằng người đọc sẽ tìm thấy tinh thần từ các ấn bản trước đang thịnh hành ở thời điểm hiện tại và nhận ra sự tập trung vào chất lượng và chiều sâu vốn là dấu ấn của Tom Pitt Ford.
Essential Endodontology www.ajlobby.com Essential Endodontology Prevention and Treatment of Apical Periodontitis Third Edition Edited by Dag Ørstavik cand odont & dr odont Professor Emeritus Department of Endodontics Institute of Clinical Dentistry University of Oslo Oslo, Norway www.ajlobby.com This edition first published 2020 © 2020 John Wiley & Sons Ltd Edition History Blackwell Munksgaard Ltd (2e, 2008), Blackwell Science Ltd (1e 1998) All rights reserved No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions The right of Dag Ørstavik to be identified as the author of the editorial material in this work has been asserted in accordance with law Registered Office(s) John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, USA John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK Editorial Office 9600 Garsington Road, Oxford, OX4 2DQ, UK For details of our global editorial offices, customer services, and more information about Wiley products visit us at www.wiley.com Wiley also publishes its books in a variety of electronic formats and by print‐on‐demand Some content that appears in standard print versions of this book may not be available in other formats Limit of Liability/Disclaimer of Warranty The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting scientific method, diagnosis, or treatment by physicians for any particular patient In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions While the publisher and authors have used their best efforts in preparing this work, they make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of merchantability or fitness for a particular purpose No warranty may be created or extended by sales representatives, written sales materials or promotional statements for this work The fact that an organization, website, or product is referred to in this work as a citation and/or potential source of further information does not mean that the publisher and authors endorse the information or services the organization, website, or product may provide or recommendations it may make This work is sold with the understanding that the publisher is not engaged in rendering professional services The advice and strategies contained herein may not be suitable for your situation You should consult with a specialist where appropriate Further, readers should be aware that websites listed in this work may have changed or disappeared between when this work was written and when it is read Neither the publisher nor authors shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages Library of Congress Cataloging‐in‐Publication Data Names: Ørstavik, Dag, editor Title: Essential endodontology : prevention and treatment of apical periodontitis / edited by Dag Orstavik Description: 3rd edition | Hoboken, NJ : Wiley-Blackwell, 2020 | Includes bibliographical references and index Identifiers: LCCN 2019026638 (print) | ISBN 9781119271956 (hardback) | ISBN 9781119271970 (adobe pdf ) | ISBN 9781119271994 (epub) Subjects: MESH: Periapical Periodontitis–prevention & control | Periapical Periodontitis–therapy | Endodontics Classification: LCC RK450.P4 (print) | LCC RK450.P4 (ebook) | NLM WU 242 | DDC 617.6/32–dc23 LC record available at https://lccn.loc.gov/2019026638 LC ebook record available at https://lccn.loc.gov/2019026639 Cover Design: Wiley Cover Image: © Dag Ørstavik Set in 10/12pt Warnock by SPi Global, Pondicherry, India 10 9 8 7 6 5 4 3 2 1 www.ajlobby.com v Contents Foreword ix List of Contributors xi About the Companion Website xiii Apical Periodontitis: Microbial Infection and Host Responses Dag Ørstavik 1.1 Introduction 1.2 Terminology 1.3 Pulp Infection and Periapical Inflammation 1.4 Biological and Clinical Significance of Apical Periodontitis 1.5 Concluding Remarks References Dentin‐Pulp and Periodontal Anatomy and Physiology 11 Leo Tjäderhane and Susanna Paju 2.1 Introduction 11 2.2 Dentin 11 2.3 Pulp Tissue and its Homeostasis 22 2.4 Pulp Inflammation 27 2.5 Pulp Nociception and Hypersensitivity 32 2.6 Age‐related Changes in Dentin‐pulp Complex 34 2.7 The Periodontium 39 2.8 The Periodontal Ligament (PDL) 39 2.9 Cementum 44 2.10 Alveolar Bone 46 References 49 Etiology and Pathogenesis of Pulpitis and Apical Periodontitis 59 Ashraf F Fouad and Asma A Khan 3.1 Introduction 59 3.2 Etiology of Pulpitis and Apical Periodontitis 60 3.3 Inflammation Versus Infection of the Pulp and Periapical Tissues 61 3.4 The Dental Pulp 62 www.ajlobby.com vi Contents 3.5 The Periapical Tissues 70 3.6 Concluding Remarks 79 References 80 Microbiology of Apical Periodontitis 91 Josộ F Siqueira Jr and Isabela N Rụỗas 4.1 ưIntroduction 91 4.2 Microbial Causation of Apical Periodontitis 91 4.3 Endodontic Biofilms and the Community‐as‐Pathogen Concept 95 4.4 Mechanisms of Bacterial Pathogenicity 102 4.5 Microbial Ecology and the Root Canal Ecosystem 105 4.6 Types of Endodontic Infections 110 4.7 Identification of Endodontic Bacteria 111 4.8 Endodontic Biofilm Community Profiles 115 4.9 Microbiota in the Apical Root Canal 116 4.10 Symptomatic Infections 117 4.11 Persistent/Secondary Endodontic Infections 120 4.12 Extraradicular Infections 123 4.13 Other Microorganisms in Endodontic Infections 125 References 127 Epidemiology, Treatment Outcome, and Risk Factors for Apical Periodontitis 143 Lise‐Lotte Kirkevang and Michael Vaeth 5.1 Introduction 143 5.2 General Aspects of Epidemiology 144 5.3 Elements of an Epidemiologic Study 155 5.4 Evaluation of Epidemiologic Data 157 5.5 Factors and Conditions Associated with Treatment Outcome 160 References 169 Radiology of Apical Periodontitis 179 Shanon Patel and Conor Durack 6.1 Introduction 179 6.2 Normal Apical Periodontium 180 6.3 Radiographic Appearance of Apical Periodontitis 190 6.4 Healing Characteristics 194 6.5 Conventional Radiography for Assessment of Apical Periodontitis 195 6.6 Advanced Radiographic Techniques for Endodontic Diagnosis 195 6.7 Differential Diagnosis 197 6.8 CBCT for Assessment of AP 202 6.9 Concluding Remarks 204 References 204 Clinical Manifestations and Diagnosis 211 Asgeir Sigurdsson 7.1 Introduction 211 7.2 Pulpal Diagnostic Terms 212 7.3 Symptomatology of Pulpal Disease 213 www.ajlobby.com Contents 7.4 Clinical Findings 216 7.5 Diagnostic Testing 217 7.6 Formulation of a Pulpal Diagnosis 223 7.7 Periapical Diagnosis 225 7.8 Symptomatology of Periapical Disease 226 7.9 Formulation of a Periapical Diagnosis 230 7.10 Future of Pulpal and Periapical Diagnosis 231 References 231 Biological Basis for Endodontic Repair and Regeneration 237 Kerstin M Galler 8.1 Principles of Regeneration and Repair 237 8.2 Vital Pulp Therapy 238 8.3 Cell Types Involved in Pulp Healing 239 8.4 The Role of Inflammation 242 8.5 Signaling Molecules in Dentine 243 8.6 Tissue Engineering Approaches to Dental Pulp Regeneration 245 References 248 Prevention: Treatment of the Exposed Dentine Pulp Complex 253 Lars Bjørndal 9.1 Diagnostic Challenges of Deep Caries and Traumatic Pulp Exposure 253 9.2 Discerning Pulpal Diagnosis 254 9.3 The Pulp Biology Associated with Pulp Capping 257 9.4 Criteria for Assessing Success of Vital Pulp Therapies 259 9.5 Indirect Pulp Capping and Stepwise Excavation 259 9.6 Pulp Capping of the Uninflamed Pulp (Class I) 261 9.7 Pulp Capping of the Cariously Involved Pulp (Class II) 261 9.8 Partial Pulpotomy 261 9.9 Pulpotomy 262 9.10 Treatment Details for Pulp‐preserving Techniques 263 9.11 The Available Evidence for Relative Merit of Treatment Procedures for Vital Pulps 264 9.12 Future Perspectives of More Advanced Biological Approaches 270 References 270 10 Vital Pulp Extirpation 275 John Whitworth 10.1 Introduction 275 10.2 Pulpectomy – Definition and Rationale 275 10.3 The Challenge of Effective Local Anesthesia 277 10.4 Principles of Effective Pulpectomy 278 10.5 Canal Shaping 283 10.6 Canal Irrigation and Medication 294 10.7 Preserving the Aseptic Environment: Root Canal Filling and Coronal Restoration 299 10.8 Concluding Remarks 304 References 304 www.ajlobby.com vii viii Contents 11 Endodontic Treatment of Apical Periodontitis 313 Dag Ørstavik 11.1 Introduction 313 11.2 Anatomic Location of the Microbes 314 11.3 Bacteriological Status During Treatment 316 11.4 Infection Control During Treatment 318 11.5 Root Filling Phase 323 11.6 Clinical Issues During Diagnosis and Treatment of Primary Apical Periodontitis 326 11.7 Treatment of Persistent or Recurrent Apical Periodontitis 327 11.8 Treatment of Immature Permanent Teeth with Apical Periodontitis 328 11.9 Monitoring Healing, Prognostication 329 11.10 Concluding Remarks 330 References 331 12 Surgical Endodontics 345 Frank C Setzer and Bekir Karabucak 12.1 Introduction, Including History 345 12.2 Surgical Endodontic Procedures 346 12.3 Indications 346 12.4 Contraindications 348 12.5 General Preparations for Surgery 348 12.6 Anesthesia 349 12.7 Surgical Anatomy 351 12.8 Clinical Steps in Root‐end Surgery 354 12.9 Perforation Repair 363 12.10 Replantation 363 12.11 Root Amputation, Hemisection 364 12.12 Guided Tissue Regeneration 366 12.13 Retreatment of Failed Surgical Cases 367 12.14 Modes of Healing 368 12.15 Outcome of Surgical Endodontics 368 References 372 Index 387 www.ajlobby.com ix Foreword Two infections affect the survival of teeth: those of the gingival/periodontal and pulpal/ apical periodontal tissues The pain and loss of function that come with severe forms of either disease may also severely impair the quality of life in affected individuals Infections of the pulp and periapical tissues belong to the domain of endodontology While other conditions and diseases form important part of the discipline, treatment of teeth with pulpitis or apical periodontitis by root fillings or apical surgery constitute by far the most important part Essential Endodontology seeks to integrate basic, biological, and microbiological knowledge of apical periodontitis with diagnostic and treatment practices The emphasis of the book remains the same as before It focuses on the biology and clinical features of endodontology’s most important disease in order 16000 to promote ever better approaches to its diagnosis, prevention, and therapy One might ask if there is still a need for textbooks of this kind Any student or practitioner can access the most advanced, novel techniques and methods, as well as scientific publications, directly on social media or from public databases However, one may argue that there is an even greater need for the more advanced, basic text today than before The figure illustrates the explosion in the number of publications related to endodontics in recent years In the decade leading up to the second edition in 2008, the number of new endodontic publications was up by 38 per cent from the decade before In the next 10 years, the increase was 125 per cent, totaling 14,685 publications It is clear that the total scientific contributions to the discipline now far outnumbers 14685 12000 8000 4000 6525 4040 4454 4712 1968–1977 1978–1987 1988–1997 1998–2007 2008–2017 Figure: The number of publications listed in PubMed (US National Library of Medicine, National Institutes of Health) with the search term “endodontics” during the past five decades www.ajlobby.com x Foreword what any researcher, scientist, or clinician can possibly read or absorb It is also impossible for a novice in the field to navigate in an area where the quality of available information will be highly variable Thus, a compressed basis of knowledge provided by experts in their fields is essential as a starting point for further studies, and provides a backbone of knowledge and insights The target audience for the book remains postgraduate students, teachers, and researchers focusing on endodontology Essential Endodontology will also serve as a supplement for undergraduate students of endodontics The 2008 edition was hardly a year out in print before the co‐editor of both previous editions, Thomas R Pitt Ford, passed away His contributions to the previous two editions were a sine qua non for their completion, and his professional and personal qualities were sorely missed in the preparation of this third edition I hope that the reader will find the spirit from the previous editions prevailing in the present, and recognize the focus on quality and depth that was Tom Pitt Ford’s hallmark www.ajlobby.com Dag Ørstavik 378 12 Surgical Endodontics 123 Khoury, F and Hensher, R (1987) The 124 125 126 127 128 129 130 131 132 bony lid approach for the apical root resection of lower molars International Journal of Oral and Maxillofacial Surgery 16: 166–170 Kim, E et al (2008) Prospective clinical study evaluating endodontic microsurgery outcomes for cases with lesions of endodontic origin compared with cases with lesions of combined periodontal– endodontic origin Journal of Endodontics 34: 546–551 Kim, S and Kratchman, S (2006) Modern endodontic surgery concepts and practice: a review Journal of Endodontics 32: 601–623 Kim, S., Pecora, G., and Rubinstein, R (2001) Comparison of traditional and microsurgery in endodontics In: Color Atlas of Microsurgery in Endodontics (ed. S Kim, G Pecora, and R Rubinstein), 5–11 Philadelphia, PA: W.B Saunders Kim, S and Rethnam, S (1997) Hemostasis in endodontic microsurgery Dental Clinics of North America 41: 499–511 Knoll‐Kohler, E et al (1989) Changes in plasma epinephrine concentration after dental infiltration anesthesia with different doses of epinephrine Journal of Dental Research 68: 1097–1101 Koenig, K.H., Nguyen, N.T., and Barkhordar, R.A (1988) Intentional replantation: a report of 192 cases General Dentistry 36: 327–331 Kohli, M.R et al (2018) Outcome of endodontic surgery: a meta‐analysis of the literature – part 3: comparison of endodontic microsurgical techniques with two different root‐end filling materials Journal of Endodontics 44: 923–931 Kohli, M.R et al (2015) Spectrophotometric analysis of coronal tooth discoloration induced by various bioceramic cements and other endodontic materials Journal of Endodontics 41: 1862–1866 Kramper, B.J et al (1984) A comparative study of the wound healing of three 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A.O and Olusile, A.O (2002) Follow‐up study of apicectomised anterior teeth South African Dental Journal 57: 136–140 177 Olson, A.K et al (1990) An in vitro 178 179 180 181 182 183 184 185 186 187 evaluation of injectable thermoplasticized gutta‐percha, glass ionomer, and amalgam when used as retrofilling materials Journal of Endodontics 16: 361–364 Pantschev, A et al (1994) Retrograde root filling with EBA cement or amalgam: a comparative clinical study Oral Surgery, Oral Medicine, Oral Pathology 78: 101–104 Parashos, P and Messer, H.H (2006) Rotary NiTi instrument fracture and its consequences Journal of Endodontics 32: 1031–1043 Park, S.Y et al (2009) Factors influencing the outcome of root‐resection therapy in molars: a 10‐year retrospective study Journal of Periodontology 80: 32–40 Partsch, C (1896) Dritter Bericht der Poliklinik für Zahn‐ und Mundkrankheiten des zahnärztlichen Instituts der Königl Universität Breslau Deutsche Monatszeitschrift für Zahnheilkunde 14: 486–499 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and iRoot BP plus root repair material as root‐end filling materials in endodontic microsurgery: a prospective randomized controlled study Journal of Endodontics 43: 1–6 www.ajlobby.com 385 387 Index a Abrasion 20, 61 Acessory canals/foramina 11, 18, 20, 190, 225, 302–3, 355–6 Actinomyces 110, 111, 113–15, 124, 316, 347 Actinomycosis 111, 124 Activation of immune system 62–3, 102, 104 of nerves 26, 33, 43, 213, 215, 219 of stem cells 237, 240–2, 246 Activation of irrigant laser 167, 295–6 manual 295–6, 298 negative pressure 295–7 sonic 295 ultrasonic 167, 295, 320–1, 328 Adaptive immunity 30–1, 61–4, 77, 97, 242 Adhesion molecules 68, 73 Aging 34, 214, 243 Alloprevotella 114 Amalgam 224, 345–6, 358–60, 368, 371 Ameloblastoma 200 Amensalism 93, 108 Analgesia 349 Anestesia 277–8, 348–9 Angiogenesis 22, 30, 244–5, 368 Ankylosis 41 Antibiotics 4–5, 101, 116, 167, 225–30, 299, 314, 316, 328, 354 prophylactic 6, 7, 366 resistance 6, 105, 108, 299 Antisepsis 1, 5, 167, 368 Apexification 238, 247, 328 Apexogenesis 216, 276, 321, 328–9 Apical abscess, acute 2, 71, 103, 105, 111, 114–19, 122–3, 127, 225 Apical constriction 21, 281, 283, 325, 346 Apical curettage 345–6 Apical delta 11, 18, 321 Apical instrumentation size 166, 286, 292, 325 Apical periodontitis acute 1, 122, 225, 227, 231 asymptomatic 2, 59, 71, 78, 105, 114–16, 124, 125, 225, 227–8, 313, 346, 348 chronic 2, 45, 71–3, 78, 102, 122, 124, 143, 179, 181, 203, 225, 227–30, 262, 313, 316, 323 classification 1–2 condensing 2, 191–2, 222–3, 226, 230 exacerbation 2, 72, 96, 111, 119, 227–9, 243, 313, 325–7 incipient 190–1, 193 recurrent/persistent/ secondary 5, 74, 105, 110–16, 120–1, 124, 126, 276, 316, 327–8 symptomatic 2, 71, 104, 117, 127, 225, 227, 313 Apoptosis 18, 35, 37, 41, 104 Arachidonic acid 62 Archaea 61, 91, 93, 125, 126 Arterioles 23, 30, 40–2 Asepsis 1, 5, 123, 165, 253–4, 262–3, 266, 275, 278–82, 297, 299–300, 304, 318, 331 Aspiration 166, 318 Attrition 27, 45, 61, 183, 371 Autophagy 35 b Bacteremia 6–7, 314 Bacteroidaceae 113, 122 Balanced force instrumentation 284–5 B‐cells 61–2, 64, 69, 73, 77 Beta‐defensins 62–3, 244 Biocompatibility 301–2, 323, 358–61 Biofilm 4, 60, 93, 95–110, 115, 118, 123–5, 166, 256, 280, 296, 297, 315–16, 327 Bisphosphonates 73, 79 Blood clot 194, 258, 281, 351–2, 362, 368 Blood flow 23, 26–30, 40, 42–4, 218, 240 Essential Endodontology: Prevention and Treatment of Apical Periodontitis, Third Edition Edited by Dag Ørstavik © 2020 John Wiley & Sons Ltd Published 2020 by John Wiley & Sons Ltd Companion website: www.wiley.com/go/orstavik/essentialendodontology www.ajlobby.com 388 Index Bone marrow stem cells (BMSC) 241 Bone morphogenetic proteins (BMPs) 79, 241, 244–5 Bone remodeling 34, 48, 77, 368 Bone resorption 41, 59, 62, 70, 73 Bone trabeculae 186, 190–1, 200 Bradykinin 26, 29, 76, 214 c Calcification 24, 26–7, 60, 64, 79, 124, 216, 222, 238, 316, 357 Calcium hydroxide 104, 126, 228, 237, 239, 244, 258–64, 268, 299–302, 321–3, 328–9 Calcospherites 14, 298 Campylobacter 110, 113, 114 Cancellous bone 46, 186, 190–2, 198, 226, 230, 368 Candida 111, 125 C albicans 126 Canine fossa 188 Capnocytophaga 114 Capsaisin 26 Cardiovascular disease 7, 163, 348 Caries 1, 4, 17–19, 21, 27, 29–32, 39, 60–2, 64–5, 77, 91, 100–1, 106, 159, 211–17, 227, 242–4, 253–69, 276, 278, 329, 364, 366 Carious teeth 21, 70, 260, 262 Case‐control study 145 Cell‐free layer 22 Cell‐rich layer 22 Cementicles 41, 43, 45–6 Cementoma 45 Cementum 11–12, 39–47, 59, 61, 79, 99, 180–3, 238, 247, 282, 314–16, 351, 356, 360, 361–4, 367–8 Chemokines 30–1, 59, 62, 68, 73, 78, 239, 242, 244 Chip space 290–2 Chlorhexidine 167, 258, 279, 298–300, 318–19, 363 Cilia 33–4 Circulation PDL 42 pulp 23, 91, 105–6, 108, 217, 222 systemic 351 Cohort study 145, 151, 160, 163–4, 166 population‐based 146, 151–2, 158, 161–2, 165, 168, 169 Collagen 11–15, 18, 22, 27, 37–41, 45–6, 48, 69, 79, 97, 100, 107, 109, 216, 238, 243–4, 254, 354, 366, 368 Complement factor C 73 system 62, 104, 108, 241 Complications 4, 6, 143, 167, 260, 265–6, 313, 348 cardiovascular 7 Composite resin 303, 358, 360, 363 Computed tomography (CT) 196 Condensing osteitis 2, 191–4, 226, 230 Cone beam computed tomography (CBCT) 2, 62, 75, 179–204, 259, 265, 268–9, 280, 323, 330–1, 348–9, 350, 353, 370 Coronal restoration 122, 157–8, 168, 203, 260, 263–4, 275–6, 299–300, 304, 325, 347–8, 359, 364, 371 Cortical bone 46, 183–8, 192–6, 199, 201, 278, 353, 368, 372 Cross‐sectional study 145–6, 155–6 Cyst apical, periapical, radicular 1–3, 41, 70–1, 73–5, 77, 99, 192, 196, 198, 202, 225–6, 231, 313, 346, 355, 368 www.ajlobby.com bay, pocket, “true” 2, 75–6, 123, 196, 346 dentigerous 198, 200 lateral periodontal 200 nasopalotine (incisive) canal 200, 202 traumatic bone 200 Cytokines 6, 7, 29–31, 41, 59, 74, 76, 78, 94, 102–4, 127, 239, 242, 244–5 d Defensins 31, 62–3, 242, 244 Dendritic cells 30, 31, 62–5, 102, 242, 244 Dens invaginatus 326–7 Dental trauma 13, 17, 64–5, 79, 91, 94, 181–2, 200, 211–13, 217–18, 243, 269, 277, 328–9, 347 complicated 1, 4, 261, 276 iatrogenic trauma 257, 259 occlusal trauma 185, 190, 198, 225 Dentin 11–22 bridge 92, 94, 258–9, 268, 270, 276 discolored 260, 263, 267 flexure strength 37–8 formation of 13 mantle 15 peritubular 12–14, 16–17, 37–8, 238, 240, 243 primary 16, 238 reactionary 15, 18–19, 31, 33, 238, 240, 256–7, 277 reparative 14–15, 18, 19, 32–3, 35, 41, 217, 238, 240, 256–8, 270 root 11, 18, 37–41, 45, 165, 282, 293 secondary 15, 34, 37 tensile strength of 37, 39 tertiary 15, 17–19, 65, 79, 101, 237–41, 154–262 tubular occlusion 37 Dentinal fluid 17, 20–2, 34, 62, 68 Index Dentinal tubules 12–17, 19–21, 27, 30, 33–4, 37, 60–2, 99–100, 120–1, 123, 166, 240, 242, 256, 298, 315, 319, 324, 326, 345, 356 Dentin‐enamel junction 13, 15, 25 Dentinogenesis 12, 16, 24, 33–4, 79, 240 Dentin‐pulp complex 11–12, 16, 21, 31–2, 34, 37, 214–5 Diabetes mellitus 73, 79, 163 Dialister 72, 110, 112–14, 122 Disinfection 1, 2, 18, 60, 120, 167, 227–30, 253, 258, 263, 279–80, 298, 314, 318–23, 326, 328, 331 e Eikenella 114 E corrodens 108, 114 Electronic apex locator 281–2 Emdogain 80 Endodontic instruments 279–80 nickel‐titanium 166, 286–95, 300, 302, 319, 347 stainless steel 166, 284–9, 293–4, 302, 319, 347 Enterococcus 111, 113, 115 E faecalis 111, 121–2, 316, 318 Epigenetic 70, 80 Epinephrine 351, 355 Epithelial root sheath of Hertwig 11, 41 Epstein–Barr virus (EBV) 119, 126 Ethylenediaminetetraacetic acid (EDTA) 244, 246, 294, 298–9, 319, 360 Eubacterium 108, 114 Exacerbation 119, 227–9, 243, 325–6 Extracellular polymeric substance (EPS) 93, 95, 100 Extraradicular infection 110–11, 123–5, 230, 315–16, 328, 345, 347, 355–6 f Fetuin‐A 20–1 Fibroblasts 19, 22, 35, 40–1, 46, 62–3, 77, 238, 241 Fibronectin 22, 244 Filifactor 72, 110, 112–13 F alocis 114, 122 Flap 349, 351–2, 354, 362–3, 366, 368 Flaring 280, 285, 294 Flute depth 290 Fracture instrument 285–94, 304, 320 root 110, 197–8, 275, 280, 326, 328, 347, 358 Fretibacterium 114 Fungi 61, 91, 109, 111, 125–6 Furcal canals 190, 315 Fusobacterium 107, 110, 112–14, 122 F nucleatum 71, 77, 107, 112, 114 g Giant cell granuloma 200 Granulicatella 72 Granuloma apical, periapical 1, 2, 73–5, 202, 225, 231, 315–16, 346, 368 giant cell 200 Guided tissue regeneration (GTR) 358, 366–7 h Healing of apical periododontitis 1, 5–7, 73, 78–80, 120, 125, 153–7, 163, 168, 194–5, 203, 237, 240, 279, 317, 321–3, 327, 329–30, 347 www.ajlobby.com after surgery 346, 359, 361–2, 365, 368–71 wound 348, 350–2, 354, 356, 362–3, 366–7 Hedstrom file 327 Helical angle 290, 292 Hemisection 364 Hemostasis 32, 68, 257–8, 263, 266, 299, 349, 351, 355–6, 368 Herpesviruses 119, 126–7 Hertwig’s epithelial root sheath 11 Histamine 26 Homeostasis 3, 22, 243 Human cytomegalovirus (HCMV) 119, 126 Human immunodeficiency virus (HIV) 126–7 Hydrogen peroxide 279, 318 Hypersensitivity 32–4, 221, 223 i IgG 20, 68 Immature teeth, treatment of 247, 276, 321, 328–9 Immunodeficiency 73 Incidence 6, 70, 144, 146, 151, 155, 159–60, 168, 216, 259, 261, 313, 321–2, 364 Incision 349, 351, 354, 366, 368 intrasulcular 351, 354 submarginal 352 Incisive canal 187, 200 Inflamed periapical progenitor cells (iPAPC) 241 Inflammatory mediators 26, 29–30, 59, 71, 76, 180, 213–16, 228, 243 Integrins 65, 68 Interferon (IFN) 64, 70, 73 Interleukins 41, 62–3, 65, 69, 73, 76, 79, 245 Interstitial fluid 22, 24 Intracanal medication 227, 321–2 Iodine 167, 279, 298, 318, 321–2 389 390 Index Irrigation intracanal 167, 220, 227, 263, 294–8, 300, 314, 317, 319–22, 326 during surgery 364–5 ISO endodontic file specification 20, 285, 294, 300, 302, 308 l Lamina Dura 46–7, 76, 146, 180, 183–4, 188, 190–1, 194–5, 198, 200, 330 Ledging 286, 321, 346–7, 356 Lipopolysaccharide (endotoxin, LPS) 29, 31, 62–3, 65–6, 73, 76–7, 102, 104, 242, 301 Lipoteichoic acid 31, 62–3, 73, 102, 104 Local anesthesia 277–8, 348–9 Lymph 23–4, 30, 46 nodes 63–4 Lymphocytes 74, 77 m Macrophages 27, 31, 41, 63, 74, 77, 79, 96, 102, 104 Magnetic resonance imaging (MRI) 196 Malassez 11, 41, 198, 200 Mandibular canal 44, 190, 354 Mast cells 41, 74, 77 Matrix metalloproteinase (MMP) 14, 27, 30, 79, 231 Maxillary sinus 47–8, 188, 302, 313, 353, 367 Megasphaera 113–14 Mental foramen 188–90, 350, 353–5 Mesenchymal stem cells (MSC) 22–3, 238, 240–1, 247, 270 Meta‐analysis 156 Metaproteomics 93, 105 Methanobrevibacter oralis 126 Microsurgery 346, 349, 360–1, 371 Mineral trioxide aggregate (MTA) 239, 259, 264, 268, 329, 358, 360, 361, 363, 367–8, 370–1 Mitogen activated protein kinase (MAPK) 62, 73 Modulins 94, 102 Monocytes 30, 63, 104 Mogibacterium 115 n Nasal cavity 187, 367 Natural killer cells (NK) 31, 62–3, 65 Necrosis bone 198 pulp 6, 19, 60–1, 65, 71, 74, 77–9, 91–2, 100, 106, 164, 212–13, 215, 218, 221–2, 225, 228, 238–9, 243, 246–7, 253, 255, 265–6, 275, 276–8, 315 Necrotizing fasciitis Negative predictive value 157, 202, 218 Nerves 22, 25, 63, 183, 214, 330 A delta 26, 29, 32–3, 43, 214–15, 218 afferent 34, 242 C fibers 26, 43, 214–17, 219 degeneration of 217 immunoreactive 42–3 infra‐alveolar 348 mental 348 myelinated 25, 44 NPY‐containing 44 periodontal 41 sensory 27, 33, 214, 216, 218–20, 222, 242, 277–8 spontaneous 64, 104, 212, 216, 220, 223–4, 227, 257, 259, 261 sprouting 44 www.ajlobby.com sympathetic 24, 26, 29–30, 41–4, 213 unmyelinated 25, 44, 215, 217 Neural theory of pain 33–4 Neurogenic inflammation 26, 29, 63, 190, 212, 216, 240–1 Neuropeptides 24, 27–30, 41, 44, 59, 76, 104, 214, 216, 240–2, 245 CGRP 24, 29, 41, 44, 214, 216 neurokinin A 29, 214 neuropeptide Y 24, 29–30, 245 Neutrophils (PMNs) 19, 27, 31, 63, 67, 70, 74, 77–8, 96, 98, 101, 103 Nitric oxide 29, 62–3, 104, 213 Nociception 32–3, 240, 245 Nuclear factor kappa B (NF‐kB) 73, 78 Nucleotide‐binding oligomerization domain (NOD) 73 o Odontoblast 13, 28–36, 238, 247, 257 Olsenella 61, 72, 110, 113, 115 O uli 116 Osteoclasts 29, 41, 47–8, 77 Osteomyelitis 59, 70, 73, 95, 198, 313 Osteoprotegrin (OPG) 77–8 Osteotomy 349, 351–3, 355–6, 362 Oxygen tension 103, 106, 108, 109, 116 p Pain 2–4, 7, 26, 76, 161–2, 169, 212–31, 259, 261–2, 265, 313 from abscess 67, 225 gene regulation in 68 Index lingering 64, 212, 214, 257, 261–2, 265 mechanisms 26, 32–4, 43, 59, 62, 72, 104, 118, 277 postoperative 165, 167, 299, 326, 351–2 preoperative 165 referred 212, 224, 239 spontaneous 64–5, 212 thermal 212, 257 Palpation test 64, 215, 217, 221, 224–30 Parathyroid hormone 77 Parvimonas 107, 110, 113, 115 P micra 71, 77, 112, 115 Patency 167, 280, 282, 325 Peptidoglycan 62, 102 Peptostreptococcaceae 114 Peptostreptococcus 77, 115 P anaerobius 115 P micros 77 P stomatis 115 Percussion test 64, 217, 221, 223, 225, 227–30, 257, 369 Perforation during instrumentation 120, 167, 321, 323, 346–7, 356, 363–4 to nasal cavity or sinus 48, 353, 367 to pulp 224, 261, 263 repair 324, 346, 361, 363 Periapical cemental dysplasia 200 Periapical index (PAI) 146, 157, 164, 193, 330 Pericytes 22, 24, 241 Periodontal disease 46, 60, 91, 126, 197–8, 211, 216, 221, 223, 348 Periodontal ligament (PDL) 11–12, 39–48, 184–5, 193, 230–1, 247, 360, 362, 364, 368 widening of 76, 185, 190–1, 194, 197–8, 203, 231 Perivascular niche 240–1 Perivascular stellate cells 22, 41 Persistent infections 5, 74, 105, 110–11, 114–15, 316, 327, 328 Phylotype 94, 112–13, 115, 118, 122 Plasma blood 21, 22, 24 membrane 26 proteins 24 Plasma cells 27, 74, 77 Polyamines 102, 104 Porphyromonas 72, 107, 109, 110, 112, 114, 116 P endodontalis 114, 118, 123 P gingivalis 114 Positive predictive value 157, 202, 218 Post‐treatment infections (apical periodontitis) 95, 99, 103, 105, 111, 114–16, 120–3, 125–6, 194, 316, 318, 326 Prevalence 6, 27, 72, 74–6, 145, 151, 155, 161, 163, 167, 179, 197, 202 bacterial 74, 98, 112, 121–2, 125–6 Prevotella 61, 72, 107, 110, 112–14, 116, 122–3 P baroniae 116, 118 P intermedia 77, 119 Primary infections 60, 72, 104–5, 110–11, 114–15, 121–3, 126, 316 Prognosis 1, 2, 61, 64–5, 73, 76, 80, 143, 151, 160, 163–4, 168, 203, 266–7, 302, 318, 324–5, 328, 331, 348, 355, 363, 367 Prostaglandins (PGE) 29, 68–9, 102, 104 Proteases 31–2, 59, 102, 105, 108, 243 Proteinase‐activated receptors (PARs) 32 www.ajlobby.com Pseudomonas aeruginosa 111, 123 Pseudoramibacter 61, 110, 113–14 P alactolyticus 116 Pulpal exposure 27, 44, 60–1, 63, 73, 106, 213, 216, 223–4, 238, 241, 243, 253–4, 257, 258–9, 261, 263, 265, 267, 276, 278, 300, 323 Pulp capping direct 223, 238–9, 247, 255, 258, 262, 264, 266–7, 269 indirect 247, 259, 260, 267, 269 Pulpectomy 218, 224–5, 227, 253–4, 263–4, 266, 275–84, 288, 294, 296–304, 324 Pulpitis 7, 31, 33, 59–71, 164, 318, 331 acute 227 asymptomatic/symptomatic 65–71, 275–6 reversible/irreversible 31, 34, 59–71, 106, 185, 193, 202, 212–17, 231, 242, 246–7, 254, 257, 261–2, 265, 267–9, 275–6 Pulpotomy/pulp amputation full 65, 224, 247, 253, 258, 262–4, 266, 269, 270, 276, 297, 300 partial 65, 224, 238, 261–3, 266–7, 269 Pulp stone 24, 26–8, 41, 216, 222 Pyramidobacter 113–14 q Quorum‐sensing 96, 107, 120 r Radiation dose 179, 195–7, 203–4 Rake angle 290–2 391 392 Index Randomized controlled trial (RCT) 145, 154, 156, 161, 165, 167, 258–9, 261, 267–8, 279, 322–3, 361, 371 Reamer 281 Receiver operating characteristic curve (ROC) 157 Receptor activator of NF‐kB (RANK) 78 Receptor activator of NF‐kB ligand (RANKL) 78 Reciprocating file movement 284–5, 292–3, 321, 327 Redox potential 103, 106 Regeneration 30, 37, 79, 237–47, 255–6, 317, 323, 328 guided tissue 358, 366, 368 Reliability 156–7, 219 Replantation 346, 363–5 Resilience 16, 18, 21, 37 Resorption apical 315, 347 bone 41, 46–7, 59, 62, 70, 73, 76–8, 102, 104, 119, 193, 228 cementum 42, 282 dentine 282, 315 external 182, 364 inflammatory 182, 199, 276 internal 276, 284, 295, 299, 303 root 6, 41, 45–6, 59, 123, 181, 199, 200–2, 282, 364, 366, 368 surface 364 tooth 41, 99 Retreatment 5, 363 orthograde/non‐surgical 125, 161, 165, 203, 301, 316, 322, 325, 327–8, 331, 345–7, 355–6, 364–5, 371, 372 surgical 346–7, 367, 371 Ribosomal RNA (16S rRNA) 93–4, 113 Root amputation 346, 364–5 Root‐end preparation 345, 349, 353–8, 360, 363–4, 371 Root filling 146, 149, 159, 165, 300–3, 317–25, 348 apical level 324–5 extrusion of 155, 194, 294 homogeneity 168, 325 quality 151, 157–8, 166, 168, 328, 357, 367 Root resection 116, 345–7, 349, 353–7, 363–4, 366–7, 371–2 Rotary instrumentation 293, 321, 327 Rubber Dam 110, 166, 220–1, 253–4, 263, 279, 304, 318–19 s Scaffold 194, 245–6 Sclerosis bone 198 tubule 17–18, 20, 217, 240, 243 Sealer cement 301–2, 323 calcium silicate 216, 239, 244, 259, 263, 265–6, 276, 300, 302, 324, 347, 358, 360–2, 364 epoxy 302, 324 glass ionomer 302, 358 methacrylate 302, 324 Secondary infections 110–11, 114–15, 120, 123, 126 Selenomonas 113–14 Self‐adjusting file 293 Sensitivity bacterial detection 72, 318 pulp 25, 33, 214–16, 221, 326 radiological 62, 179, 202–3 statistical 157 testing 64, 217, 220–2, 225, 227–9, 231, 369 Serotonin 26, 214 Sharpey’s fibres 11, 39, 40, 46, 48 www.ajlobby.com Short‐chain fatty acids (SCFA) 104 Sialophosphoprotein 65–6 Single‐visit 167, 320, 322 Sinus tract 2, 76, 104, 110, 123–4, 165, 197, 226, 227, 229–31, 266, 313, 316, 322, 329, 369 Smear layer 296, 298, 319 Sodium hypochlorite (NaOCl) 279, 286, 297–9, 318–19 Specificity microbial 5 radiological 179, 202 statistical 157 Spirochetes 72, 227 Stem cells 22–3, 237–47, 257–8, 368 Stem cells human exfoliated deciduous teeth (SHED) 241 Stem cells of the apical papilla (SCAP) 241 Stenotrophomonas 61 Stepwise excavation 259–61, 263, 267, 269 Streptococcus 61, 113, 116, 118, 122 S anginosus 115 S constellatus 115 S gordonii 115 S intermedius 77, 115 S mitis 115 S mutans 30, 32, 60 S sanguinis 115 Subodontoblastic area 27, 30 DCs 31 plexus 23, 34 Substance P (SP) 24, 29, 214, 240, 245 Superoxide dismutase, (SOD3) 20–1 Sympathectomy 41 sympathetic nerve 24, 41, 44 Synergistes 72 Syntrophy 96 Systemic disease 5, 45, 313, 320, 348 Index t Tannerella 110, 112, 114 T forsythia 116 Taper 283, 285, 288, 292–4, 320–1 T‐cells 30–1, 62–5 helper 64, 74 regulatory 31, 64, 74 suppressor 74 Tenascin 22 Tissue engineering 237, 244–7, 328 Toll‐like receptors (TLRs) 31, 63, 74, 242, 244 Transferrin 20–1 expression by odontoblasts 21 Transforming growth factor TGF‐alfa 79 TGF‐beta 31–2, 64, 78–9, 240, 242, 244–5 Transient receptor potential ankyrin (TRPA) 33–4 Transient receptor potential vanilloid (TRPV) 33–4, 63 Transportation of canal shape 285–8, 292, 325, 346 Treatment outcome 99, 120, 155–68, 203, 268, 300, 317, 318, 330 Treponema 72, 110, 112–14, 116, 123 T denticola 72, 77, 118 Tuned aperture computed tomography (TACT) 195–6 u Ultrasound diagnostic 196–7 as preparation adjunct 294, 320–1 www.ajlobby.com v Validity 151, 156–7, 160–1 Varicella V zoster 6, 72, 119 Vascular endothelial growth factor (VEGF) 79, 242, 244–5 Vasoconstriction 26, 29–30, 42, 368 Vasodilation 27, 29, 42–3, 240, 242, 245 Veillonella 113–14 Venule 23–4, 30 Vertical root fracture 197–8, 347–8, 354 Vitamin D3 77 Volksmann’s canals 46 z Zinc oxide‐eugenol (ZOE) 302, 324, 358, 360 393 .. .Essential Endodontology www.ajlobby.com Essential Endodontology Prevention and Treatment of Apical Periodontitis Third Edition Edited by Dag Ørstavik cand odont & dr odont Professor Emeritus... Diagnosis and? ?Treatment of Primary Apical Periodontitis? ?? 326 11.7 ? ?Treatment of? ?Persistent or Recurrent Apical Periodontitis? ?? 327 11.8 ? ?Treatment of? ?Immature Permanent Teeth with? ?Apical Periodontitis? ??... been termed apical periodontitis, apical granuloma/cyst, periapical osteitis and Essential Endodontology: Prevention and? ?Treatment of Apical Periodontitis, Third Edition Edited by Dag Ørstavik ©