Restorative dentistry

Module Endodontics

The student will have tha preparation that allows to recognize, deal with and solve complex cases of endodontics. In particular, the student will be able to manage endodontic emergencies and their treatment; recognize and appropriately use the main instrumental preparation techniques; recognize and properly use the substances used for root canal irrigation; learn about various methods of filling the endodontic space; managing endoparodontal diseases; plan and organize simple endodontic surgery; coordinate an assistant in the chair for conducting endodontics interventions.

Theoretical lessons in the classroom, pre-clinical exercises on extracted teeth: preparation of the access cavity, root canal probing, determination of the working length, shaping with manual and rotating tools in Nickel Titanium, filling of the endodontic space, coronal reconstruction. Laboratory of materials used in endodontics.

Endodontic diagnosis. Pulpal pathology and periapical pathology. The pathology of necrotic pulp. Pulp vitality test.
Radiographic examinations in endodontics. Interpretation of radiographic anatomy. Anamnestic findings and preliminary diagnosis. Treatment and decision-making plan.
Anesthesia in Endodontics: Surface anesthesia. Local infiltration. Regional or troncular anesthesia. Additional anesthesia. Endodontic pretreatments.
Field isolation. Pre-endodontic restoration: biological and clinical reasons. Requirements for the access cavity. The preparation of the access cavity in the various dental elements. The access cavity in the prosthetic abutments and through the prosthetic crowns.
The location of the chamber and the retrieval of the canal entrances in the mono and multi-collars. Polar chamber grinding with passive point cutters. The ultrasonic tips for grinding the pulp chamber.
Classification of endodontic instruments. The root canal probing with steel tools. Determination of working length: use of the latest generation apex locators. Apical limit of the preparation: anatomical, electronic, endodontic, radiographic apex.
Standardized endodontic instruments. Files, caterpillars, pull yourself together. The nickel-titanium endodontic instruments with increased taper. Ni-Ti characteristics. Coronal enlargement and elimination of interferences: Glide-path. Preparation of root canals according to the Schilder technique. The curved channels. The obliterated root canals. Treatment of teeth with vital pulp and necrotic pulp. Endodontic shaping with Ni-Ti rotary instruments and steel manuals. Sequence of use of rotating instruments in mono and multi-collars. How to prevent the separation of instruments: the splitting of work areas. Preparation and verification of apical diameter (apical gauging). Iatrogenic perforations: rational in the choice between MTA and calcium hydroxide.
Biological objectives of cleansing and shaping of the root canal system. Endodontal cleansing. Irrigating in endodontics. Rational use of sodium hypochlorite and EDTA during and after shaping. Techniques for implementing the activity of irrigating agents.
The filling of the endodontic space: biological principles, materials and techniques. Properties of filling materials. Gutta-percha. Lateral condensation of gutta percha. Vertical compaction of hot gutta percha according to the Schilder technique. I Thermafil. The technique of continuous condensation wave: System B and syringe Obtura II. The Microseal technique. Ocalessic therapy. Endodontic treatment of deciduous teeth and immature apex teeth. The importance of post-endodontic restoration in endodontics.
Definition of success and endodontic failure. Radicular reabsorption. Endodontal lesions. Endodontic retractions. Removal of extracanal and obstacle barriers. Orthograde reprocessing methods. Drilling. Surgical endodontics: indications, limits and operating procedures. Retrograde filling. Radicular amputation.
The laser in endodontics. Ultrasound in endodontics. Emergency endodontics. Complications during endodontic treatments. Replanting of the tooth.
Endo-perio correlations
Endodontic therapy in pediatric patients
Endodontic therapy in elderly patients
Discoloration and internal whitening

• F. SOMMA: Endodonzia. Principi di base, procedure operative e tecniche - Masson Editore, Milano
• K. Hargreaves, L. Berman: “Cohen’s Pathways of the pulp” XI edition 2016 ELSEVIER
• I.Rotstein, J. Ingle: “INGLE’S Endodontics 7” PMPHUSA 2019
• M.Versiani, B. Basrani, D. Sousa-Neto: “The Root Canal Anatomy in Permanent Dentition” Springer 2019
• E. FOCE: Lesioni endo-parodontali - Quintessenza Edizioni, Rho (MI)

1) Esame pratico mid-term su denti estratti da eseguire durante le esercitazioni pratiche. 

2) Esame scritto con questionario a scelta multipla. 

3) Esame orale da sostenere solo se si è: ottenuto il 70% almeno di frequenze oltre che superato l'esame pratico mid-term sulle esercitazioni pratiche oltre che superato l’esame scritto con valutazione almeno 6/10.