Page 8 - The Beauty and Sorrow in Endodontics-Chapter 3

restore the health around the tooth. In these cases, the dentist must also ensure good

apical and coronal seal following root canal treatment for long term success. On the
other hand, some longstanding endodontic infections can lead to secondary

periodontal infection. In these instances, or when both infections have developed

independent of each other but occurred at the same time, endodontic treatment should
be completed FIRST, followed by periodontal treatments of deep scaling/root

planning/open flap surgery, etc. Both etiologies must be addressed to allow for

complete healing.

3. Occlusal Vector
Other sources of periapical lesions include clenching or grinding due to stress,
parafunction caused by malocclusion, or long-term gum chewing habits. Over time, if

these issues are not corrected and secondary damage to the pulpal and periodontal
tissue ensues, then root canal and periodontal treatment must be completed to relieve
the patient from pain and discomfort. Dentists must then complete a thorough
examination to determine all the factors that may cause this traumatic occlusion and

remove it in order for the apical tissues to fully heal.

Recall Schedule

After the completion of each endodontic treatment, a responsible dentist should

prepare a written letter for the patient outlining:
a) The treatment completed,

b) The current status of the tooth in question,
c) Post-operative instructions,

d) The materials used to seal the canals,

e) Whether or not the tooth can be used for normal chewing,
f) When the patient should return for follow-up appointments,

g) If any other treatments are required, inform the patient which dentist they would be
seeing and their contact information, and

h) Any medications to take.

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