Determining the Correct Course of Endodontic Retreatment With No Patient History Available.

Forensic endodontics is an empirical concept that has a clinical application. By definition, forensic endodontics is the determination of the diagnosis and etiology of a patient's tooth pain and/or periradicular radiographic lesion on a tooth that has been previously endodontically treated. Forensic endodontics diverges from conventional endodontic retreatment in that the patient has no recollection of when the tooth was treated or by whom, and the clinician has no access to any past radiographs to assess the healing progression of the previous endodontic treatment.

The Importance of Obtaining a Pulpal and Periradicular Diagnosis Prior to Restorative Treatment.

Maintaining dental pulp vitality should be among the clinical goals of any restorative treatment. By obtaining a pretreatment pulpal and periradicular diagnosis before performing restorative treatment, the clinician will be better able to proceed with treatment of the pulp, especially if it is exposed during caries excavation. A pretreatment pulpal and periapical diagnosis may be effectively attained by performing five objective clinical tests: pulp sensibility, percussion (which may include bite testing), palpation, periodontal probing/ tooth mobility, and updated radiography.

Clinically Enhancing Local Anesthesia Techniques for Endodontic Treatment.

Local anesthesia is one of the most important drugs given to patients who undergo endodontic treatment. Yet, clinicians often do not view local anesthetic agents as drugs and, therefore, struggle clinically to consistently achieve profound pulpal anesthesia. To improve the clinical effects of local anesthesia for endodontic treatment, in conjunction with selecting the correct type of local anesthesia, clinicians need to thoroughly understand how the local anesthetic process works and how to objectively test for clinical signs of pulpal anesthesia and integrate supplemental anesthesia when appropriate.

Using 3-dimensional printing to create presurgical models for endodontic surgery.

Advances in endodontic surgery--from both a technological and procedural perspective-have been significant over the last 18 years. Although these technologies and procedural enhancements have significantly improved endodontic surgical treatment outcomes, there is still an ongoing challenge of overcoming the limitations of interpreting preoperative 2-dimensional (2-D) radiographic representation of a 3-dimensional (3-D) in vivo surgical field. Cone-beam Computed Tomography (CBCT) has helped to address this issue by providing a 3-D enhancement of the 2-D radiograph.