APICAL THIRD PPT.pptx

dental apical third

1. Importance of Apical Third in Endodontics Arjun AR 2 nd year pg

2. INTRODUCTION

3. pla i ns mountains the mountain pass ar m y fr ont

4. 3000 permanent teeth minute details like extensions, ramifications, branching as well as size, shape and number of root canals in different teeth

5. Development of root Hertwig’s epithelial root sheath . size and shape o f th e root o f the to o th

6. horizontally epithelial diaphragm encl o ses delineates

7. , the epithelial diaphragm HERS

8. single rooted teeth , single opening double rooted teeth , two openings. three rooted teeth , three openings multi rooted

9. ACELLULAR CEMENTUM . CELLULAR CEMENTUM cementocytes.

10. ro o t coronal middle third of apical third of the root apical third of the root thicker than cervical third.

11. A C CESSO R Y C A N A L FORM A TION inefficient source of collateral circulation Defect in the epithelial root sheath Failure in the induction of dentinogenesis The presence of small blood vessels more prevalent apical third produce a gap - accessory canal

12. ROOT LENGTH AND APICAL CLOSURE completion of the root length dates of tooth eruption apical closure

13. early in females maxillary posterior teeth are slightly later than mandibular teeth

14. AN A T OMY OF ROOT APEX

15. Morphologically : most complex region Prognostically : important part

16. Morphology of the Physiological Foramen:I. Maxillary and Mandibular Molars VOL. 30, NO.5,MAY2004

17. CEMENTODENTINAL JUNCTION ( CDJ ) It is the point in the canal where cementum meets dentin

18. LOCATION & DIAMETER OF CDJ

19. THE DIAMETER OF THE CANAL

20. APICAL F ORAMEN Funnel shaped Hyperbolic Morning glory

21. MEAN DISTANCE DIAMETER OF AF

22. E X IT O F AF

23. Number of apical foramen

24. Size of apical foramen

25. Variations in morphology of apical third of the root & its significance in endodontics

26. ACCES S O R Y CANAL

27. Accessory canals occur in three distinct patterns in the mandibular first molars. A, In 13% a single furcation canal extends from the pulp chamber to the intraradicular region. B, In 23% a lateral canal extends from the coronal third of a major root canal to the furcation region (80% extend from the distal root canal). C, About 10% have both lateral and furcation canals.

28. does not appear to be significant factor granulation tissue

29. percentage of failures due to unfilled lateral canals is small biological hard closure of lateral canal foramina

30. Areas of resorption

31. PULP STONES / DENTICLES

32. V ARIED AMOUNTS OF IRREGULAR SECONDARY DENTIN

33. THIN “PINCHED” APEX BULBOUS APEX

34. RESORBED APEX BLUNDERBUSS APEX

35. TERMINATION POINT FOR ROOT CANAL PROCEDURES

36. FROM THE APEX CONDITION 1mm No bone/root resorption 1.5mm Only bone resorption 2mm Bone & root resorption

37. CHALLENGES FACED DUE TO APICAL THIRD ANATOMY DURING ENDODONTIC PROCEDURES

38. Vertucci classification

39. Gulabivala et al extended the types as follows

40. crown down instrumentation.

41. NI -TI

42. Controlled & directed canal preparation into the bulky portions / safety zones, away from the thinner portions of the curved canals – which risk of stripping or perforation – danger zone.

43. N I - TI

44. CHALLENGES FACED DUE TO APICAL THIRD ANATOMY IN ENDODONTIC SURGERY

45. Leakage through dentinal tubules originating at the beveled root surface. A, Reverse filling does not extend coronally to the height of the bevel. Arrows indicate a possible pathway for fluid penetration. B, Reverse filling extends coronally to the height of the bevel, blocking fluid penetration (arrows) into the root canal space.

46. FREQUENCY OF ACCESSORY CANALS & RAMIFICATION FOUND A T DIFFER E N T LEVE L S O F RO O T CAN A LS

47. ISTHMUS

48. Schematic representation of isthmus classifications described by Kim et al. Type I is an incomplete isthmus - faint communication between two canals. Type II is characterized by two canals with a definite connection between them (complete isthmus). Type III is a very short, complete isthmus between two canals. Type IV is a complete or incomplete isthmus between three or more canals. Type V is marked by two or three canal openings without visible connections.

49. Conclusion