•
Endo treatment should not be carried out on teeth with third degree mobility unless mobility is reduced by drainage of acute apical abscess.
Mobilometers •
are electronic devices / gad gets, which aid in determining tooth mobility
•
Apparatus consists of two electrodes (Prays which hold facial and lingual surface of the teeth.
•
Degree of mobility tested is reflected as a numerical reading.
5. Periodontal examination •
Consists use of a blunt celibrated probe to explore the integrity of gingival sulcus around each tooth.
•
A significant pocket if present in the absence of periodontal disease it increases the probability of presence of vertical treatment.
•
To distinguish disease of periodontal origin from pulp origin, thermal and EPT along with PDL probing are essential.
6. Radiographic examination •
Radiograph is 2 dimensional image of 3 – dimensional tooth because radiographic strategy should involve the exposure of 2 films at the some vertical angulation but with 10-15 degree change in horizontal angulation (SLOB rule)
Radiographs can contain information on 1.
Presence of caries that may involve or threat on to involve the pulp.
2.
May show the number, cause, sharp length and width of root canals.
3.
Presence of calcified materials in the pulp chamber or root canals.
4.
Resorption of dentin originating with in the root canal or from the root surface.
5.
Calcification or obliteration of pulp cavity
6.
Thickening of PDL
7.
Resorption of cementum
8.
Nature and extent of periapical and alveolar bone destruction.
Radiographic interpretation -
A single root canal should appear tapering from crown to apex, sudden change in appearance of canal from dark to light indicates that the canal had bifurcated or trifurcated.
-
Horizontal root and may be confused radiographically with linear patterns of bone trabeculae. Lines of bony trabecular extend beyond the border of the root while root and often cause thickening of PDL.
-
Radiographic differentiation of external and internal resorptoin. Internal R : have sharp smooth margins and the pulp “disappears” into the lesion. External R : margins not smooth and pulp appears to pass through the lesion unaltered.
- Shift method can be used to differentiate internal and external resorption, here the position of internal resorption is unaltered lesions of cancellous bone only are not seem in radiograph until the cortical bone has been reached or penetrated. Radiographic misinterpretation Presence of periapical radiolucency on a tooth does not indicate a diseased tooth. In many instances an area of rare faction on the root apex may be the super imposition of an image on the apex. This phenomenon may be seen, where anatomy is normal as in maxillary sinus, incisive and mental foramen, medullary space, traumatic bone cysts etc. A number of pathological changes in and near the alveolar process may be mistaken for true periapical lesions 1.
2.
Non-odontogenic cysts : Lamina dura is intact in all non-odontoblastic cysts i.
Globulomaxillary cyst lesion appears inverted pear shaped
ii.
Midline palatal cyst lesion occurs in midline.
Apical scar : History of apical surgery intact lamina dura
7. Xeroradiography •
Derived from Greek word “Xeros” which means dry.