50ūü¶∑Most Common Golden Points of Endodontics|Dental Study Notes

50ūü¶∑Most Common Golden Points of Endodontics|Dental Study Notes

Endodontics Notes For Dental Students. Did you know these high yield statements from top dental books?

Root canal dressing material

Even today, a watery paste of calcium hydroxide is the most important material for use as an interim root canal dressing. The most commonly used commercial agent is Pulpdent

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Rubber Dam

A 15 √ó 15 cm (6 √ó 6 in) sheet of rubber is the most frequently used rubber¬† dam¬† for¬† clinical¬† use.¬† The¬† raw¬† material‚ÄĒas¬† with¬† latex gloves‚ÄĒis the sap of the native rubber tree. Chemically, the substance is a cis-1.4 polyisoprene.¬†The material is available in Ô¨Āve different¬† thicknesses;¬† in¬† endodontics¬† the¬† medium,¬† strong,¬† and¬†extra strong sheets are most commonly used

Gutta percha

The¬† root¬† canal¬† Ô¨Ālling¬† material¬† most commonly¬† used¬† worldwide¬† is¬† gutta-percha.¬† Regardless¬† of¬† the clinical technique used to compact gutta-percha within the root canal, use of this material without simultaneous application of a root canal ‚Äúsealer‚ÄĚ will inevitably result in some inadequately obturated sections of the root canal

Root canal dressing material

Even today, a watery paste of calcium hydroxide is the most important material for use as an interim root canal dressing. The most commonly used commercial agent is Pulpdent


The¬† most¬† common¬† endodontic¬† surgical¬† procedure is the root resection (apicectomy). A standard clinical procedure, apicectomy is characterized by removal of the root tip, retrograde preparation of accessible root canal areas, and hermetic retrograde¬† canal¬† closure,¬† with¬† the¬† removal¬† of¬† inÔ¨ā amed¬† extraradicular tissue and ‚ÄĒ if present ‚ÄĒ any extruded root canal Ô¨Ālling materials.

Extenal resorption

In inÔ¨āammatory root resorption, the necrotic, infected pulp provides the stimulus for periodontal inÔ¨āammation. The most common cause of external inÔ¨āammatory root resorption is trauma. If the cementum has been damaged, leaving the dentinal tubules exposed, this creates an open communication between the internal¬† and¬† external¬† surfaces¬† of¬† the¬† root.¬† Bacteria¬† and¬† their¬† by-products, and tissue breakdown products from within the pulp space, diffuse through the dentinal tubules and stimulate an inÔ¨āammatory¬† response¬† over¬† large¬† areas¬† of¬† the¬† periodontal¬† ligament, leading to aggressive and progressive resorption of the root

Dental flap

The most common flap design in the mandibular posterior region is the full thickness, triangular sulcular incision. The vertical incision should be done in the mesial interproximal site one tooth anterior to where the mental foramen is located. The location is determined by CBCT

Endodontic surgery

One of the most common teeth requiring endodontic microsurgery surgery is the maxillary molar, due to its complicated anatomy involving the mesiobuccal root. Aberrant anatomy involving the distobuccal root can also occur, especially in cases where the distobuccal may be fused to either the mesiobuccal or palatal roots. A significant number of maxillary premolar teeth can have non-healing apical periodontitis as well. Due to the anatomic and restorative conditions that involve thin-rooted premolar teeth, endodontic surgery can be the preferred procedure in a majority of cases

Lateral root canal

Lateral  root canals may  be  single  or  multiple  or  large  or  small. They  may occur anywhere along the root but are most common in the  apical  third.  In  molars,  they  may  join  the  pulp chamber  PDL  in  the  root  furcation

Pulp cells

Fibroblasts  are  the  most  common  cell  type  in  the  pulp and  are  seen  in  greatest  numbers  in  the  coronal  pulp. They  produce  and  maintain  the  collagen  and  ground substance of the pulp and alter the structure of the pulp in disease. As with odontoblasts, the prominence of their cytoplasmic organelles changes according to their activity


Caries¬† is¬† a¬† localized,¬† progressive¬† destruction¬† of¬† tooth structure and the most common cause of pulp disease. It is now generally accepted that for caries to develop, speciÔ¨Āc¬† bacteria¬† must¬† become¬† established¬† on¬† the¬† tooth surface. Products of bacterial metabolism, notably organic acids and proteolytic enzymes, cause the destruction of enamel and dentin. Bacterial metabolites diffusing from the lesion to the pulp are capable of eliciting an immune response¬† and¬† inÔ¨āammatory¬† reaction

Extraradicular infection

Extraradicular¬† infection¬† is¬† characterized¬† by¬† microbial invasion of and proliferation in the inÔ¨ā amed periradicular tissues and is almost invariably a sequel to intraradicular infection. Extraradicular infection can be dependent on¬† or¬† independent¬† of¬† the¬† intraradicular infection.¬† The most¬† common¬† form¬† of extraradicular¬† infection¬† dependent¬† on¬† the intraradicular¬† infection¬† is¬† the¬† acute¬† apical abscess. The most common form of extraradicular infection that can be independent of the intraradicular infection is the apical actinomycosis

Bleaching agent

Today,¬† preparations¬† containing¬† hydrogen¬† peroxide¬† are¬† the most¬† commonly¬† used¬† bleaching¬† agent.¬† Depending¬† on¬† the¬† pH¬† value,¬† light¬† effects,¬† temperature,¬† presence¬† of¬† Ko-catalysts¬† or metallic¬† reactions,¬† free¬† hydrogen¬† peroxide¬† can¬† release¬† various radicals¬† (Hňô,¬† Oňô,¬† OHňô,¬† HO2ňô),¬† hydroxyl¬† (OH ‚Äď )¬† or¬† perhydroxyl¬† ions (OOH ‚Äď ), which are responsible for the oxidative or reduction and therefore bleaching characteristics of hydrogen peroxide

Sling suture

The continuous sling suture and the single knot interrupted suture are the most commonly used types of suture in endodontic microsurgery

Mental foramen

Visualization of the mental foramen on intraoral radiographs may be difficult and must be interpreted cautiously. The most common reason for this difficulty is when it is in proximity to periapical radiolucencies. Patients with a small mouth, large mandibular tori, a shallow floor of the mouth, or mal-positioned teeth may prevent proper placement of the film for exposure of the mental foramen

Endodontic infection

Gram-negative bacteria appear to be the most common microorganisms in primary endodontic infections. Species belonging  to  several  genera  of  gram-negative  bacteria have  been  consistently  found  in  primary  infections associated  with  different  forms  of  apical  periodontitis, including abscesses

Mandibular anaesthesia

Although the most common method of mandibular anesthesia is the inferior alveolar nerve block, this injection also has the greatest number of failures

Maxillary anaesthesia

Anesthesia is more successful in the maxilla than in the mandible.¬†The most common injection for the maxillary¬†teeth is inÔ¨Āltration

Endodontic file

Files and reamers are available in three shaft lengths: 21, 25,  and  31  mm.  Shorter  instruments  afford  improved operator  control  and  easier  access  to  posterior  teeth,  to which  limited  opening  impairs  access.  The  25-  and  31-mm  instruments  are  used  for  longer  roots. The  25-mm instruments  are  the  most  commonly  used  instruments during root canal preparation

Dens invaginatus

Dens  invaginatus,  which  is  most  common  in  maxillary lateral incisors, results from an infolding of the enamel organ during proliferation and is an error in morpho differentiation. It  often  results  in  an  early pulp-oral  cavity  communication  requiring  root  canal treatment

Dens evaginatus

A variation of dens invaginatus, dens evaginatus is most common¬† in¬† mandibular¬† premolars¬† and¬† in¬† individuals with¬† Asian¬† ancestry,¬† as¬† well¬† as¬† Native¬† Americans¬† and Hispanics. Clinically, dens evaginatus initially appears as a¬† small¬† tubercle¬† ‚Äúbulge‚Ä̬† on¬† the¬† occlusal¬† surface,¬† but¬† it may not be obvious radiographically . These tubercles often contain an extension of the pulp

Dental pulp horn

Occasionally, a pulp horn extends far into a cusp region, resulting¬† in¬† premature¬† exposure¬† by¬† caries¬† or¬† accidental exposure¬† during¬† cavity¬† preparation.¬† These¬† high¬† pulp horns are often not visible on radiographs.¬†This is most¬†common in the mesiobuccal of Ô¨Ārst molars

Mandibular molars

The¬†mandibular molars¬†are similar in anatomic conÔ¨Āguration;¬† however,¬† there¬† are¬† subtle¬† differences. The¬† most¬†common¬† mandibular¬† Ô¨Ārst¬† molar¬† conÔ¨Āguration¬† is¬† two canals¬† in¬† the¬† mesial¬† root,¬† although¬† three¬† have¬† been reported, and one canal in the distal root. The presence of a second canal in the distal root is 30% to 35%

Mandibular 2nd molar

The¬† most¬† common¬† conÔ¨Āguration¬† for¬† the¬† mandibular second¬† molar¬† is¬† two¬† canals¬† in¬† the¬† mesial¬† root¬† and¬† one canal in the distal root. The incidence of four canals is low

Household bleach

The most common irrigant is NaOCl, which is also known as¬† household¬† bleach.¬† Advantages¬† to¬† NaOCl¬† include¬† the mechanical Ô¨āushing of debris from the canal, the ability of the solution to dissolve vital and necrotic tissue, the antimicrobial action of the solution, and the lubricating action. In¬† addition, it¬† is¬† inexpensive¬† and¬† readily available

Root canal procedure accidents

The most common procedural accidents during cleaning and shaping of the root canal system are ledge formation, artiÔ¨Ācial canal creation, root perforation, instrument separation, and extrusion of irrigating solution peri-apically. Correction of these accidents is usually difÔ¨Ācult, and the patient should be referred to an endodontis

Coronal seal

Lack of a coronal seal is probably the most common and best¬† controlled¬† problem.¬† A¬† coronal¬† restoration¬† protects and seals the tooth, preventing percolation of saliva and bacteria apically that results in failed treatment. There is a deÔ¨Ānite correlation between poorly restored crowns of endodontically treated teeth; leakage of dye, bacteria, or endotoxin through the canals; and a poorer prognosis. The coronal access to a root canal‚Äďtreated tooth must be sealed completely for the lifetime of this organ


Obturating¬† materials¬† are¬† the¬† most¬† common¬† and¬† severe cause of single tooth discoloration. Incomplete removal of¬† materials¬† from¬† the¬† pulp¬† chamber¬† on¬† completion¬† of treatment often results in dark discoloration .¬† Removing¬† all¬† obturation¬† materials¬† to¬† a¬† level just cervical to the gingival margin can prevent such discoloration. Primary offenders are sealer remnants, whether of the zinc oxide‚Äďeugenol type or plastics, which themselves also darken with time

Walking bleach technique

The  methods  most  commonly  used  to  bleach  teeth  in conjunction with root canal treatment are the thermocatalytic  technique  and  the  so-called  walking  bleach  technique. These techniques are somewhat different, but both produce similar results. The walking bleach technique is preferred because it requires the least chair time and  is  more  comfortable  and  safer  for  the  patient

Canal configuration

Three-rooted mandibular Ô¨Ārst molars¬†exhibit usually four separate root canals and accessory canals in the mesial and DB root are found quite often.¬†The most common canal conÔ¨Āguration was Vertucci type I for the distal root and Vertucci type IV for the mesial root

Facial pain

Pain, when present, is obviously an indicator of some form of disease. Pain in the mid and lower facial regions can be confusing for patients and they are often unsure as to whether they should consult a doctor or dentist.¬†By far, one of most common causes of pain in the mid and lower face is pain of dental origin. Epidemiologic studies indicate that toothache is the prevalent form of pain in the orofacial region, with approximately 12‚Äď14 % of the population reporting a history of toothache in the preceding 6-month period

Metastatic neoplasia of jaw

Metastatic neoplasia to the jaw¬†is rare with 1‚Äď3 % of all malignant oral neoplasias being metastatic. The common primary sources for the metastases to the oral region are the breast, lung, and kidney.¬†The mandible is the most¬†common location of the metastases, with the molar region being more commonly involved. Although rare, patients with multiple myeloma can develop osseous osteolytic lesions adjacent to teeth. When this occurs, odontogenic pain is common and presents a radiologic diagnostic challenge

Root fractures

Root fractures are generally only directly visible radiographically in around 30 % of teeth where a fracture is known to be present. In endodontically treated teeth, one the most common signs of vertical root fractures is a narrow deep osseous defect that is generally located on the buccal aspect of the tooth

Maxillary pulpal anaesthesia

The supraperiosteal (inÔ¨Āltration) injection is the most commonly used local anesthetic technique for maxillary pulpal anesthesia. Ninety-Ô¨Āve percent (95 %) of maxillary¬† inÔ¨Āltration injections (supraperiosteal¬† or Ô¨Āeld¬† blocks)¬† produce¬† successful anesthesia

Electric pulp testing

The most commonly used medium applied on tooth for electric pulp testing  is toothpaste. The coated probe tip is placed in the incisal third of the facial or buccal area of the tooth  to  be  tested.

Traumatic dental injury

The prevalence of traumatic dental injuries varies according to the  population  studied,  but  these  injuries  occur  most  commonly in children 7 to 10 years of age

Endodontic file separation

The most common cause for file separation are improper use, limitations in physical properties, inadequate access, root canal anatomy, and possibly manufacturing defe

Root resection technique

Even without periradicular pathosis, the distance between the root apices of the maxillary posterior teeth and the maxillary sinus sometimes is less than 1 mm. 225  An inflammatory  periradicular  lesion  often  increases  the  likelihood  of sinus exposure during surgery. If the maxillary sinus is entered during surgery, special care must be taken to prevent infected root fragments and debris from entering the sinus. The most commonly used root resection  technique  involves  grinding  the  root  apex  with  a  high-speed  drill  for  approximately  3  mm  in  an  apical  to  coronal direction;  therefore,  an  opening  could  allow  infected  debris into the sinus. A sinus opening can be temporarily occluded with a material such as Telfa gauze, although the gauze should be secured so as to prevent inadvertent displacement into the sinus. A suture can be placed through the packing material to prevent displacement and aid retrieval

Tooth resection

Tooth  types  (i.e.,  location  within  the  arch)  may  vary  with respect  to  their  susceptibility  to  tooth  fracture,  a  common  reason  for  tooth  loss  after  endodontic  treatment. It was found that maxillary premolars and mandibular molars were found to have the highest frequency of extraction, with tooth fracture  being  the  most  common  reason

Reparative dentin

The  term  most  commonly  applied  to  irregularly  formed dentin  is  reparative  dentin,  presumably  because  it  frequently forms in response to injury and appears to be a component of the  reparative  process

Extra-radicular infection

The  most common  form  of  extra-radicular  infection  is  the  acute  apical abscess, characterized by purulent inflammation in the peri-radicular  tissues  in  response  to  a  massive  egress  of  virulent bacteria from the root canal

Tooth resection

Tooth  types  (i.e.,  location  within  the  arch)  may  vary  with respect  to  their  susceptibility  to  tooth  fracture,  a  common  reason  for  tooth  loss  after  endodontic  treatment. It was found that maxillary premolars and mandibular molars were found to have the highest frequency of extraction, with tooth fracture  being  the  most  common  reason