State of the art and science of endodontics

Background. Advances in the art and science of endodontics have facilitated better understanding of disease processes and have led to development of treatment modalities aimed to restore health to the pulp and periradicular tissues. This article presents a summary of both basic and clinical breakthroughs in endodontics. Results. The author indicates that, on the basis of the reviewed literature, pulp and periradicular diseases are primarily microbial. Basic research has led to development of methodologies that have allowed for specific and accurate identification of pathogens that are likely to cause persistent infections. Close examination of clinical data shows that meticulous débridement of the infected root canal system will result in a high probability of successful treatment outcome. Progress in visualization, mechanical and chemical disinfection, and biological seal of portals of entry will improve quality of care further. Conclusions and Clinical Implications. A better understanding of the pathogenesis of pulp and periradicular diseases, inflammation and healing, as well as of pain pathways, will improve patient care and result in preservation of natural tissues.