Root Structure and Supporting Tissue

Permanent teeth-root numbers Incisors and cuspids have 1 root Premolars have 1 root except Max 1 st which has two roots Molars-Max molars have 3 roots, mandibular molars have 2 roots

Primary teeth-root numbers Primary incisors and cuspids have 1 root Primary molars=Maxillary have three roots, mandibular have two roots.

Root numbers

Root position Maxillary 1 st premolars-One root facial, one lingual Maxillary molars-Two roots facial (MF, DF) one root lingual Mandibular molars-One root mesial, one root distal

Root canals Not all roots contain a single canal –MF roots of max molars usually contain 2 root canals (MB1, MB2) –Mesial roots of mandibular molars have two root canals (MF, ML)

Root canals are not totally predicable There are exceptions to all the rules.

Views and sections

Pulpal anatomy

Subjective symptoms (symptoms reported by the patient) Spontaneous pain Swelling “My bite feels high” “It hurts to bite on”

Swelling

Objective symptoms Pain with percussion (tapping) No response to cold or slow recovery from cold, no response to electricity Apical radiolucency Drainage, fistula Looseness of the tooth

Apical radiolucency

Fistula

Root canal therapy 1. Diagnose 2. Access the pulpal chamber 3. Determine length of roots –Electronic apex locators –Radiographic determination 4. Clean chemically and mechanically 5. Obturate with gutta percha and sealer 6. Restore the tooth (Crowns or fills)

Decay accessing the pulpal chamber

Mechanical and chemical cleaning

Obturation with Gutta Percha and sealer

Early abscess

Endo files

Gates Gliddens

Endo files in tooth

Bleach irrigant

Electronic apex locator

Drying the canals

Paste sealer

Gutta percha in place

Finished Root canal treatment

Supporting bone

Alveolus and the PDL

Osteoclasts and osteoblasts

Orthodontic movement and the PDL

Terms related to the oral muccosa Gingiva –Free gingiva –Attached gingiva Muccogingival junction Muccosa Sulcus Stippling

Gingivitus

Advanced periodontal disease

PSR (Periodontal screening and recording)

What predisposes for Periodontal disease? Home care (brushing and flossing) Genetics Diseases like diabetes Habits like smoking or other drug use Number of roots –Incidence of periodontal disease is directly proportional to the number of roots Dominant bacteria in the mouth-Mothers gum health

How is periodontal disease treated? Changing home care habits Controlling habits like smoking Controlling disease like diabetes Monitoring and deep debridement of infected sites Chemical controls such as antibiotics Surgery

Periodontal disease and it’s relationship to other factors

Partial in place