Endodontic Advances and Evidence-Based Clinical Guidelines: new perspectives and evidence–based clinical guidelines

Endodontic Advances and Evidence-Based Clinical Guidelines
Contents
Preface
Acknowledgements
Editors’ Biography
List of Contributors
About the Companion Website
Part I: Advances in Knowledge
1 Tooth, Root, and Canal Anatomy
Summary
1.1 Introduction
1.2 Different Perspectives in Characterizing Root and Canal Morphology
1.2.1 Deficiencies of Current Classification Systems for Root Canal Morphology
1.2.2 Introduction to the New Coding System for Root and Canal Morphology
1.3 Advances in Apical Canal Morphology
1.3.1 Cemento-dentinal Junction (CDJ)
1.3.2 Apical Constriction (AC)
1.3.3 Major Apical Foramen (MAF)
1.3.4 Isthmus
1.3.5 Accessory Canals and Apical Deltas
1.3.6 Bifid Apex
1.3.7 The Importance of Apical Canal Anatomy in Apical Surgery
1.4 Root and Canal Morphology in Different Tooth Types
1.4.1 Maxillary Anterior Teeth
1.4.2 Maxillary First Premolar
1.4.3 Maxillary Second Premolar
1.4.4 Maxillary First Molar
1.4.5 Maxillary Second Molar
1.4.6 Mandibular Anterior Teeth
1.4.7 Mandibular First Premolar
1.4.8 Mandibular Second Premolar
1.4.9 Mandibular First Molar
1.4.10 Mandibular Second Molar
References
2 The Bioactive Properties of Dentine and Molecular Advances in Pulp Regeneration
Summary
2.1 Introduction
2.2 Regenerative Endodontics
2.3 The Role of Dentine in Pulpar Repair and Regeneration
2.4 Infection, Inflammation, and Stem Cells Interaction in Pulp Regeneration
2.4.1 Immune Response
2.4.2 Inflammation and Regeneration
2.4.3 Opportunities for Clinical Translation
2.5 Regenerative Endodontic Procedures (REPs)
2.5.1 Cell-Homing
2.5.2 Cell-based Therapies
2.6 Conclusion
References
3 Microbial Biofilms in Root Canal Systems
Summary
3.1 Introduction
3.2 General Characteristics of Microbial Biofilms
3.2.1 How do Bacteria Build Biofilms?
3.2.2 Formation of Biofilms in Root Canals
3.2.3 Planktonic Versus Biofilm Lifestyles
3.2.4 The Biofilm Phenotype
3.3 Ecological Factors Affecting Biofilms in Root Canals
3.3.1 The Inflammatory and Necrotic Environments
3.3.2 The Post-Treatment Environment
3.4 Survival of Biofilm Bacteria to Antimicrobials
3.5 Biofilm Resistance in Endodontics
3.6 Conclusion
References
4 Pulp, Root Canal, and Periradicular Conditions
Summary
4.1 Introduction
4.2 What Causes Pulp, Root Canal, and Periradicular Conditions?
4.3 The Development and Progression of Pulp and Root Canal Conditions
4.4 The Development and Progression of Periradicular Conditions
4.5 Classifications of Conditions and/or Diseases
4.6 Classification and Description of Pulp and Root Canal Conditions
4.7 Classification and Description of Periradicular Conditions
4.8 Summary
References
5 Root Resorption
Summary
5.1 Introduction
5.2 Histopathology of Root Resorption
5.3 Internal Root Resorption
5.3.1 Internal Inflammatory Root Resorption
5.3.2 Internal Replacement Resorption
5.4 External Root Resorption
5.4.1 External Inflammatory Resorption
5.4.2 External Replacement Resorption
5.4.3 External Surface Resorption
5.4.4 External Cervical Resorption
References
6 Minimally Invasive Endodontics
Summary
6.1 Introduction
6.2 Embracing the Concept of Minimally Invasive Endodontics
6.2.1 The Need for Patient-focused Approaches
6.2.2 Technological Advancements in Endodontics that Has Made Minimally Invasive Strategies Possible
6.2.3 What Does Minimum Intervention Root Canal Treatment Encompass?
6.3 Rationale for Minimally Invasive Root Canal Treatment
6.3.1 Failure of Root Canal Treatment: Microbial Causes
6.3.2 Failure of Root Canal Treatment: Structural Causes
6.4 Minimum Intervention in Endodontics: Prevention Is Better than Cure?
6.5 Minimally Invasive Management of the Deep Carious Lesion
6.6 Minimally Invasive Root Canal Treatment Procedures
6.7 Access Cavity Terminology
6.8 Minimally Invasive Root Canal Preparation
6.8.1 Goals of Root Canal Preparation
6.8.2 So, What Happens to These Untouched Walls?
6.8.3 Apical Preparation Sizes and Root Canal Preparation Tapers – How Much Is Enough?
6.8.4 Supplementary Irrigation Strategies in Minimally Prepared Root Canals
6.8.5 Is It Possible to Clean Root Canals with No Instrumentation at All?
6.9 Minimally Invasive Surgical Endodontics
6.10 Conclusion
References
7 Systemic Health and Endodontics
Summary
7.1 From Focal Infection Theory to Endodontic Medicine
7.1.1 The Discredited Focal Infection Theory
7.1.2 Endodontic Medicine: Interrelation Between Systemic and Endodontic Pathosis
7.2 Pathways Linking Periapical Inflammatory Lesions to Systemic Health Status
7.2.1 The Spread of Endodontic Bacteria to Adjacent Tissues and Organs
7.2.2 Local Production of Soluble Regulatory Molecules that
May Initiate or Sustain Inflammatory Events in Remote Tissues and Organs
7.2.3 Extrinsic or Intrinsic Pathological Mechanisms Resulting or Contributing to Both Local and Systemic Inflammation
7.3 Endodontic Implications of Systemic Diseases – Systemic Factors Affecting Periapical Repair
7.4 Diabetes and Endodontics
7.4.1 Scientific Evidence on the Association Between Diabetes and Endodontics
7.4.2 Biological Mechanisms Involved in the Association Between Diabetes and Endodontics
7.4.3 Endodontic Management of Diabetic Patients
7.5 Cardiovascular Disease and Endodontics
7.5.1 Scientific Evidence on the Association Between Cardiovascular Diseases and Endodontics
7.5.2 Mechanisms Involved in the Association Between Cardiovascular Diseases and Endodontics
7.5.3 Endodontic Management of Cardiovascular Patients
7.6 Relationship Amongst Other Systemic States and Endodontics
7.6.1 Smoking Habits
7.6.2 Digestive Diseases and Other Systemic Diseases
References
8 Technology Enhanced Education
Summary
8.1 Introduction
8.2 E-learning in Dentistry
8.3 Contemporary E-learning Models
8.4 E-learning During the COVID-19 Pandemic
8.5 Limitations of E-learning in Dental Education
8.6 Advances in Endodontology Education
8.6.1 3D Technology for Pre-clinical Training
8.6.2 Augmented and Virtual Reality
8.7 Digital Dentistry and Clinical Endodontics
8.7.1 Guided Endodontics
8.7.2 Surgical Endodontics
8.8 Conclusion
References
Part II: Advances in Materials and Technology
9 Computed Tomography Imaging Devices and Techniques
Summary
9.1 Digital Dentistry and Impact on Clinical Training and Education
9.1.1 3D Endodontic Rendering
9.1.2 3D Endodontic Software
9.1.3 Dynamic Navigation Systems (Software and Devices)
9.2 Advances in Micro-CT and Nano-CT Technologies and Their Impact on Clinical Training and Education
9.2.1 Fundamentals of Micro-CT and Nano-CT Imaging
9.2.2 Micro-CT Versus Nano-CT Technology
9.2.3 CT Technology in Dental Education and Training
9.2.4 Advances in Micro-CT and Nano-CT Applications
9.5 Conclusion
References
10 Advances in Working Length Determination
Summary
10.1 Introduction
10.2 Morphology of the Root Canal Terminus
10.3 Determining the Root Canal Terminus
10.4 An Overview of Basic Electronics
10.4.1 Atom Structure
10.4.2 Ions and Electrolytes
10.4.3 Electrical Charge, Voltage, and Current
10.4.4 Resistance
10.4.5 Electric Circuits and the Human Body
10.4.6 Ohm’s Law
10.4.7 Direct Current and Alternating Current
10.4.8 Capacitor
10.4.9 Impedance and its Measurement
10.5 Electrical Features of Tooth Structure
10.6 Electronic Root Canal Length Measurement Devices (ERCLMDs)
10.6.1 Fundamental Assumption
10.6.2 Background
10.6.3 Resistance-based ERCLMDs
10.6.4 Low-frequency Oscillation ERCLMDs
10.6.5 High-frequency Devices (Capacitance-based Devices; ERCLMDs)
10.6.6 Capacitance and Resistance ERCLMDs (Look-up Tables)
10.6.7 Voltage Gradient ERCLMDs (Difference in Impedance with Three Nodes)
10.6.8 Two Frequencies: Impedance and Difference ERCLMDs
10.6.9 Two Frequencies: Impedance Ratio (Quotient) ERCLMDs
10.6.10 Multifrequency ERCLMDs
10.6.11 Root Canal Length Measurement Devices Integrated Into Rotary Endodontic Motors
10.6.12 Effect of ERCLMDs on Cardiac Devices
10.6.13 Application of ERCLMDs in the Primary Dentition
References
11 Advances in Materials and Techniques for Microbial Control
Summary
11.1 Introduction
11.2 Biofilms
11.3 Sodium Hypochlorite
11.4 Detoxification of the Root Canal System by Endodontic Procedures
11.5 Inactivation of Root Canal Irrigants
11.6 Etidronic Acid and the Continuous Chelation Concept
11.7 Cetrimide and Surfactants
11.8 Passive Ultrasonic Irrigation
11.9 Negative Apical Pressure
11.10 Photodynamic Antimicrobial Therapy
11.11 Laser-activated Irrigation
11.12 Multisonic Technique
11.13 Conclusion
References
12 Nickel-Titanium Metallurgy
Summary
12.1 Introduction and Classification of Current NiTi Alloy Phases
12.2 Properties of Each Phase (Austenitic, Martinsitic, R-phase)
12.3 Surface Treatment of NiTi Alloys
12.4 Post-machining Heat Treatment of NiTi Alloys
12.5 Effects of Irrigants and Sterilisation Procedures on NiTi Alloys
12.6 Relevance of Current Studies
12.7 Conclusion
References
13 Rotary and Reciprocating Motions During Canal Preparation
Summary
13.1 Goals and Limitations of Engine-driven Root Canal Preparation
13.2 Current Instrument Designs, Movements, and Manufacturing Methods
13.3 Clinical Recommendations for Rotary and Reciprocating Canal Preparation
13.3.1 Preparation for Treatment
13.3.2 Early Coronal Modification
13.3.3 Working Length and Patency
13.3.4 Glide Path Preparation
13.3.5 Canal Preparation
13.4 Physical Properties of Engine-driven Root Canal Instruments
13.4.1 Cutting Efficiency
13.4.2 Cyclic Fatigue Resistance
13.4.3 Torsional Performance
13.5 Surrogate and Clinical Parameters Affecting Outcomes
13.5.1 Geometry of Root Canals After Preparation
13.5.2 Induction of Dentinal Micro-crack Formation
13.5.3 Debris Extrusion and Postoperative Pain
13.5.4 Functionality in Retreatment
13.6 Clinical Experiences with Rotary and Reciprocating Root Canal Instruments
References
14 Hydraulic Calcium Silicate-based Endodontic Cements
Summary
14.1 Introduction
14.2 Material Properties
14.2.1 Cement Characteristics
14.2.2 Radiopacifier Characteristics
14.2.3 Admixtures, Additives, and Vehicles
14.3 Classification of Hydraulic Cements
14.4 Specific Uses and Material Properties
14.4.1 Application on the Coronal Pulp
14.4.2 Intraradicular Use
14.4.3 Extraradicular Use
14.5 Current Challenges and Conclusions
References
15 Nanomaterials in Endodontics
Summary
15.1 Introduction
15.2 Applications and Challenges
15.3 Nanomaterials in Endodontics
15.3.1 Application of Nanomaterials for Endodontic Disinfection
15.3.2 Nanomaterials in Root Canal Fillings
15.3.3 Nanomaterials in Restorative Materials
15.3.4 Nanomaterials in Regenerative Endodontic Procedures
15.3.5 Nanomaterials as Bioactive Molecule Delivery Systems
15.3.6 Nanomaterials in Scaffolds
References
Part III: Advances in Clinical Management
16 Vital Pulp Treatment
Summary
16.1 Introduction
16.2 Caries: Current Thinking and Radiographic Classification
16.3 Role of Pulp and Dentine in Repair
16.4 What Does Vital Pulp Treatment Encompass?
16.5 How Do We Classify and Diagnose Pulpal Disease?
16.6 How Do We Treat Pulpal Disease? Techniques to Avoid Pulpal Exposure
16.6.1 Indirect Pulp Capping
16.6.2 Selective Carious-tissue Removal in One Visit
16.6.3 Stepwise Excavation
16.6.4 When Should Pulp Exposure Be Avoided?
16.6.5 Follow-up
16.6.6 Outcome Analysis
16.7 How Do We Treat Pulpal Disease? Techniques When the Pulp Is Exposed
16.7.1 When Should We Expose the Pulp and How Much Tissue Should We Remove?
16.7.2 Direct Pulp Capping
16.7.3 Pulpotomy
16.7.4 Pulpectomy
16.7.5 Assessing Success
16.7.6 Future Opportunities and Therapies
16.7 Conclusion
References
17 Detection of Canal Orifices, Negotiation, and Management of Calcified and Curved Canals
Summary
17.1 Introduction
17.2 Detection of Canal Orifices
17.2.1 The Significance of Missed Anatomy on the Prognosis of Root Filled Teeth
17.2.2 Anatomical Landmarks for Detection of Root Canals
17.2.3 Clinical Detection of Canal Orifices
17.2.4 Magnification and Ultrasonics: The Perfect Tools for Detection of Canal Orifices
17.2.5 Radiographic Techniques for Detection of Root Canals
17.2.6 Guided Endodontics for Detection of Root Canals
17.3 Negotiation of Calcified and Curved Canals
17.3.1 Background
17.3.2 Negotiation, Glide Path, and Preflaring
17.3.3 Clinical Strategies for the Negotiation of Easily Scoutable Canals
17.3.4 Clinical Strategies for the Negotiation of Complex Canals
17.4 Shaping of Calcified and Curved Canals
17.4.1 Basic Principles
17.4.2 The Ideal Instruments for Shaping Calcified and Curved Canals
17.5 Conclusion
References
18 Management of Fractured Instruments
Summary
18.1 Aetiology of Instrument Fracture
18.1.1 Factors Affecting Instrument Fracture
18.1.2 Incidence of Instrument Fracture
18.1.3 Mechanisms for Instrument Fracture
18.2 Diagnosis and Treatment Planning of Fractured Instruments
18.2.1 Factors Affecting the Success of Instrument Retrieval
18.2.2 Diagnostic Examination Using CBCT for Instrument Retrieval
18.2.3 Treatment Planning for Instrument Retrieval
18.3 Root Canal Preparation Techniques
18.3.1 Potential Accidents in Ultrasonic Activation
18.3.2 Refinement of the Damaged Ultrasonic Tip
18.3.3 Root Canal Preparation Techniques for Visible Instrument Retrieval
18.3.4 Root Canal Preparation for Nonvisible Instrument Retrieval
18.4 Instrument Retrieval Techniques
18.4.1 Type of fluid used in instrument removal attempts
18.4.2 Use of Ultrasonic Activation
18.4.3 Use of the Loop
18.4.4 Use of the XP-endo Shaper
18.4.5 Mechanical Techniques Other than Ultrasonics
18.4.6 Non-mechanical Techniques
18.5 Prognosis
References
19 Repair of Pulp Chamber and Root Perforations
Summary
19.1 Introduction
19.2 Occurrence and Diagnosis of Perforations During Root Canal Treatment
19.3 Diagnosis of Perforations
19.4 Classification of Perforations and Factors Affecting Prognosis
19.4.1 Time of Repair
19.4.2 Size of Perforation
19.4.3 Location of Perforation
19.4.4 MTA as a Perforation Repair Material
19.4.5 Alternative Materials for Perforation Repair in Specific Indications
19.5 Techniques and Considerations to Clinically Repair Perforations
19.5.1 Appropriate Material Selection
19.5.2 Use of a Matrix
19.6 Nonsurgical Management of Perforations
19.6.1 Crown, Pulpal Floor, and Furcation Areas
19.6.2 Middle One Third of the Root Canal
19.6.3 Apical One Third of the Root Canal
19.7 Surgical Management of Perforations
19.8 Clinical Outcomes
19.9 Conclusion
References
20 Removal of Root Canal Filling Materials
Summary
20.1 Indications for Root Canal Retreatment
20.2 Objectives of Root Canal Retreatment Procedures
20.3 Removal of Crowns and Posts
20.3.1 Indications
20.3.2 Post Removal Techniques
20.3.3 Complications of Post Placement and Removal
20.3.4 Custom Cast Core Posts
20.3.5 Ceramic Posts
20.3.6 Removal of Fibre Posts (Tooth 26 Case with Video 3)
20.3.7 Prognostic Assessment of Post Removal
20.4 Methods for Removal of Gutta-percha
20.4.1 Hand Instruments
20.4.2 Softening of Gutta-percha
20.4.3 Engine-driven NiTi Instruments
20.4.4 Adjunctive Instruments and Techniques
20.5 Removal of Carrier-based Root Canal Filling Materials
20.6 Retrieval of Silver Cones
20.6.1 Need for Removal
20.6.2 Methods of Retrieval
20.6.3 Success of Silver Point Removal and Outcome
20.7 Removal of Calcium Silicate-based Cements
20.8 Removal of Calcium Silicate-based Sealers
20.9 Removal of Resorcinol-formaldehyde Resin Paste (Russian Red)
References
21 Restoration of Root filled Teeth
Summary
21.1 Introduction
21.2 Examination of Root filled Teeth Before Selection of a Treatment Approach
21.2.1 Ferrule
21.2.2 Remaining Coronal Walls
21.2.3 Marginal Ridges
21.3 Evidence from Clinical Studies Regarding Factors Affecting the Prognosis of Root filled Teeth
21.3.1 Outcome Measures and Clinical Questions Addressed by Clinical Studies
21.4 Decision-making for Restoration of Root filled Teeth
21.4.1 Root filled Teeth with Minimal Loss of Coronal Structure
21.4.2 Root filled Teeth with Significant Loss of Coronal Structure
21.5 Clinical Considerations for the Management of Root filled Teeth Using Posts
21.5.1 Relevance of Tooth Anatomy
21.5.2 Classification of Posts
21.5.3 Effect of Post Space Preparation and Post Placement on the Fracture Resistance of Root filled Teeth
21.5.4 Clinical Steps to Cement a Post
21.6 Importance of the Final Restoration
21.7 Conclusion
References
22 Classifications and Management of Endodontic-Periodontal Lesions
Summary
22.1 Communication Pathways Between the Pulp and Periodontal Tissues
22.1.1 Endo-perio Lesions: A Terminological Controversy
22.1.2 Classifications of Endo-perio Lesions
22.1.3 Foce Classification System for Endo-perio Lesions
22.1.4 Ahmed Classification System for Endoperio Lesions
22.2 Management and Prognosis of Endo-perio Lesions
22.2.1 Crown-down Plaque-induced Periodontal Lesions Without Pulpal Involvement
22.2.2 Crown-down Plaque-induced Periodontal Lesions With Pulpal Involvement
22.2.3 Down-crown Periodontal Lesions of Endodontic Origin
22.2.4 Combined Endo-perio Lesions
22.3 Conclusion
References
23 Management of Coronal Discolouration
Summary
23.1 Introduction
23.2 Aetiology
23.3 Prevention of Coronal Discolouration Related to Endodontic Procedures
23.4 Management Guidelines
23.4.1 History
23.4.2 Evaluation and Preparation
23.4.3 Selection of the Appropriate Treatment Approach
23.4.4 Types of Intracoronal Bleaching
23.5 Bleaching of Teeth with Calcified Pulp Chambers and Root Canals
23.6 Prognosis of Intracoronal Bleaching
23.6.1 Initial Results of Intracoronal Bleaching
23.6.2 Colour Stability
23.7 Complications After Intracoronal Bleaching
23.8 Other Treatment Options
23.8.1 Restoration of Teeth After Bleaching
23.9 Tooth Discolouration Following Regenerative Endodontic Procedures
23.10 Management of Tooth Discolouration Following Regenerative Endodontic Procedures
References
24 Surgical Endodontics
Summary
24.1 Introduction
24.2 Historical Perspective
24.3 Indications for Surgical Endodontics with Root-end Resection and Treatment Alternatives
24.4 Endodontic Microsurgery (EMS) Technique
24.4.1 Diagnosis
24.4.2 Anaesthesia
24.4.3 Mucoperiosteal Flap
24.4.4 Bone Access
24.4.5 Root-end Management
24.4.6 Root-end Filling Materials, Types, and Current Advances
24.4.7 Management of the Bone Cavity
24.5 Prognosis and Outcome Evaluation
24.6 Case Difficulty Classification for Surgical Endodontics
24.6.1 Patient Level
24.6.2 Tooth Level
24.7 Other Surgical Endodontics Procedures
24.7.1 Incision and Drainage
24.7.2 Exploratory Surgery
24.7.3 Periradicular Curettage and Biopsy
24.7.4 Root Resection
24.7.5 Tooth Resection
24.7.6 Extraction with Replantation
References
25 Alternatives to Root Canal Treatment: Tooth Autotransplantation
Summary
25.1 Introduction
25.2 Indications for Autotransplantation
25.3 Advantages and Disadvantages of Tooth Autotransplantation
25.4 The Role of Interdisciplinary Team Planning
25.5 Pretransplantation Bone Management
25.6 Case Selection
25.6.1 Availability of a Donor Tooth
25.6.2 Donor Tooth Assessment
25.6.3 Recipient Site Characteristics
25.7 Success and Survival of Tooth Autotransplantation
25.7.1 Factors Affecting Prognosis of Autotransplanted Teeth
25.8 Presurgical Preparations
25.9 Tooth Autotransplantation Surgical Technique and Considerations
25.10 Socket Assessment
25.11 Antibiotic Prophylaxis
25.12 Postoperative Instructions
25.12.1 Post-transplantation Pulpal and Periodontal Management
25.13 Interim Restorative Camouflage
25.14 Pulpal Management
25.15 Orthodontic Tooth Movement
25.16 Definitive Restoration
25.17 Conclusion
References
Part IV: Evidence-based Clinical Guidelines
26 Endodontic Diagnosis
Summary
26.1 Introduction
26.2 History Taking
26.2.1 Presenting Problem
26.2.2 Dental History
26.2.3 Medical History
26.2.4 Antibiotic Cover
26.2.5 Social History
26.3 Clinical Examination
26.3.1 Extraoral assessment
26.3.2 Intraoral assessment
26.3.3 Routine Tests
26.3.4 Special Tests
26.3.5 Radiography
26.4 Classification of Pulp and Periradicular Diseases
26.4.1 American Association of Endodontists Classification System
26.4.2 Limitations of the American Association of Endodontists Classification System
26.4.3 Endolight Classification
26.5 Referred Pain
References
27 The Use of Cone-Beam Computed Tomography in Endodontics
Summary
27.1 Introduction
27.2 Detection of Apical Periodontitis
27.3 Root Canal Anatomy
27.4 Root Canal Retreatment
27.5 Endodontic Surgery
27.6 Dental Trauma
27.7 Diagnosis and Management of Root Resorption
27.8 Vertical Root Fractures
27.9 Limitations
27.10 Conclusion
References
28 Endodontic Emergencies and Systemic Antibiotics in Endodontics
Summary
28.1 Endodontic Emergencies
28.1.1 Diagnosis and Treatment Planning in Endodontic Emergencies
28.1.2 Emergency Treatment of Symptomatic Reversible Pulpitis
28.1.3 Emergency Treatment of Symptomatic Irreversible Pulpitis
28.1.4 Emergency Treatment of Acute Periapical Abscess
28.1.5 Cracked Tooth
28.1.6 Traumatic Injuries of the Teeth
28.2 Systemic Antibiotics in Endodontics
28.2.1 Antibiotics as Antimicrobial Medicaments in Endodontic Infections
28.2.2 Indications for Systemic Antibiotics as Adjuvants in the Treatment of Endodontic Infections: European Society of Endodont
28.2.3 Indications for Antibiotic Prophylaxis in Endodontics: European Society of Endodontology Position Statement
28.2.4 Systemic Antibiotics for the Treatment of Traumatic Injuries of the Teeth
28.3 Conclusion
References
29 Revitalization Procedures
Summary
29.1 Regeneration and Repair Processes in the Dental Pulp
29.2 Revitalization – Terminological Aspects
29.3 Position Statements of the ESE and AAE
29.4 Case Selection, Indications, and Contra-indications
29.5 Clinical Procedure
29.5.1 Disinfection
29.5.2 Provocation of Bleeding
29.6 Outcome
29.7 Future Perspectives
References
30 Management of Traumatic Dental Injuries in the Permanent Dentition
Summary
30.1 Introduction and Epidemiological Data
30.2 Classification of Traumatic Dental Injuries
30.3 Diagnosis of Traumatic Dental Injuries
30.4 Enamel Cracks and Crown Fractures
30.4.1 Vital Pulp Treatment
30.4.2 Materials for Vital Pulp Treatment
30.4.3 Success Rates of Vital Pulp Treatment in Traumatised Teeth
30.4.4 Reattachment Restoration
30.4.5 Direct Resin Composite Restoration
30.4.6 Indirect Ceramic Restoration
30.5 Crown-root Fractures
30.5.1 Adhesive Fragment Reattachment
30.5.2 Two-step Direct Composite Restoration
30.5.3 Restorative Treatment of the Accessible Regions
30.5.4 Surgical Crown Lengthening
30.5.5 Extrusion
30.6 Splinting of Traumatised Teeth (Root Fractures and Luxation Injuries)
30.7 Root Fractures
30.8 Luxation Injuries (Concussion, Subluxation, Extrusion, Lateral Luxation)
30.9 Luxation Injuries (Intrusion)
30.10 Luxation Injuries (Avulsion)
30.10.1 Avulsed Teeth with Favourable Storage Conditions
30.10.2 Avulsed Teeth with Unfavourable Storage Conditions
30.11 Systemic Doxycycline Administration
30.12 Tetanus Prophylaxis
30.13 Conclusion
References
Index
EULA