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Chapter 1 Modern Endodontic Therapy

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Chapter 1 Modern Endodontic Therapy
Chapter 1 MODERN ENDODONTIC THERAPY
John I. Ingle, Leif K. Bakland, Edward E. Beveridge, Dudley H. Glick, and Anthony E. Hoskinson

“Because I’ll have you know, Sancho, that a mouth without teeth is like a mill without its stone, and you must value a tooth more than a diamond.” – Miguel de Cervantes, Don Quixote

The newspaper headline read, “Ancient Root Canal Filling Found.” Datelined Jerusalem, the article went on to state that “a green tooth containing the oldest known root canal filling was discovered in the skull of a Nabatean warrior who was buried in a mass grave 2,200 years ago.” Joseph Zias, curator of the State of Israel Department of Antiquities, later reported on this historic archeologic finding in the Journal of the American Dental Association.1 The tooth in question—a maxillary right lateral incisor—dated from the Hellenistic period (200 BC). Radiographic examination of the ancient skull “disclosed a 2.5 mm bronze wire that had been implanted in the root canal—the earliest known archeologic example of a tooth filled with a metal object” (Figure 1-1). Professor Zias went on to explain the probable reason for the primitive “endodontics”: “The accepted cause of tooth disease in the Mediterranean—a worm burrowing inside the tooth— may give a clue as to why this tooth was filled with a metal wire. It is possible that the wire was implanted into the tooth canal to close the passage and prevent ‘toothworms’ from burrowing into the tooth and causing further dental pain.” The first mention of the “toothworm” theory is found in the Anastasia Papyrus of the thirteenth century BC.1 Somewhat earlier in China, the ancient Chinese subscribed to the “toothworm” theory of dental caries as well. According to Tsai-Fang, “The oracle bone inscription, excavated from the ruins of the Ying Dynasty (fourteenth century BC), clearly shows a character meaning ‘caries.’”2 Since the cause of tooth decay was

Figure 1-1 Oldest known root canal filling. Radiograph of skeletal



References: 1. Zias J, Numeroff K. Operative dentistry in the second century BCE. J Am Dent Assoc 1987;114:665. 2. Tsai-Fang T. Endodontic treatment in China. Int Endodont J 1984;17:163. 3. Grossman LI. Pioneers in endodontics. JOE 1987;13:409. 4. Grossman LI. Endodontics 1776-1976: a bicentennial history against the background of general dentistry. J Am Dent Assoc 1976;93:78. 5. Pucci FM. Conductos radiculares. Vol. II. Buenos Aires: Editorial Medico-Quirurgica; 1945. 6. Ingle JI, Levine M. The need for uniformity of endodontic instruments, equipment, and filling materials. In: Grossman LI, editor. Transactions of the Second International Congress on Endodontics. Philadelphia: 1958. p. 133–45. 7. Ingle JI. A standardized endodontic technique utilizing newly designed instruments and filling materials. Oral Surg 1961;14:83. 8. American Dental Association. 1990 Services rendered report (estimates). 9. American Association of Endodontists recertification document, 1989. 10. Burns R. Surveys document more people choosing root canal therapy over extractions. Report of the Public Affairs Committee of the American Association of Endodontists. Public education report. April 1987. 11. Molven O, et al. Prevalence and distribution of root-filled teeth in former dental school patients: follow-up after 1017 years. Int Endodont J 1985;18:247. 12. Torrey Report. American Dental Trade Association, 1984. 13. Dental products marketing strategic survey-1997: Strategic Dental Marketing. 14. AAE Internet report, 1999. 15. National Institute of Dental Research. Dental caries continues downward trend in children. J Am Dent Assoc 1988;117:625. 16. Burgess JO. A panoramic radiographic analysis of Air Force basic trainees. Oral Surg 1985;60:113. 17. National Institute of Dental Research. Survey of adult dental health. J Am Dent Assoc 1987;114:829. 18. Bailit H, et al. Does more generous dental insurance coverage improve oral health? J Am Dent Assoc 1985;110:701. 19. ADA 1996 Survey of dental practice. 20. Waldman BH. A favorable prognosis for dentistry. Dent Econom 1984;74:51. 21. U.S. Health Care Financing Administration and the Bureau of Labor Statistics, 1997. 22. Louis Harris Associates. Nuprin pain report. Newsweek 1985;Dec 2. 23. Gale EN, et al. Effect of dentist’s behavior on patient’s attitudes. J Am Dent Assoc 1984;109:444. 22 Endodontics 51. Mulhern JM, Patterson SS, Newton CW, Ringel AM. Incidence of postoperative pain after one appointment endodontic treatment of asymptomatic pulpal necrosis in single-rooted teeth. JOE 1982;8:370. 52. Roane JB, Dryden JA, Grimes EW. Incidence of post-operative pain after single- and multiple-visit endodontic procedures. Oral Surg 1983;55:68. 53. Genet J. Factors determining the incidence of post-operative pain in endodontic therapy. JOE 1986;12:126. 54. Fava L. A comparison of one versus two appointment endodontic therapy in teeth with non-vital pulps. Int Endodont J 1979;22:179. 55. Fava L. One appointment root canal treatment: incidence of post-operative pain using a modified double flared technique. Int Endodont J 1991;24:258. 56. Fava L. A clinical evaluation of one and two-appointment root canal therapy using calcium hydroxide. Int Endodont J 1994;27. 57. Trope M. Flare-up rate of single-visit endodontics. Int J Endodont 1991;24:24. 58. Harrison JW, Baumgartner JC, Svec TA. Incidence of pain associated with clinical factors during and after root canal therapy. Part I. Interappointment pain. JOE 1983;9:384. 59. Eleazer PD, Eleazer KR. Flare-up rate in pulpally necrotic molars in one-visit versus two-visit endodontic treatment. JOE 1998;24:614. 60. Ørstavik O, et al. Sensory and affective characteristics of pain following treatment of chronic apical periodontitis [abstract]. J Dent Res 1996;75:373. 61. Pekruhn R. The incidence in failure following single-visit endodontic therapy. JOE 1986;12:68. 62. Sjogren U, et al. Influence of infection at the time of root filling on the outcome of the endodontic treatment of teeth with apical periodontitis. Int Endodont J 1997;30:297. 63 Ørstavik D, et al. Effects of apical reaming and calcium hydroxide dressing on bacterial infection during treatment of apical periodontitis. Int Endodont J 1991;24:1. 64. Ingle JI, Zeldow BJ. An evaluation of mechanical instrumentation and the negative culture in endodontic therapy. J Am Dent Assoc 1958;57:471. 65. Zeldow BJ, Ingle JI. Correlation of the positive culture to the prognosis of endodontically treated teeth. J Am Dent Assoc 1963;66:23. 66. Trope M, Delano EO, Orstavik D. Endodontic treatment of teeth with apical periodontitis: single vs. multivisit treatment. JOE 1999;25:345. 67. Katebzadeh N, Hupp J, Trope M. Histological periapical repair after obturation of infected canals in dogs. JOE 1999;25:364. 68 Cohen S, Schwartz S. Endodontics and the law. Calif Dent Assoc J 1985;13:97. 69. Milgrom P, Ingle JI. Consent procedures as a quality control. J Oral Surg 1975;33:115. 70. Association reports. Code on dental procedures and nomenclature. J Am Dent Assoc 1989;118:369. 71. Quality assurance guidelines. Chicago: American Association of Endodontists; 1988. 72. Harman B. A roundtable on referrals. Dent Econ 1987;77:44. 73. Appropriateness of care and quality assurance guidelines. 3rd ed. Chicago: American Association of Endodontics; 1998. 74. Cohen S, Schwartz S. Endodontic complications and the law. JOE 1987;13:191. 24. What is root canal treatment? American Dental Association pamphlet No. W-117. 25. American Association of Endodontists, survey. ADA News 1985; Apr 15;7. 26. Burns JM. Why root canal therapy? Chicago: Quintessence; 1986. 27. Milgrom P, et al. The prevalence and practice management consequences of dental fear in a major U.S. city. J Am Dent Assoc 1988;116:641. 28. Gatchel RJ. The prevalence of dental fear and avoidance: expanded adult and recent adolescent surveys. J Am Dent Assoc 1989;118:591. 29. LeClaire AJ, et al. Endodontic fear survey. JOE 1988;14:560. 30. Lord J, Teel S. The overdenture: patient selection, use of copings. J Prosthet Dent 1974;32:41. 31. Bohannan HM, Abrams L. Intentional vital extirpation in periodontal prosthesis. J Prosthet Dent 1961;11:781. 32. Abou-Rass M. The elimination of tetracycline discoloration by intentional endodontics and internal bleaching. JOE 1982;8:101. 33. Hayward JR, Kerr DA, Jesse RH, Ingle JI. The management of teeth related to the treatment of oral cancer. CA Cancer J Clin 1969;19:98. 34. Hiatt WH. Regeneration of the periodontium after endodontic therapy and flap operation. Oral Surg 1959;12:1471. 35. Prichard J. The intrabony technique as a predictable procedure. J Periodontol 1957;28:202. 36. Sommer RF, Ostrander FD, Crowley MC. Clinical endodontics. 2nd ed. Philadelphia: WB Saunders; 1961. 37. Grossman LI, Rossman SR. Correlation of clinical diagnosis and histopathologic findings in 101 pulpless teeth with areas of rarefaction [abstract]. J Dent Res 1955;34:692. 38. Priebe WA, Lazansky JP, Wuehrmann AH. The value of roentgenographic film in the differential diagnosis of periradicular lesions. Oral Surg 1954;7:979. 39. Bhaskar SN. Synopsis of oral pathology. 7th ed. St. Louis: CV Mosby; 1986. 40. Crump MC, Natkin E. Relationship of broken root canal instruments to endodontic case prognosis: a clinical investigation. J Am Dent Assoc 1970;80:1341. 41. Calhoun RL, Landers RR. One-appointment endodontic therapy: a nationwide survey of endodontists. JOE 1982;8:35. 42. Landers RR, Calhoun RL. One-appointment endodontic therapy: an opinion survey. JOE 1980;6:799. 43. Fox JL, Atkinson JS, Dinin PA. Incidence of pain following one-visit endodontic treatment. Oral Surg 1970;30:123. 44. Wolch I. The one-appointment endodontic technique. J Can Dent Assoc 1975;41:613. 45. Soltanoff W. Comparative study of the single visit and multiple visit endodontic procedure. JOE 1978;4:278. 46. Ether S, et al. A comparison of one and two visit endodontics. J Farmacia Odontol New Orleans, Louisiana State University 1978;8:215. 47. Pekruhn RB. Single-visit endodontic therapy: a preliminary clinical study. J Am Dent Assoc 1981;103:875. 48. Oliet S. Single-visit endodontic therapy: a preliminary clinical study. J Am Dent Assoc 1981;103:873. 49. Galberry JH. Incidence of post-operative pain in one appointment and multi-appointment endodontic treatment: a pilot study [thesis]. Louisiana State University; 1983. 50. Nakamuta H, Nagasawa H. Study on endodontic treatment of infected root canals in one visit. Personal communication, 1983. Modern Endodontic Therapy 75. Åkerblom A, Hasselgren G. The prognosis for endodontic treatment of obliterated root canals. JOE 1988;14:565. 76. Ørstavik D, et al. Paraesthesia following endodontic treatment: survey of the literature and report of a case. Int Endodont J 1983;16:167. 77. Rowe AHR. Damage to the inferior alveolar nerve during or following endodontic treatment. Br Dent J 1983;153:306. 78. Cohenca C, Rotstein I. Mental nerve paresthesia associated with a non vital tooth. Endod Dent Traumatol 1996;12:298. 79. Reeh ES. Messer HH. Long term paresthesia following inadvertent forcing sodium hypochlorite through perforation in incisor. Endod Dent Traumatol 1989;5:200. 80. Joffe E. Complications during root canal therapy following accidental extrusion of sodium hypochlorite through the apical foramen. Gen Dent 1991;39:460. 81. Dietz G. A roundtable on referrals. Dent Econ 1987;77:51. 82. Harman B. Op cit, p. 72. 83. Nash K. Endodontic referrals. Calif Dent Assoc J 1987;15:47. 23 84. Weichman JA. Malpractice prevention and defense. Calif Dent Assoc J 1975;3:58. 85. Selbst AG. Understanding informed consent and its relationship to the incidence of adverse treatment events in conventional endodontic therapy. JOE 1990;16:387. 86. Hourigan MJ. Oral surgery for the general practitioner. Palm Springs Seminars, Mar., 1989. 87. American Association of Endodontists. Informed consent. Communique 1986;3:4. 88. Bailey B. Informed consent in dentistry. J Am Dent Assoc 1985;110:709. 89. Curley A. Informed consent, past, present and future [bulletin]. Sacramento (CA): The Dentists Insurance Co.; 1989. p. 3. 90. Association Reports, Council on Insurance. Informed consent: a risk management view. J Am Dent Assoc 1987;115:630. 91. Paladino T, Linoff K, Zinman E. Informed consent and record keeping. AGD Impact 1986;14:1. 92. Howard W. A roundtable on referrals. Dent Econ 1987;77:50.

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