... Endodontics at Faculty of Dentistry at the University of Toronto: Length: 3 Year(s) Admission Requirements. University of Toronto. Computed tomography uses a fan-shaped beam and multiple exposures around an object to reveal the internal architecture of this object. In 2009, Dr. Margel obtained his dental degree from The University of Pennsylvania. Authored by: Dr. Andres Plazas-Garzon. A root canal should be readily discernible. Treatment Outcome in Endodontics: The Toronto Study. Dr. Fox has published original research papers in the Journal of Endodontics and Ontario Dentist. A cyst is a three-dimensional epithelial lined cavity filled with fluid. Toronto, Ontario, Canada. 6th ed. The M.Sc. contents note. Graduate Endodontics Clinic Referral. Heated gutta-percha or a compound stick or using a rubber cup with slow speed motors is also used to conduct a heat test. Tracking a sinus tract will provide an important clue for the proper diagnosis. Graduate Endodontics Clinic Referral. 101 Elm Street. The program is accredited by the Commission on Dental Accreditation of Canada and the Commission on Dental Accreditation in the United States through a reciprocal agreement. To achieve this objective it is recommended to record the patient’s chief complaint, ask about the sympto… National Dental Specialty Examination (the National Dental Examining Board of Canada), Fellowship Examination (Royal College of Dentists of Canada), Diplomate Examination (American Board of Endodontics). 2nd ed. Phases I and II: Orthograde Retreatment Journal of Endodontics Sep 2004 Other authors. As a result, radiographs are needed during several aspects of the treatment and their proper interpretation and analysis is crucial to the establishment of a favorable outcome. On the other hand, if the source of cold is applied very close to the soft tissues, the patient may experience pain or sensitivity that is not related to the tooth being tested, but associated to these soft tissues. The M.Sc. As part of her training to become an Endodontist, Dr. Phee worked as a clinical instructor at the University of Toronto and she published her Master's Thesis in the Journal of Endodontics titled "Efficacy of Bacteriophage Reduction on Pseudomonas aeruginosa Biofilms". Intraoral soft tissues should be routinely examined. The infrared light beam is scattered as it passes through the pulp tissue. Quick Facts Profile Admissions Fees Financial Aid Programs Contact. The increase in the mobility of a tooth is not necessarily an indication of pulpal infection. Pulp testing is utilized to determine the status of the sensory neurons present in the pulp and the integrity of the pulpal vasculature. We train future dentists by providing high-quality, affordable dental care across more than 78,000 patient visitors each year. Welcome to the Graduate Endodontics Program at the University of Toronto's Faculty of Dentistry. Seltzer S, Bender IB. This communication/pathway extends directly from the source of infection to the surface (intraoral surface or extraoral surface). This objective test works by transmitting two wavelengths of light, red and infrared. A clinical examination of the patient is carried out after the case history has been completed. E. Formulate an appropriate diagnosis, differential diagnosis and treatment plan. The clinician has to record the readings from the pulp tester. To avoid misdiagnosis and to rule out orofacial pain that is not of endodontic origin, the clinician should identify and document all signs and symptoms that are confused with tooth pain. + 1 computer optical disc. In irreversible pulpitis, pain lingers after the thermal stimulation of A delta nerve fibers. The tooth in this case may be elevated out of its socket because of the buildup of fluid pressure in the PDL. xvii, 974 p. : ill. ; 29 cm. Heat test is used when the patient complains about pain upon contact with hot food/ drinks. Normal pulp – A clinical diagnostic category in which the pulp is symptom free and normally responsive to vitality testing. Dr. Rastegar joined the dental community in London Ontario providing care in a busy general dental practice until 1993, when he further pursued post-doctorial training in Endodontics at the University of Michigan. Pulp necrosis – A clinical diagnostic category indicating death of the dental pulp. Cone bean CT, other scans: Cone beam computed tomography (CBCT), ultrasound, and other emerging technologies seem to be very promising tools for more accurate diagnosis of changes in the root supporting structures. It is the largest dental school in Canada with a range of undergraduate and graduate level programs and an enrolment of around 610 students (not including specialty or residency programs). University of Toronto Policy on Official Correspondence with Students. Additional terminologies used are (a) Symptomatic – Lingering thermal pain, spontaneous pain, referred pain, (b) Asymptomatic – No clinical symptoms but inflammation produced by caries, caries excavation, trauma, etc. University of Toronto - Faculty of Dentistry. However, if radiopaque obturation materials are present, there can be scattering and creation of artifacts, which can significantly hamper visualization. There is also the option for lip clips to perform the same propose. Cold test is considered to be a more reliable test when combined with the electrical pulp test. Heat test is performed by spraying warm water from an irrigating syringe on the teeth that are believed to be affected. Systematic compilation of the history and clinical findings is essential for the precise diagnosis, and to determine the prognosis of the endodontic treatment. D. Conduct all necessary objective and subjective examinations, 2. Histologically, a mild chronic inflammatory infiltrate is associated with the osseous tissue. Gary received his DDS from the University of Toronto, Faculty of Dentistry in 1984 and was awarded the James B. Willmott Scholarship, the Mosby Scholarship and the George Hare Endodontic Scholarship for proficiency in Endodontics. It requires a surgical root canal treatment. 28. Anil Kishen. Radiology is an indispensable tool in the clinical practice of endodontics because most structures harboring disease are not visible to the naked eye. Treatment Outcome in Endodontics: The Toronto Study. 2. University of Toronto. Licensed for access by U. of T. users. The chief complaint is the reason(s) that the patient provides for consulting the dentist. Overview of graduate studies with specialty training, Application form on the School of Graduate Studies website, Oral and Maxillofacial Pathology and Oral Medicine, University of Toronto - Faculty of Dentistry, MSc or PhD program with specialist clinical training, application process for Graduate studies without clinical training, Number of spaces available across MSc and PhD, morphology, physiology and pathology of the dental pulp and periradicular tissues, basic clinical sciences, including biology of the normal pulp. Clinical Professor - Endodontics Western University. 3) University of Toronto Qualifying Program is offered at the following Canadian dental school(s): 1) University of Toronto From the *Discipline of Endodontics and †Discipline of Prosthodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada. Clinically, swelling to various degrees is present along with pain and a feeling that the tooth is elevated in the socket. Clinically, this lesion is asymptomatic and is detected radiographically by a periradicular radiolucency. The alcohol washes away the dye on the surface, but the dye within the fracture line remains and becomes apparent. The pulp tissue in reversible pulpitis is able to accommodate increased pressure and repair the damage. Walton R, Torabinejad M, Principles and Practice of Endodontics. The depth of the sulcus is bounded apically by the gingival fibers of the connective tissue attachment and coronally by the free gingival margin. It is important to record the periodontal pocket depths on the mesial, middle and distal aspects of both buccal and lingual sides of the tooth. Outcome 4-6 years after retreatment was assessed for Phases 3 and 4 of the Toronto Study. Pavel Cherkas. A cutaneous sinus tract of dental origin is relatively uncommon and may be misdiagnosed easily. During testing, the sensor should conform well with the anatomy of the tooth so that all emitted light is received by the detector. In Cohen S, Burns RC. J Endodon, 12, 1986. Normal apical tissues – Teeth with normal periradicular tissues that will not be abnormally sensitive to percussion or palpation testing. This Masters programme is designed for dental graduates who wish to develop clinical skills in endodontics. Edinburgh ; New York : Mosby/Elsevier, [2014] isbn. During transillumination, it is recommended to reduce overhead lighting as much as possible and to place the transilluminator on the buccal gingival area of the suspect tooth. Full Member, School of Graduate Studies, University of Toronto. The etiology of the sensitivity to percussion may be trauma, occlusal prematurities, periodontal disease, or extension of pulpal disease into the periradicular area. About. Philadelphia: Lea & Febiger, 1988. Pathologic conditions such as neuralgia, multiple sclerosis, myocardial ischemia and psychiatric disorders may also produce symptoms that are confused with tooth pain. Includes bibliographies and index. To perform the electric test, the probe of the electric pulp tester should be placed in contact with the natural tooth and the patient may be required to place a finger(s) on the tester probe to complete the electrical circuit. In 2018, she earned a Master of Dental Science and an Advanced Education Certificate in Endodontics from University of Florida College of Dentistry and has since worked as an associate in the Western New York Area. The periodontium, jaws, sinuses, ears, temporomandibular joints, masticatory musculature, nose, eyes, blood vessels and other structures may induce pain that mimics pulpal pain. These sinus tracts are most commonly found on the chin or in the submandibular area. To achieve this objective it is recommended to record the patient’s chief complaint, ask about the symptoms and history of the complaint (subjective findings), perform objective clinical tests coupled with appropriate investigations and correlate the objective findings with the subjective information. The pain will remain until bone is resorbed, the fluid is drained or the irritants are removed. Most orofacial pain is of pulpal or periradicular origin and the pain to thermal stimulus is often an indication of an endodontic problem. Reads . Dr. Gary Glassman graduated from the University of Toronto, Faculty of Dentistry in 1984 and was awarded the James B. Willmott Scholarship, the Mosby Scholarship and the George Hare Endodontic Scholarship for proficiency in Endodontics. University of Toronto - Faculty of Dentistry. Acute apical abscess – An inflammatory reaction to pulpal infection and necrosis characterized by rapid onset, spontaneous pain, tenderness of the tooth to pressure, pus formation and swelling of associated tissues. Paediatric Care Under Sedation Referral Form. The testing for percussion sensitivity should initially be carried out gently, with light occlusal pressure, applied digitally with a finger. Endodontic therapy is required in cases of irreversible pulpitis and If left untreated may end up with complete necrosis. An assessment of the patient’s general dental status is usually made by noting in particular the following aspects: standard of oral hygiene, amount and quality of restorative work, prevalence of caries, missing and unopposed teeth, general periodontal condition, presence of soft or hard swellings, and presence of any sinus tracts, discoloured teeth, tooth wear and facets. Radiological diagnosis of the affected tooth is mandatory prior to any root canal treatment. It may or may not be associated with an apical radiolucent area. Sep 2015 – Present 5 years 2 months. In Acute Periradicular Abscess, a large number of bacteria pass the apex into the periradicular tissues. This implies a breakdown of the host immune system, which usually contains the microbes inside the root canal system. We will download them from ROSI. The main objective of diagnosis is to identify the cause of the patient’s complaints or because of some abnormal findings during routine clinical exam, which in turn aids the clinician in deciding the ideal treatment required for that particular patient. Philadelphia: JB Lippincott, 1984. Annie Shrestha. This test is applied when the patient is not able to isolate the cause of the pain, particularly to a specific arch. Faculty of Dentistry at the University of Toronto. Focal Sclerosing Osteomylitis occurs because of a very low grade pulpal inflammation which results in an increase in the bone density rather than resorption. Endodontic therapy is advised in these cases. The stoma of the intraoral sinus tract may open in the alveolar mucosa, attached gingiva, or on the furcation or gingival crevice. Endodontist Endodontic Centre. Necrosis of the pulp caused by the inflammation of the pulp due to caries will most probably spread to the periradicular tissues, while, the necrosis of the pulp caused by trauma that severed the blood supply to the tooth would result in a dry necrosis that may not spread to the periradicular tissues. 2013 – Present 7 years. The infection may spread along the facial planes to form a cellulitis, and systemic symptoms such as fever, malaise may be present in these patients. The CO2 stick is applied to the facial surface of the tooth crown during testing. Honorary Professor, Faculty of Dentistry, The Hong Kong University, Hong Kong. pulpotomy, pulpectomy). Dr. Fox graduated from the University of Toronto, Faculty of Dentistry, in 2006. The teeth involved in the test should be isolated individually. Diagnosis is the art and science of identifying a disease or distinguishing one disease from another, by carefully considering the history, symptoms and signs. A thermal test commonly employs either hot or cold approaches. 124 Edward Street. The soft tissues overlying the root apices of suspect and control teeth are palpated to locate tender areas. This test is mainly used to determine the presence of cracks or vertical crown fractures. Toronto, Ontario M5G 1G6. Listening carefully to the patient’s description of his/her symptoms can provide invaluable information. Bettina Basrani, DDS, PhD, Specialist in Endodontics, is Associate Professor and Co-Director MSc Endodontic Program, Discipline of Endodontics, at the Faculty of Dentistry University of Toronto, Toronto… Dr Fox practiced as a general dentist for 9 years, prior to returning to the University of Toronto in 2015, where he completed his Masters in Endodontics in 2018. Acute periradicular periodontitis indicates inflammation in the PDL (periodontal ligament) caused by tissue damage and the extension of pulpal pathosis or occlusal trauma. Schulich School of Medicine & Dentistry . A calibrated periodontal probe is used for this purpose. Application of a small amount of lubricating material over the surface to be tested is advised to avoid the adherence of the test material on to the tooth surface. Anil KISHEN, Professor of University of Toronto, Toronto (U of T) | Read 226 publications | Contact Anil KISHEN From understanding the underlying biology, to diagnosis and prevention, including topics such as epidemiology, treatment outcomes, and the optimization of root canal procedures. Endodontics [electronic resource] / edited by Kishor Gulabivala, BDS, MSc, FDS RCS (Edin), PhD, FHEA, ... University of Toronto Libraries 130 St. George St.,Toronto, … Address requests for reprints to Shimon Friedman, DMD, Professor and Head, Discipline of Endodontics, Faculty of Dentistry, University of Toronto, 124 Edward St, Toronto, Ontario, M5G 1G6, Canada. 124 Edward Street. The periodontal pocket depth is measured from the height of the free gingival margin to the height of the attachment apparatus apically. Of 477 teeth retreated, 333 were lost to follow-up, 18 were extracted, and 126 (41% recall, excluding 124 discontinuers) were examined for outcome of healed (periapical index score, < or = 2; no signs or sym … Z Fuss, H Trowbridge, IB Bender, B Rickoff and S Sorin, Assessment of reliability of electrical and thermal pulp testing agents. The response of the pulp to the electric pulp testing does not reflect the histologic health or disease status of the pulp. The acute inflammatory response is observed with the PMNs being the dominant cells in this condition. Endodontics [electronic resource] / edited by Kishor Gulabivala, BDS, MSc, FDS RCS (Edin), PhD, FHEA, Yuan-Ling Ng, BDS, MSc, MRD RCS (Eng), PhD, FHEA. A necrotic tooth does not cause radiographic changes at the apex until the periapical pathosis has destroyed bony trabeculae at their junction with the cortical plate. Dr. Aaron Fox graduated from the University of Toronto in 2006, where he completed his DDS. Differential diagnosis should be assessed if lack of response is found with recently traumatized teeth. The pulp is non-responsive to vitality testing. He owned and practised as a General Dentist in downtown Toronto from 1992 to 2006. 9780702054259 (eISBN) restrictions. 9,508. Clinically, the patient exhibits the same symptoms as that of an acute periradicular abscess, however, radiographically there is a radiolucency associated with the tooth. The transilluminator is then moved slowly from the mesial to distal side while observing from the occlusal for a dark line, since fractured segments do not transmit light. 1 Discipline of Endodontics, Faculty of Dentistry, University of Toronto, Ontario, Canada. University of Toronto, Graduate Endodontics Program 124 Edward Street Toronto, M5G 1G6 . Phoenix abscess is an acute periradicular abscess superimposed on a preexisting chronic periradicular periodontitis. Though it will not be able to provide information about the condition of the pulp or the types of pulpitis, it is can provide useful indications on the (a) carious lesions not identified in clinical examination (b) pulp stones and patency of the root canal, (c) number and course of tooth roots (d) root resorption (e) internal resorptions (f) width of the periodontal ligament space (g) condition of apical tissue (h) condition of the periodontal attachment and (i) presence of root fractures. Bettina Basrani. 6th ed., Mosby, 2004. Non odontogenic swelling also have to be considered, especially if no obvious dental etiology is found. It is recommended that the tooth to be tested is isolated and dried, and tested at least twice. Clinical Professor - Endodontics University of Toronto. Visiting Professor of Endodontics, King Juan Carlos University at Madrid, Spain Extraoral facial swelling of odontogenic origin typically is the result of endodontic etiology, as periodontal problems rarely produce abscesses. 1.3K likes. The probe must be coated with a petroleum based conductive medium (example: tooth paste) before touching the tooth surface. Abnormalities in color and texture, and raised lesions or ulcerations should be recorded as well. Department of Dentistry, Mount Sinai Health System, Mount Sinai Hospital, Toronto. Meet Dr. Lalani Endodontist in Toronto ON. PMID: 14686806 DOI: 10.1097/00004770-200312000-00001 Cold test can be conducted by using frozen carbon dioxide delivered using a specially designed plastic cylinder. The periodontal pocket is a pathological deepening of the gingival sulcus. It is one of the most important responsibilities of the clinician to document a proper medical history of the patient. 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