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Medicine

 

Review Essays of Academic, Professional & Technical Books in the Humanities & Sciences

 

Endodontics 3rd Edition by Christopher J. R. Stock, Kishor Gulabivala, Richard T. Walker (Mosby) This lavishly illustrated, practical guide to endodontic treatment and procedures covers the latest developments in instrumentation and filling techniques * Includes 1,600 superb illustrations, with color coded line diagrams that present clinical, diagnostic, and practical information in an easy-to-follow manner. * Provides a full chapter on radiography to emphasize its importance in both diagnosis and treatment.

Rational endodontic therapy must be founded upon a sound understanding of the biological concepts of disease, its natural history and the physical, chemical and therapeutic basis of treating infection. Much fundamental biological and clinical endodontic research still remains to be undertaken. The principles of endodontic therapy have not changed greatly since the beginning of the twentieth cen­tury. However, research findings and collective clinical experiences have prompted a re-evaluation of treatment concepts. Modern approaches to treatment, together with the large array of new equipment and materials, have resulted in a need to rewrite and update most of this third edition.

This book has been designed to lead both the undergraduate student and the general dental practitioner, in a logical fashion, through the subject of endodontics. Chapters 1 and 2 outline the biological basis of endodontics, as it is understood today. The remaining chapters provide practical details, describing the current techniques and materials used in the treatment of patients. The text is liberally illustrated with photographs and colour diagrams to convey an effective message.

The standard of endodontic teaching and practice has improved considerably over the past few years. This is due in part to a height­ened patient awareness of the benefits of dental care and a rise in the demand for procedures that help to retain teeth longer. The restoration of aesthetics and function is now commonly practised. With the prevention of dental disease and the decline in dental caries, an increasing number of patients present with problems that relate to the `natural wear and tear' of teeth due to attrition, abrasion, erosion and trauma. Patients of all ages now expect to receive treatment that is successful. The vast need for endodontic treatment globally is certainly matched by the demands of informed patient population bases for predictably reliable conservative treatment.

Endodontics, together with periodontics, forms an essential foundation for restorative management of patients. Apart from the root canal treatment that forms an integral part of a restorative plan, there is also the treatment of pulp and periapical disease consequent

upon the restorative procedures. Students and practitioners of the subject must, therefore, be competent to carry out root canal treatment of both anterior and posterior teeth, in order to cope with the increasing number of difficult cases that present before, during and after complex restorative care.

The overall success rate of conventional root canal treatment has been shown to range from about 65% to 95%. Successful outcome of treatment is influenced by the preoperative state of infection, technical quality of root canal treatment, apical extent of the root filling and the design and technical quality of the subsequent restoration. Poorly adapted root fillings and those short by more than 2 mm from the root apex are correlated with higher failure rates, which increases the risk of tooth loss.

Book learning alone cannot convey clinical skills, however practi­cal the information. Theory has to be assimilated into a working knowledge by vigilant practice. Some individuals have an innate ability to make this transition, whereas for others the process is facil­itated by further hands-on instruction. The acquisition of practical skills requires a constant disciplined effort to achieve a preconceived end result. The scientific rationale behind the strategy required to attain the preconceived end result should be continuously reviewed in the light of new knowledge. There is nothing new in this general concept, which is embodied in the following age-old adage from Aristotle:

`Excellence is an art won by training and habituation. We do not act rightly because we have virtue or excellence, rather we have those because we acted rightly. We are what we repeatedly do. Excellence then is not an act but a habit'.

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