Color Atlas of Dental Medicine: Endodontology by Rudolf Beer, Michael Baumann, Syngucuk Kim

By Rudolf Beer, Michael Baumann, Syngucuk Kim

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The extent of the pulp chamber and the curves in the roots and canals should also be discernible. In addition, 99 Diagnostic radiograph The first radiograph does not show all of the lower second molar that is to be treated, but it does show defective fillings with secondary caries on all three teeth. The cavity on the second molar has penetrated the pulp, causing pulpal necrosis. 100 First measurement radiograph To avoid overextending the instruments during preparation of the canals and transporting bacteria from the infected coronal portion of the pulp apically, a radiograph is taken for orientation and measurement.

On the radiograph, chronic apical periodontitis appears as a round or oval radiolucency that is usually sharply demarcated. Sometimes a diffuse boundary is observed. Average-sized radicular cysts are indistinguishable from chronic periapical lesions. The percentage of radiolucencies that represent cysts rises among lesions larger than 10 mm, although even among radiolucencies that are 10-15 mm in diameter, less than 50% are likely to be cysts. Only a computer tomographic study can provide the differential diagnosis (Trope et al.

Center: After the pulp chamber was entered and the initial enlargement made with a Hedstrom file, pus mixed with blood flowed from the root canal. Right: The root canal was prepared to the working length with a size 55 master file and flushed with a sodium hypochlorite solution. 51 Root canal filling Left: One month following the endodontic treatment, the patient returned to the dental office. The pulp chamber of the right central i ncisor had already been opened i n an emergency clinic. Radiographically, a periapical radiolucency i s evident on the central as well as l ateral incisor.

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