Critical Evaluation of your Endodontic Treatment

Endodontic treatment is a common and technique sensitive procedure performed in the advanced veterinary dental practice in dogs and cats. It is the treatment of choice in retention of periodontally sound teeth with pulp pathoses. Dental radiographs are mandatory in this procedure.
Deciduous teeth are not candidates for endodontic treatment. They should be extracted when pathology is present.

Generally, there are two options:

• direct pulpcapping
• total pulpectomy

Direct pulpcapping/partial pulpectomy.
The aim of the direct pulpcapping is to keep the tooth vital with an intact endodontic system. This is performed in immature permanent teeth with a complicated fracture. In matured teeth a complicated fracture should not be older than 48 hours. A preoperative radiograph is necessary to evaluate the rootcanal and the periapex. Possible pathological processes that can be found are rootfractures, periapical lucencies and rootabnormalities.

A postoperative radiograph controls the coronal filling. Follow up postoperative radiographs are planned after six months and recalls should be made after one year.

Criteria for evaluation are:
Dentinal bridge however not all materials used are inducing a dentinal bridge. A dentinal bridge is not a true sign of vitality. It is only a sign that the tooth was responding to the material used in the treatment.

Diameter of the canal. The treated tooth should be in the same stage of development as the counter teeth.
Signs of micro-leakage of the coronal restoration.

In a total pulpectomy, the diseased pulp is removed and replaced by a suitable filling material. The first step in the treatment is a preoperative dental radiograph to evaluate the rootcanalsystem of the affected tooth. The whole tooth should be visible. Pulpal necrosis, preoperative root resorption and periapical lucencies decrease the success rate. The preoperative radiograph provides information to locate the position of a correct access opening. Intraoperative radiographs are made for working length, the shape of the canal, master file and master guttapercha cone.

A tapered preparation of the canal is important to improve root canal disinfection. Inadequately shaped canals can not be cleaned efficiently, even if the pulp tissue has been removed from the root canal.  [...]