Essential Endodontology

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The authoritative reference that continues to present a systematic analysis of the scientific basis of endodontology The third edition of Essential Endodontology: Prevention and Treatment of Apical Periodontitis has been revised and updated to include the most recent developments in the field, maintaining its position as the major scientific treatise of apical periodontitis. Making an often-complex subject more digestible, the book explores the scientific basis of endodontology, adopting a systematic analysis of the available clinical and laboratory evidence. Promoting apical periodontitis as a disease entity, the comprehensive third edition focuses on its biology and clinical features, enabling the reader to have a better understanding of its diagnosis, prevention and treatment. In addition to thorough updates and full colour illustrations throughout, a new chapter on regenerative endodontics has been added to this edition. * Written with a focus on the scientific basis of endodontology * Includes a new chapter on regenerative endodontics * Presents the most current information and major developments in this fast-moving field * Provides helpful learning outcomes in each chapter * Contains full colour illustrations, enriching the text * Features contributions from a noted panel of international experts, including new contributors from across the globe Regarded as a vital companion to the pursuit of excellence in postgraduate and specialist education, Essential Endodontology is an indispensable and accessible resource for practicing endodontists, postgraduate students of endodontology and those seeking professional certification in endodontology.


Dag Ørstavik is Professor Emeritus of Endodontology at the Institute of Clinical Dentistry, University of Oslo, Oslo, Norway. From 2004 until 2017, he was Head of the Department of Endodontology and responsible for the undergraduate and specialty training programs in endodontics at the Dental Faculty.


Foreword ix

List of Contributors xi

About the Companion Website xiii

1 Apical Periodontitis: Microbial Infection and Host Responses 1
Dag Ørstavik

1.1 Introduction 1

1.2 Terminology 1

1.3 Pulp Infection and Periapical Inflammation 3

1.4 Biological and Clinical Significance of Apical Periodontitis 4

1.5 Concluding Remarks 7

References 8

2 DentinPulp and Periodontal Anatomy and Physiology 11
Leo Tjaderhane and Susanna Paju

2.1 Introduction 11

2.2 Dentin 11

2.3 Pulp Tissue and its Homeostasis 22

2.4 Pulp Inflammation 27

2.5 Pulp Nociception and Hypersensitivity 32

2.6 Agerelated Changes in Dentinpulp Complex 34

2.7 The Periodontium 39

2.8 The Periodontal Ligament (PDL) 39

2.9 Cementum 44

2.10 Alveolar Bone 46

References 49

3 Etiology and Pathogenesis of Pulpitis and Apical Periodontitis 59
Ashraf F. Fouad and Asma A. Khan

3.1 Introduction 59

3.2 Etiology of Pulpitis and Apical Periodontitis 60

3.3 Inflammation Versus Infection of the Pulp and Periapical Tissues 61

3.4 The Dental Pulp 62

3.5 The Periapical Tissues 70

3.6 Concluding Remarks 79

References 80

4 Microbiology of Apical Periodontitis 91
José F. Siqueira Jr and Isabela N. Rôças

4.1 Introduction 91

4.2 Microbial Causation of Apical Periodontitis 91

4.3 Endodontic Biofilms and the CommunityasPathogen Concept 95

4.4 Mechanisms of Bacterial Pathogenicity 102

4.5 Microbial Ecology and the Root Canal Ecosystem 105

4.6 Types of Endodontic Infections 110

4.7 Identification of Endodontic Bacteria 111

4.8 Endodontic Biofilm Community Profiles 115

4.9 Microbiota in the Apical Root Canal 116

4.10 Symptomatic Infections 117

4.11 Persistent/ Secondary Endodontic Infections 120

4.12 Extraradicular Infections 123

4.13 Other Microorganisms in Endodontic Infections 125

References 127

5 Epidemiology, Treatment Outcome, and Risk Factors for Apical Periodontitis 143
LiseLotte Kirkevang and Michael Vaeth

5.1 Introduction 143

5.2 General Aspects of Epidemiology 144

5.3 Elements of an Epidemiologic Study 155

5.4 Evaluation of Epidemiologic Data 157

5.5 Factors and Conditions Associated with Treatment Outcome 160

References 169

6 Radiology of Apical Periodontitis 179
Shanon Patel and Conor Durack

6.1 Introduction 179

6.2 Normal Apical Periodontium 180

6.3 Radiographic Appearance of Apical Periodontitis 190

6.4 Healing Characteristics 194

6.5 Conventional Radiography for Assessment of Apical Periodontitis 195

6.6 Advanced Radiographic Techniques for Endodontic Diagnosis 195

6.7 Differential Diagnosis 197

6.8 CBCT for Assessment of AP 202

6.9 Concluding Remarks 204

References 204

7 Clinical Manifestations and Diagnosis 211
Asgeir Sigurdsson

7.1 Introduction 211

7.2 Pulpal Diagnostic Terms 212

7.3 Symptomatology of Pulpal Disease 213

7.4 Clinical Findings 216

7.5 Diagnostic Testing 217

7.6 Formulation of a Pulpal Diagnosis 223

7.7 Periapical Diagnosis 225

7.8 Symptomatology of Periapical Disease 226

7.9 Formulation of a Periapical Diagnosis 230

7.10 Future of Pulpal and Periapical Diagnosis 231

References 231

8 Biological Basis for Endodontic Repair and Regeneration 237
Kerstin M. Galler

8.1 Principles of Regeneration and R...

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Essential Endodontology
Prevention and Treatment of Apical Periodontitis
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