glossary of en do terms web

8/6/2019 Glossary of en Do Terms Web

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aberrantA deviation from the normal orusual course, form or location.

abfractionA v-shaped pathologic lossof hard tooth substance caused bybiomechanical loading forces; such loss isthought to be due to flexure and chemicalfatigue degradation of enamel and/ordentin at some location distant from theactual point of loading; most typically thefacial cervical region.

ablationThe separation, detachment oreradication of a structure; commonly usedin laser treatment of dental tissue or nerveresection.

abrasionThe pathologic wearing away of

a substance or structure (such as a tooth),through some unusual or abnormalmechanical process.

abscessA localized collection of pus withina tissue or a confined space.

acute periradicular abscessacuteapical abscess An inflammatory reactionto pulpal infection and necrosis characterizedby rapid onset, spontaneous pain, tendernessof the tooth to pressure, pus formation andeventual swelling of associated tissues. HS:

acute periapical abscess, acute alveolarabscess, dentoalveolar abscess, phoenixabscess, recrudescent abscess, secondaryapical abscess

chronic periradicular abscesssuppurative periradicular periodontitis(chronic apical abscess, chronic periradicularabscess, chronic periapical abscess)Aninflammatory reaction to pulpal infectionand necrosis characterized by gradualonset, little or no discomfort and theintermittent discharge of pus through anassociated sinus tract. HS: chronic alveolarabscess, chronic dentoalveolar abscess, suppurative apical periodontitis

periodontal abscessAn inflammatoryreaction originating in the periodontium;usually characterized by rapid onset,spontaneous pain, tenderness of thetooth to pressure, pus formation andswelling; frequently caused by foreignbody entrapment and often associatedwith a tooth with a vital pulp.

pulp abscessA localized collection of

purulent exudates within the pulp of thetooth; initiated by microorganisms and/orits byproducts; describes a histologicalfinding.

absorptionThe uptake or removal ofsubstances into or through tissues, such asthe biological removal of extruded sealer.

access cavity (access preparation, endodonticaccess, root canal access)The openingprepared in a tooth to gain entrance tothe root canal system for the purpose of

cleaning, shaping and obturating.

access, surgicalThe opening preparedthrough soft tissue and bone surrounding atooth to expose the root and periradiculartissues.

accessory canalSee canal, pulpaccessory canal.

accessory foramenSee foramenaccessory foramen.

acoustic streaming (acousticmicrostreaming)The circulation offluid and hydrodynamic shear forces in thevicinity of a small vibrating object such asan ultrasonically activated endodontic file.

Acquired Immune Deficiency SyndromeSee AIDS.

actinomycosisClinical infection causedby a species of the genusActinomyces;abscess and multiple or persistent sinustract formations are common and, in thecervicofacial form of the disease, usuallydrain to the skin surface.

aerodontalgiaSee barodontalgia.

AIDS (Acquired Immune DeficiencySyndrome)A syndrome caused by theprogressive loss of immune function thatcharacterizes the progression of human

immunodeficiency virus infection; thisnatural history is thought to be responsiblefor opportunistic, pernicious and eventuallyfatal conditions that include Kaposissarcoma, Pneumocystis cariniipneumonia,and others; oral lesions may includenecrotizing ulcerative gingivitis, necrotizingulcerative periodontitis, candidiasis, hairyleukoplakia and others.

allodyniaPain resulting from a non-nox-ious stimulus to normal skin or mucosa.

allograftSee graftallograft.

alloplastSee graftalloplast.

alloyA compound combining two or moreelements having properties not existing inany of the single constituent elements.

anachoresisThe localization or seeding ofmicroorganisms to areas of inflammationduring bacteremia.

analgesiaAbsence of sensibility to pain,designating particularly the relief of painwithout loss of consciousness.

analgesicPharmacological agent used toreduce sensibility to pain.

nonsteroidal anti-inflammatory drugs(NSAIDs)Pharmacological agents thatinhibit the cyclooxygenase pathways.

opioid agonist analgesicsPharmacologic agents that bind to opioidreceptors thereby mimicking the action ofmorphine; opioid agonists induce analgesia,sedation, euphoria, dysphoria, emesis,constipation, respiratory depression andaddiction.

opioid agonist/antagonistanalgesicsPharmacologic agents thatinclude a combination of agonist effects,

as well as an antagonist effect similar tonaloxone; opioid agonist/antagonistanalgesics have a similar effect as theagonists but do not induce respiratorydepression and addiction; have potentialto induce drug withdrawal syndromein opioid-addicted individuals.

anaphylactic shockA severe, sometimesfatal, immediate allergic reaction, usuallyoccurring seconds to minutes afterexposure to an antigen, and mediatedvia histamine.

anaphylaxisImmediate hypersensitivityresponse to antigenic challenge, mediatedby IgE and mast cells, typicallylife-threatening.

anastomosis (isthmus)A thincommunication between two or morecanals in the same root or betweenvascular elements in tissues.

anatomic apexSee apexanatomic apex.

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Institute)The national clearingorganization for standards; formerly calledthe American Standards Association. TheAmerican National Standards CommitteeMD 156 for Dental Materials and Devicesis one arm of the ANSI.

anesthesiaThe loss of feeling or sensationas a result of an anesthetic agent to permitdiagnostic and treatment procedures.

anesthetic testA diagnostic procedure inwhich a tooth suspected of being thesource of referred pain is anesthetizedwith a local anesthetic. If the pain isalleviated, the suspected tooth may bethe source of the pain.

ankylosisSee resorptionreplacementresorptionClinical diagnosis for theend result of replacement resorption

whereby the tooth is no longer capable ofnormal physiologic movement due to thefusion of bone to the root surface.

anodyneA medicine that relieves pain.

anomalyAn aberration or deviation fromnormal anatomy, development or function.

antibioticsSoluble substances derivedfrom a mold or bacteria that inhibit thegrowth of other microorganisms.

cephalosporinsBroad spectrumbeta-lactam antibiotics chemically relatedto and having the same mechanism ofaction as the penicillins.

clindamycinA lincosamide antibioticwith a broad spectrum of bacteriostaticactivity especially against anaerobes.

macrolidesNarrow-spectrum antibioticswith a lactone ring that inhibit proteinsynthesis.

metronidazoleAn antibiotic withbactericidal activity primarily againstobligate anaerobic bacteria.

penicillinsAntimicrobial agents inthe beta-lactam group; inhibit cell-wallbiosynthesis; drug of choice for mostendodontic infections in the non-penicillinallergic patient.

quinolonesA class of synthetic, broadspectrum antibacterial agents that exhibitbactericidal action; they inhibit DNAreplication and their indications are limitedin the treatment of orofacial infections.

tetracyclinesBroad-spectrum antibioticsthat inhibit protein synthesis.

antibodySerum proteins that are producedfollowing interaction with an antigen;they bind specifically to the antigen that

produced their formation, thereby causingor facilitating the neutralization of theantigen.

anticurvature filing (reverse filing) Intentional alteration of canal shape bythe removal of structure from thickerregions of the root canal wall to preventa perforation (strip) into the furcationadjacent to a curved canal.

antigenAny substance recognized by theimmune system that induces antibody

formation.

antinodePoint of maximum oscillation ordisplacement amplitude of object vibratingin a sinusoidal pattern, such as anultrasonically activated endodontic file.

apexThe tip or end of the root.

anatomic apexThe tip or end of theroot as de termined morphologically.

radiographic apexThe tip or end ofthe root as determined radiographically;its location can vary from the anatomicapex due to root morphology anddistortion of the radiographic image.

apex locatorAn electronic instrumentused to assist in determining the rootcanal working length or perforation;operates on the principles of resistance,frequency or impedance.

apexificationA method to induce acalcified barrier in a root with an openapex or the continued apical developmentof an incompletely formed root in teethwith necrotic pulps.

apexogenesisA vital pulp therapyprocedure performed to encouragecontinued physiological development andformation of the root end; frequently

used to describe vital pulp therapyperformed to encourage the continuationof this process.

apical barrierA blockage of the apicalforamen; may be an induced hard tissueor artificial materials, such as clean dentinchips, collagen, mineral trioxide aggregateor Ca(OH)2.

apical barrier techniquePlacement of amatrix in the apical region to preventextrusion of endodontic filling materials;

typically refers to teeth with open apices.

apical clearingA technique that involvesenlargement of the apical preparationfollowed by dry reaming to remove dentindebris and to produce a more definedapical stop.

apical constriction (minor apical diameter,minor diameter)The apical portion ofthe root canal having the narrowestdiameter; position may vary but is usually0.51.0 mm short of the center of the

apical foramen.

apical curettageSee curettage,periradicular.

apical cystSee cystperiradicular cyst.

apical deltaA pulp canal morphology inwhich the main canal divides into multipleaccessory canals at or near the apex.

apical foramenSee foramenapical foramen.

apical gaugingMeasurement of theterminal diameter or shape of a canalafter initial crown-down shaping.

apical patencyA technique where theapical portion of the canal is maintainedfree of debris by recapitulation with asmall file through the apical foramen.

apical periodontitis, acute

See periodontitisacute periradicularperiodontitis .

apical periodontitis, chronicSee periodontitischronic periradicularperiodontitis .

apical periodontitis, subacuteSee periodontitissubacute periradicularperiodontitis .

apical scarDense collagenous connectivetissue in the bone at or near the apex

of a tooth with a distinctive radiolucentpresentation; a form of repair usuallyassociated with a root that has beentreated surgically and noted to haveperforation of both the facial and lingualosseous cortices.

apical seatAn incomplete barrier at theapical end of the root canal preparation.



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apical stopThe matrix of dentin or othermaterials at the apical end of a rootcanal preparation that prevents furtheradvancement or progression of bothendodontic instruments and obturatingmaterials.

apicoectomySee root-end resection.

apoptosisProgrammed cell death viafragmentation into membrane-enclosedparticles that can be phagocytized byother cells.

argyriaA bluish-gray discoloration of theskin or oral mucosa from prolongedexposure to silver; discoloration of the oralmucosa usually occurs from over-extendedsilver points, silver-containing sealer oramalgam in submucosal tissues.

asepticFree from infection.

astringentAn agent that causescontraction of tissues, arrests secretion orcontrols bleeding.

attachment level, clinicalThe distancefrom the cemento-enamel junction to thetip of the periodontal probe duringperiodontal diagnostic probing.

attritionThe physiologic wearing awayof a substance or structure, such as atooth, in the course of normal use or

parafunctional habits.

atypical facial painA syndromecharacterized by a long-term continuousaching or throbbing pain that does notfollow established neural pathways and aclinical examination that does not reveal anapparent cause; multiple etiologies havebeen suggested, including psychogenicorigins.

atypical odontalgia (phantom tooth pain)Pain with all the classic features ofpulpalgia, usually following an extractionbut not appearing to be of peripheral origin.

austenitic phaseSee martensiticphase A crystalline unstressed phase ofstainless steel and nickel titanium alloy.

autograft (autogenous graft)See graftautograft (autogenous graft).

autotransplantationThe transplantationof teeth from one site to another in thesame individual, involving the transfer ofembedded, impacted or erupted teethinto extraction sites or into surgicallyprepared sockets.

avulsionThe complete separation of a toothfrom its alveolus by traumatic injury; mostcommonly used in reference to dental

injuries resulting from acute trauma.

BB

backfillingThe injection and/or compactionof gutta-percha into a canal after creationof an apical seal.

bacteremiaThe presence of bacteria inthe bloodstream that can be transient,intermittent or continuous.

bacteriaMembers of a group of ubiquitous,single-celled prokaryotic microorganismsthat have a primitive life form; many ofthese are etiologic in diseases that affectall life forms including humans and otheranimals.

balanced force techniqueA technique ofcleaning and shaping the root canal systemthat allows opposing physical forces to

guide each preparation instrument; usesclockwise rotation to engage dentin andcounterclockwise rotation to cut dentin.

barodontalgiaTooth pain caused by anincrease or decrease in ambient pressure,usually reported by aircraft personnel(aerodontalgia) and divers.

bicuspidization (premolarization)A hemisection of a mandibular molarwhere both sections are retained andeach is restored as a premolar.

bifurcationThe anatomic area where theroots of a two-rooted tooth divide.

biofilmThe colonization and proliferation ofmicroorganisms at a surface and solutioninterface; especially problematic in thesmall-bore water lines of dental units.

biologic widthCombined width ofconnective tissue and epithelialattachment superior to crestal bone.

biomechanical preparationSee preparation, canalbiomechanicalpreparation.

biopsyThe removal of tissue for histologicexamination and diagnosis.

aspiration biopsyRemoval of fluid bysuction through a needle for the purpose

of establishing a diagnosis.

excisional biopsyRemoval of an entirelesion including a margin of contiguous,normal-appearing tissue for microscopicexamination and diagnosis.

incisional biopsyRemoval of selectedportion of a lesion for microscopicexamination and diagnosis.

bite testDiagnostic procedure in which atooth suspected of being cracked is

subjected to differential occlusal forces onindividual cusps in an attempt to replicatethe reported discomfort; usuallyaccomplished by having the patient biteon various plastic, wood or rubber objects.

bleachingThe use of a chemical agent,sometimes in combination with heat, toremove tooth discolorations.

extracoronal bleaching (vital or externalbleaching)The use of a chemical agenton the outside of a tooth to remove

discoloration from tooth structures withvital pulps; most frequently used agentsare hydrogen peroxide and urea(carbamide) peroxide.

intracoronal bleaching (nonvital orinternal bleaching)The use of chemicaloxidizing agents within the coronalportion of an endodontically treated toothto remove tooth discoloration; mostfrequently used agents are sodiumperborate and hydrogen peroxide, orsodium perborate and saline.

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walking bleachA form of intracoronalbleaching in which oxidizing agents aresealed into the pulp chamber for a limitedperiod of time, usually a few days to oneweek; procedure may be repeated untilthe desired result is obtained.

blunderbuss canalSee canal, pulpblunderbuss canal.

bondingProcedure of using an adhesive,cementing material or fusible ingredientto combine, unite or strengthen.

bone regenerationNeoformation ofosseous tissue that may occur either withinan osseous structure or on its surface.

bony cryptOsseous cavity made or modifiedin bone during periradicular surgery.

braiding techniquePlacement and

subsequent wrapping of multiple filesaround an object in the root canal to aidin its removal.

broach, endodonticA thin, flexible, fragile,usually tapered and pointed metal handinstrument with sharp projections curvingbackward and obliquely; primarily used toremove pulp tissue or other easilyengaged materials from the canal.

bruxismAn oral habit consisting ofinvoluntary rhythmic or spasmodic

nonfunctional grinding or clenchingof teeth.

buccal object ruleA method fordetermining the relative location ofobjects that are superimposed on thetraditional radiograph.Rule: When two different radiographs aremade of a pair of objects, the image ofthe buccal object moves, relative to theimage of the lingual object, in theopposite direction from which the x-ray

beam is directed.HS: Clarks Rule; Clarks Shift; horizontal orvertical shift; MBD Rule; SLOB Rule; tubeshift; and Waltons Projection.

buttressing boneA marginal lineardeposition of bone that may be formedin response to heavy occlusal forces.

calcific metamorphosisA pulpal responseto trauma characterized by rapid depositionof hard tissue within the canal space;entire space may appear obliteratedradiographically due to extensive deposition,

even though some portion of the pulpspace may remain in histological sections.

calcium hydroxide [Ca(OH)2]An odorless,basic, white powder frequently used as anintracanal medicament in nonsurgicalendodontic procedures and also secondaryto traumatic injuries; preparations appearto encourage calcification; differentpreparations may be used in pulp capping,pulpotomy, apexogenesis and apexificationprocedures in the secondary dentition;appears to inhibit inflammatory resorption

and demonstrates anti-microbial activity.

calcium sulfate [CaSO4] (plaster of Parismedical grade)A resorbable materialused in surgery as a barrier in guided tissueregeneration procedures; can be used as ahemostatic material.

calcospheritesSmall globules ofhydroxyapatite seen in predentin; thesecoalesce or fuse to form dentin.

callusA meshwork of fibrous tissue,

cartilage and bone that unites thefractured ends of a bone; a similar processmay occur in horizontal root fractureswith dentin, osteodentin or cementumuniting the segments.

canal, pulp (root canal)A passage orchannel in the root of the tooth extendingfrom the pulp chamber to the apicalforamen; may be narrow, have lateralbranches and/or exhibit irregularmorphology.

accessory canalAny branch of the mainpulp canal or chamber that communicateswith the external surface of the root.

blunderbuss canalHistorical termdenoting an incompletely formed root inwhich the apical diameter of the pulpcanal is greater than the coronal diameter.

c-shaped canalA pulp canal anatomyhaving the cross-sectional shape of theletter C; found in mandibular secondmolar teeth in which mesio-buccal anddistal canals communicate due to fusionof the mesial and distal roots.

furcation canalAn accessory canallocated in the furcation.

lateral canalAn accessory canal locatedin the coronal or middle third of the root,usually extending horizontally from the

main canal space.

carbamide peroxide (urea peroxide)Hydrogen peroxide coupled to urea;frequently marketed in an acidified,anhydrous glycerine base as apatient-applied extracoronal tooth-bleachsystem; also combined with glycerine andEDTA and used as an adjunct in canalpreparation; breaks down into urea,ammonia, carbon dioxide (carbonic acid insaliva) and hydrogen peroxide.

caries, dentalA localized and progressivebacterial infection that results in thedisintegration of a tooth usually beginningwith the dissolution of enamel andfollowed by bacterial invasion of thedentinal tubuli.

carious pulp exposureSee pulpexposurecarious pulp exposure.

carrier-based gutta-percha techniqueSee obturation techniquecarrier-based gutta-percha technique.


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C CC Ccase-control studiesStudies in which

patients who already have a certaincondition are compared with peoplewho do not; are less reliable than eitherrandomized controlled trials or cohortstudies.

causalgiaA constant, hot, burning painfollowing injury to a peripheral nerve;

thought to be of sympathetic origin andmay follow a traumatic molar extractionand alveolar osteitis (dry socket).

cavernous sinus thrombosisBlood clotthat arises from maxillary periradicularinfection and settles in cavernous sinus.

cavitationThe formation of submicroscopicvoids as a result of shearing a fluidmedium by the alternating high frequencymovement of an instrument tip; createsshock waves that propagate throughout

the medium when voids implode.

cellulitisA symptomatic edematousinflammatory process that spreads diffuselythrough connective tissue and fascial planes;frequently associated with an infection byinvasive microorganisms with subsequentbreakdown of connective tissue.

cementSee sealer, root canal.

cementodentinal junction (CDJ,dentinocemental junction)The region at

which the dentin and cementum are united;commonly used to denote the point atwhich the cemental surface terminates ator near the apex of a tooth; position canrange from 0.5 to 3.0 mm from theanatomic apex.

cementoenamel junction (CEJ, cervicalline)The region at which the enameland cementum meet in the cervical regionof the tooth; cementum may overlap theenamel; cementum and enamel may meetabruptly or a gap may exist.

cementomaSee dysplasia, periradicular cemental.

cementumA mineralized tissue coveringthe roots of teeth that provides a mediumfor the attachment of the periodontalfibers that connect the tooth to the alveolarbone and gingival tissues; composed ofapproximately 4550 percent inorganic

substances and 5055 percent organicmaterial and water; softer than dentin;histologically differentiated as cellularor acellular.

cementoblastomaA benign neoplasmthought to represent a neoplasm ofcementoblasts; radiographically continuouswith the roots of teeth.

cementum hyperplasiaSee hypercementosis .

cervical lineSee cementoenamel junction.

chelationThe removal of inorganicions from tooth structure by a chemicalagent, usually the disodium salt ofethylenediaminetetraacetic acid (EDTA);chelating agents are sometimes used inattempt to enlarge narrow canals or removethe smear layer after canal preparation.

chemical autoclave sterilizationSee sterilizationchemical autoclave

sterilization.

chemokinesA group of cytokines thatstimulate leukocyte movement andattraction.

chemomechanical preparationSeepreparation, canalchemomechanicalpreparation.

chloroform (trichloromethane)A clear,colorless, nonflammable, very volatileliquid used in root canal treatment as asolvent for gutta-percha and zinc

oxide-eugenol cements.

chlorhexidineA bis-biguanide antisepticagent used to prevent colonization ofmicrobes and to kill or inhibitmicroorganisms on surfaces.

chloroperchaA paste made by dissolvinggutta-percha in chloroform; historicallyused as a sealer in obturating root canals.

chronic focal sclerosing osteomyelitis(condensing osteitis)A radiographic andhistologic variation of chronic periradicularinflammation with localized proliferation ofperiradicular bone; may be asymptomaticor may exhibit signs of pulpitis; maydisappear once the inflammatory stimulusis removed.

circumferential filingPeripheral planingof all root canal walls equally duringpreparation.

citric acidA tricarboxylic acid used todetoxify diseased root surfaces andexpose intrinsic collagen fibers in newattachment therapy and to help removesmear layer during biomechanicalpreparation.

coagulation necrosisThe death of atissue in which cells are converted to anacidophilic opaque mass with loss ofcellular detail.

cohort studyA study involving patients

who presently have a certain condition orreceive a particular treatment, or both,and who are tracked over time andcompared with another group not affectedby the condition under investigation.

collagenA genetically distinct familyof structural macromolecules of theextracellular matrix that contains one ormore domains assembled in a triple helix;these proteins form a wide variety ofstructures.

compomerA polyacid modified compositeresin composed of glass filler, a resin anda photoinitiator.

compositeAn organic, polymerizableresin mix that typically contains inorganicparticles treated with a bonding orcoupling agent polymerized by light orchemical mechanisms.

concrescenceCemental fusion of twoadjacent teeth.

concussionA traumatic tooth injurycharacterized by tenderness to pe rcussionand no mobility or displacement.

condensing osteitisSee focal sclerosing osteomyelitis.

core (core buildup)The restorative materialsused to replace missing coronal tooth

structure in a root-filled tooth.

corrosionPhysicochemical interactionbetween a metallic element or an alloyand its environment that can result insignificant degradation of the metalsurfaces and unfavorably affectproperties of the metal.

cracked toothA phenomenon involvingposterior teeth in which fractures arenoted primarily extending mesially todistal and usually involve the marginal

ridges; primarily in minimally restoredmandibular first and second molars;symptoms may vary but pain to chewingand thermal sensitivity are common.

crepitusThe crackling or grating soundproduced by the rubbing together offragments of fractured bone or by airmoving in soft tissues, as in subcutaneousemphysema; also the grating sensationcaused by the rubbing together of drysynovial surfaces of joints.



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C CC Ccross-sectional studyAn observational

study that examines a characteristic (or setof characteristics) and a health outcomein a sample of people at one point intime.

crown infractionSee infraction, crown.

crown-down preparation (step-down

preparation)A technique of canalpreparation involving early flaring withrotary instruments followed by incrementalremoval of canal debris and dentin fromthe orifice to the apical foramen; involvesstraight files used in a larger to smallersequence with a reaming motion and withno apical pressure once binding occurs;variations have also been advocated, all ofwhich emphasize cleaning and shaping ofthe coronal portion of the canal prior tothe apical portion.

crown-lengtheningA surgical proceduredesigned to increase the extent ofsupragingival tooth structure for restorativeor esthetic purposes by apically positioningthe gingival margin, removing supportingbone, or both; may be accomplished byorthodontic or surgical extrusion.

crown-root ratioThe relationship betweenthe extra-alveolar portion of the toothand the intra-alveolar portion of the toothas determined radiographically.

c-shaped canalSee canal, pulpc-shaped canal.

culture, microbialAseptic technique toobtain and propagate a sample ofmicrobes usually from the pulp cavity orfrom a soft tissue swelling.

curettage, periradicular (apical curettage,periapical curettage)A surgicalprocedure to remove diseased or reactivetissue and/or foreign material from theperiradicular bone surrounding the rootof an endodontically treated tooth. Bydefinition, the root apex is not resected.

Cvek pulpotomy

See pulpotomy-partial pulpotomy.

cystAn epithelium-lined pathologic cavitythat may contain fluid, semi-solid materialor cellular debris; oral and perioral cystsfrequently classified as odontogenic,nonodontogenic, soft tissue andpseudocysts.

dentigerous cystAn odontogenic cystthat develops between the enamel organand the subjacent tooth crown of anunerupted or developing tooth.

lateral periodontal cystA smallodontogenic cyst of the periodontalligament found most often in themandibular canine and premolar areas;associated with a vital pulp and postulatedto originate from the rests of Malassez,the rests of the dental lamina or asupernumerary tooth bud.

nasopalatine duct cyst (incisive canalcyst or median anterior maxillary cyst)Awell-defined, radiolucent area positioned

interradicularly or apically to the maxillarycentral incisors; may demonstrate aheart-shaped appearance due to thesuperimposition of the anterior nasalspine; typically asymptomatic; may resultin root divergence; usually associated withteeth with vital pulps.

nonodontogenic cyst (fissural cyst,inclusion cyst)A cyst derived fromnon-odontogenic epithelium, such asepithelial remnants of the primitiveprocesses that participate in the embryonicformation of the face and jaws; includesnasopalatine, nasolabial and medianmandibular cysts.

odontogenic cystA cyst derived fromthe odontogenic epithelium, such as theremnants of the dental lamina or enamelorgans of teeth; includes periradicularcysts, dentigerous cysts, primordial cysts,odontogenic keratocysts, lateral periodontalcysts, glandular odontogenic cysts andcalcifying odontogenic cysts.

odontogenic keratocystAdevelopmental non-inflammatory cystwith a thin (68 cell layers thick), highlyactive corrugated epithelium; likely to

recur.

periapical pocket cyst (bay cyst)Anapical inflammatory cyst containing asac-like, epithelium-lined cavity that is opento and continuous with the root canal.

periradicular cyst (apical cyst, periapicalcyst, radicular cyst)An odontogenic cystassociated with a tooth with a necroticpulp that develops within a periradicularinflammatory lesion; derives its epitheliumfrom the cell rests of Malassez.

primordial cystAn odontogenic cystthat develops in place of a tooth throughcystic degeneration and liquefaction ofthe stellate reticulum prior to formation ofany calcified enamel or dentin; epitheliallining derived from the inner and outerenamel epithelium; often exhibitshistologically the characteristics ofodontogenic keratocyst.

pseudocystA pathologic space thatresembles a cyst but lacks an epitheliallining; includes aneurysmal, traumatic(hemorrhagic, solitary, simple) and static(Staphnes) bone cysts.

soft tissue cystA heterogeneousgroup of cysts occurring in the soft tissueof the neck, oral floor and salivary glands.

Examples include branchial, dermoidand thyroglossal duct cysts.

traumatic bone cyst (hemorrhagic bonecyst)A radiolucent lesion in bone withouta radiopaque border; a cavity of disputedcause, lined by no tissue or extremely thintissue that may contain fluid (blood orserum); assumed to have been caused bytrauma; teeth, if present, have vital pulps;not a true cyst.

true cystAn apical inflammatory cyst

with a distinct pathologic cavity; completelyenclosed in an epithelial lining so that nocommunication to the root canal exists.

cytokinesA large group of proteins thatare capable of regulating a wide variety ofcellular functions involved in controllingthe immune response.

cytotoxicityThe ability to kill cells.



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dead tractsDentinal tubules seen inhistologic sections to be devoid of cellularprocesses indicating odontoblasticdestruction; may contain debris andmicroorganisms.

debridementRemoval of foreign matter,devitalized tissue and microorganismsfrom an area of injury.

root canal debridementElimination oforganic and inorganic substances as wellas microorganisms from the root canal bymechanical and/or chemical means.

decalcificationRemoval of calciumsalts from bone or teeth; a form ofdemineralization yielding a pliable

collagenous matrix that may be digestedwith enzymes or inorganic chemicals suchas sodium hypochlorite.

decompressionSee marsupialization .

dehiscenceA narrow, vertical defect inthe alveolar plate of bone over a rootextending from the crestal area apically;usually located on the facial aspect of thealveolar process.

demineralizationThe process of removing

all mineral salts from calcified tissues.

dens evaginatusAn anomalous outgrowthof tooth structure resulting from thefolding of the inner enamel epithelium intothe stellate reticulum with the projectionof structure exhibiting enamel, dentin andpulp tissue.

dens invaginatus (dens in dente)Adevelopmental defect resulting frominfolding of the crown before calcificationhas occurred; may appear clinically as anaccentuation of the lingual pit in anteriorteeth; in its more severe form, gives aradiographic appearance of a tooth withina tooth, hence the term dens in dente;most common in the maxillary lateral

incisors but may occur in any tooth of thedental arch.

dental dam (rubber dam)A small latex ornon-latex sheet used to isolate a tooth orteeth from the oral environment and toprevent migration of fluids or foreignobjects into or out of the operative field;single or multiple holes punched throughbarrier allow placement around the toothor allow teeth to be isolated; provides adry, visible and clean operative field.

dental (rubber) dam clampA springmetal or plastic device that is placedaround a tooth at the level of the gingivato secure a rubber dam in position;available in varying configurations to fitdiffering tooth shapes.

dental (rubber) dam clamp forcepsAninstrument used to spread a rubber damclamp allowing it to be placed around orremoved from a tooth.

dental (rubber) dam frameA plastic or

metal device used to stretch the rubberdam, hold it and secure its edges awayfrom the operative site.

dental (rubber) dam punchA specialdevice used to punch holes in rubberdam sheeting.

dental granuloma (granuloma)A histologicterm used to describe tissue formedadjacent to the apex of a tooth with pulppathosis; characterized by chronicinflammatory cells such as macrophages,plasma cells and lymphocytes andsometimes a cluster of multinucleatedgiant cells; capillaries, fibroblasts andcollagen fibers also present.

dental laminaA developmental structurederived from the primary epithelial band;localized proliferation of this structureresults in a series of epithelial ingrowthsinto the ectomesenchyme at sitescorresponding to the positions of thedeveloping teeth; dental lamina gives riseto the enamel organ.

dental organSee enamel organ.

dental papillaA condensation of

ectomesenchymal cells under the dentallamina that eventually becomes the dentalpulp.

dental sacA condensation ofectomesenchymal cells surrounding thedental papilla, the enamel organ and dentalfollicle; gives rise to the periodontium.

denticleSee pulp stone.

dentigerous cystSee cystdentigerous cyst.

dentinA mineralized tissue that forms thebulk of the crown and root of the tooth,giving the root its characteristic form;surrounds coronal and radicular pulp,forming the walls of the pulp chamber androot canals; composition is approximately67 percent inorganic, 20 percent organicand 13 percent water.

globular dentinAreas of mineralizeddentin (calcospherites) that have notfused into a homogenous mass.

interglobular dentinAreas ofunmineralized or hypomineralized dentinthat persist within mature dentin and a reusually found in the circumpulpal dentin

just below the mantle dentin.

intertubular dentinThe calcifieddentinal matrix found external to theperitubular dentin and comprising the

main body of dentin; consists of largenumbers of fine collagen fibrils envelopedin an amorphous ground substance; notas highly calcified as peritubular dentin.

mantle dentinThe first portion ofdentin formed beneath both the enameland the cementum; contains variableamounts of coarse fibril bundles (VonKorffs fibrils) that are arranged at rightangles to the dentinal surface.

peritubular dentin (intratubular

dentin)A highly calcified, narrow strip ofdentin surrounding the lumen of eachdentinal tubule.

predentinA circumpulpal, collagenous,mucopolysaccharide matrix adjacent todentin; secreted by odontoblasts prior tomineralization.

primary dentinDentin formed duringtooth development; exhibits well-organizedpattern of tubules and cell processes.

reactionary dentinTertiary dentinmatrix secreted by surviving odontoblastcells in response to an appropriatestimulus.

reparative dentinTertiary dentinmatrix secreted by odontoblast-like cells inresponse to an appropriate stimulus afterthe death of odontoblasts; stimuli tend tobe much stronger than those causingreactionary dentin formation.


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D DD Dsclerotic dentin (transparent dentin)

Dentin characterized by calcification ofthe dentinal tubules as a result of injury ornormal aging; it appears translucent inground sections due to the difference inrefractive indices of calcified dentinaltubules and adjacent normal tubuleswhen examined by transmitted light.

secondary dentinCircumpulpal dentinformed by normal pulp function aftertooth formation is complete; tubularpattern is regular, but number of tubulesis less than that found in primary dentin;secondary dentin is separated from primarydentin histologically by a hyperchromaticline or demarcation zone.

tertiary dentin (irritation dentin)Dentinformed by external influences, includingcaries and attrition, and can range fromregular tubular dentin that differs little

from primary and secondary dentin(reactionary dentin), but can be verydysplastic and/or irregular, and atubularwhen there is odontoblast loss dependingon the differentiation status of theformative cell. HS: irregular dentin andosteodentin

tubular dentinDentin or predentin withtubules arranged in an orderly pattern. Theterm is used to differentiate regular dentinfrom the amorphous calcified tissue seenin irritation dentin.

dentin blushRed to pink discoloration ofdentin due to pulpal hemorrhage, usuallya result of trauma or operative procedures.

dentin bridgeTertiary (reparative) dentinformation that provides closure of apreviously exposed pulp or forms across theexcised surface of a pulp after pulpotomy;can be irregular in structure, containstunnel defects and is less calcified thansecondary dentin; may be facilitated bychemical agents such as calcium hydroxide

and mineral trioxide aggregate (MTA).

dentinal fluidAn intratubular andextracellular fluid that is thought to be anultrafiltrate of blood from the terminalpulpal capillaries. It diffuses through thespace around the odontoblastic process andpossibly through the intracellular structureof the odontoblast itself prior to enteringthe dentinal tubule and continuing a slowoutward movement under a pressure

gradient and eventually leaving the tooththrough dentinal tubules.

dentinal plugDentin particles, remnantsof vital or necrotic pulp tissue, microbialcomponents and retained irrigant forcedinto dentinal tubules for several micronsduring canal preparation.

dentinal tubuleA circular ductin the dentin matrix that contains anodontoblastic process and fluid. A typicaldentinal tubule has a diameter of 3-4 m

at its pulpal end and about 1m at thedentinoenamel or dentinocemental

junction. The number of dentinal tubulesranges from 20,000 to 75,000 per squaremillimeter of dentin.

dentinocemental junctionSee cementodentinal junction.

dentinogenesisThe formation of dentin.

dentoalveolar abscess, acuteSeeabscessacute periradicular abscess.

dentoalveolar abscess, chronicSeeabscesschronic periradicular abscess.

desensitizeTo eliminate or reduce painfuldentinal response to irritating agents.

diagnosisThe art and science of detectingand distinguishing deviations from healthand the cause and nature thereof.

differential diagnosisThe process ofidentifying a condition by comparing thesymptoms of all pathologic processes thatmay produce similar signs and symptoms.

digital radiographyUse of sensors toproduce electronic radiographic imagesthat can be viewed on a monitor andthat allow for a reduction in radiation

exposure; sensors can be integrated withintraoral digital cameras and patientmanagement database software.

dilacerationA deformity characterized bydisplacement of the root of a tooth fromits normal alignment with the crown; maybe a consequence of injury during toothdevelopment. Common usage hasextended the term to include sharplyangular or deformed roots.

direct pulp cap

See pulp capdirect pulp cap.

disinfectionA nonspecific termimplying the destruction of pathogenicmicroorganisms, but not necessarily ofspores; usually by chemical agents.

double-blind studyA study in whichneither the patient nor the investigatorknows whether the patient is receivingthe treatment of interest or the controltreatment; it is the most rigorous clinicalresearch design because, in addition to the

randomization of subjects that reduces riskof bias, it can eliminate placebo effects,which is a further challenge to the validityof the study.

dowelSee post.

downpackingThe compaction ofincremental segments of heat-softenedgutta-percha to create an apical plug.

drainA tube, wick or other material placedinto a wound, sore, abscess or body cavityto provide an avenue of escape for pus,inflammatory products and tissue exudates.

dry heat sterilizationSee sterilizationdry heat sterilization.

dysplasia, periradicular cemental

(periradicular fibrous dysplasia,periradicular osteofibrosis)A benign,reactive (non-neoplastic), fibro-osseouslesion of unknown etiology in whichbone around the apices of teeth with vitalpulps is initially replaced with fibrousconnective tissue and subsequently by amixture of tissue, cementum and bone.Radiographically, three phases arerecognized: radiolucent, mixed andradiopaque. This condition is common inAfrican-American middle-aged females,usually occurs in the anterior mandible

and may take years to reach the finalstage of development. HS: cementoma

dystrophic calcificationDiffuse foci ofcalcification frequently found in the agingpulp; usually described as beingperivascular or perineural.



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E EE E

ecchymosisAn extravasation of blood intosubcutaneous tissue or mucosa.

ectopic eruptionA tooth erupting in a siteother than its normal position.

edemaAn accumulation of fluid in a tissue.

EDTA (ethylenediaminetetraacetic acid) Anodorless, white, crystalline solid whosevarious salts are soluble in water; disodiumsalt of ethylenediaminetetraacetic acid ina buffered aqueous solution is used as achelating agent in root canal preparation;used to remove calcium, demineralize andsoften dentin, and remove the smear layer.

elasticityThe quality that allows a structure

or material to return to its original formupon removal of an external force.

elbowThe narrow portion of a curved canalimmediately coronal to a transportationor zip.

electric pulp testSee pulp testelectricpulp test.

electronic apex locatorSee apex locator.

electrosurgeryRemoval, division or

coagulation of tissue by use of a highfrequency electric current applied locallywith a metal instrument or needle; can beused to expose coronal tooth structure forisolation; may also be used in controllinghemorrhage during surgical procedures,pulpotomy and pulpectomy.

emergence profileContour of a tooth orrestoration such as a crown on a naturaltooth or dental implant as it relates to theadjacent soft tissues.

eminenceA prominence or projection,especially one on the surface of a bone.

emphysema, subcutaneousAnaccumulation of air or other gases in tissuespaces; in endodontics, usually resultsfrom injection of air through the rootcanal into surrounding soft tissues orfrom air-driven dental handpieces used

in surgical procedures.

enamelA mineralized tissue that forms aprotective covering of variable thicknessover the entire surface of the crown of thetooth. The hardest tissue in the humanbody, enamel provides a resistant coveringsuitable for mastication. Its composition isapproximately 96 percent inorganic and4 percent organic substance and water.

enamel micro-abrasionA method ofremoving certain superficial enamel

demineralization and decalcificationcoloration defects.

enamel organ (dental organ)Structureof ectodermal origin composed of fourlayers: inner enamel epithelium, stratumintermedium, stellate reticulum and outerenamel epithelium. During toothdevelopment this structure is responsiblefor determining the shape of the crown,initiating dentin formation, establishingthe dentogingival junction and formingenamel.

enamel pearlA focal mass of enamellocated apical to the cementoenamel

junction.

enamel projectionAn apical extension ofenamel usually toward a molar furcation.

endocarditisInflammation of theendocardial surface of the heart.

infective endocarditisA microbialinfection of the endocardial surface of the

heart, usually involving the heart valves.

endodontic accessSee access, surgical.

endodontic implantSee implantendodontic implant.

endodontic/periodontic lesionA processinvolving interaction of diseases of the pulpand periodontium. These interactions orlesions are classified by etiology, diagnosis

and prognosis as follows: 1) primary pulpallesions with extension to the periradiculartissues; 2) primary pulpal lesions withextension to the periradicular tissues withsecondary imposition of periodontaldisease; 3) primary periodontal lesions; 4)primary periodontal lesions with extensionto the pulpal tissues; 5) combinedpulpal-periodontal lesions in whichindependent disease processes in bothtissues have joined or coalesced in theperiradicular tissues; 6) concomitantpulpal-periodontal lesions in which disease

processes exist independently in bothtissues and are not apparently interrelated.

endodonticsThe branch of dentistryconcerned with the morphology, physiologyand pathology of the human dental pulpand periradicular tissues. Its study andpractice encompass the basic and clinicalsciences including the biology of thenormal pulp and the etiology, diagnosis,prevention and treatment of diseases andinjuries of the pulp and associatedperiradicular conditions.

The scope of endodontics includes, butis not limited to, the differential diagnosisand treatment of oral pains of pulpaland/or periapical origin; vital pulp therapysuch as pulp capping and pulpotomy;nonsurgical treatment of root canal systemswith or without periradicular pathosis ofpulpal origin, and the obturation of theseroot canal systems; selective surgicalremoval of pathological tissues resultingfrom pulpal pathosis; intentionalreplantation and replantation of avulsedteeth; surgical removal of tooth structure

such as in root-end resection, hemisection

and root resection; endodontic implants;bleaching of discolored dentin and enamel(teeth); retreatment of teeth previouslytreated endodontically; and treatmentprocedures related to coronal restorationsby means of post and/or cores involvingthe root canal space.

endodontistA dentist with two or more

years of advanced training in the scope ofendodontics who has received a certificatein endodontics from an advancededucation program accredited by the ADACommission on Dental Accreditation andwho limits his or her practice toendodontics. (Dentists who limited theirpractice to endodontics prior to recognitionof the specialty in 1963 are also recognizedas endodontists.) The endodontic specialistis responsible for the advancement ofendodontic knowledge through research,the transmission of information concerning

the most recent advances in biologicallyacceptable procedures and materials, andthe education of the public as to theimportance of endodontics in keeping thedentition in a physiologically functionalstate for the maintenance of oral andsystemic health.

Board-certified endodontistAsdefined by the American Board ofEndodontics, an endodontist who hassatisfied all requirements of the certificationprocess of the ABE, has been declared

Board-certified by the directors of the ABEand maintains Board certification. Thisindividual is a Diplomate of the ABE.

Board-eligible endodontistAs definedby the American Board of Endodontics,an educationally qualified endodontistwhose application has the approval ofthe Board.


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E EE Eeducationally qualified endodontist

As defined by the American Board ofEndodontics to identify those eligible totake the exam, an endodontist whosuccessfully completed an advancededucational program accredited by the ADAand is eligible to apply for examination bythe American Board of Endodontics.

endodontologyThe study of endodontics.

endo-osseous implantSee implantendodontic implant.

endorphinEndogenous antinociceptivemorphine-like substance in the cerebralspinal fluid that acts as an inhibitingneurotransmitter on nociceptive pathways.

endoscopyThe use of a flexible, fiberopticprobe to view and magnify anatomicalstructures.

endosseous implantSee implantendosseous implant.

endosteal implantSee implantendosseous implant.

endotoxin See lipopolysaccharide.

enostosisA condensation of normal bonewithin a bony cavity or extending centrallyfrom the cortical plate.

enucleationThe removal of an organ ortissue lesion in its entirety; in endodontics,the term usually refers to the surgicalremoval of periradicular lesions.

envelope flapA horizontal intrasulcularsurgical flap with no vertical releasingincisions.

epidemiologyThe science dealing withthe incidence, distribution and control ofdisease in a population.

epithelial rests of MalassezCellularremnants of Hertwigs epithelial rootsheath that persist as a fenestratednetwork around the tooth within theperiodontal ligament.

erosionA loss of tooth substance by achemical process without bacteria.

essential oilsA group of volatile,nongreasy, nonsaponifying oils withcharacteristic odors and tastes obtainedfrom plants and other sources or preparedsynthetically. They have varying degrees ofantiseptic, anodynic and toxic properties,and are used by the public and theprofession for the treatment of pain. Inendodontics, they have been usedprimarily as intracanal medicaments suchas eugenol and eucalyptol, componentsof sealers and provisional or sedativerestorations.

etching agentsAcidic agents used todemineralize enamel or dentin to enhanceadhesion of some filling materials to toothstructure, to remove the smear layer andplugs from canal walls prior to root canalobturation and to expose collagen fibers onthe surface of a diseased root structure tofacilitate reattachment of the periodontalligament.

ethoxybenzoic acidAn ingredient addedto zinc oxide eugenol formulations used

for root-end fillings.

ethyl chloride (chloroethane)A colorless,extremely volatile, flammable liquidused in endodontics to apply cold as apulp test; also has been used topicallyas an anesthetic and for treatmentof myofascial pain; alternative isdichlorodifluoromethane (DDM).

ethylene oxide gas sterilizationSee sterilizationethylene oxide gassterilization.

ethylenediaminetetraacetic acidSee EDTA.

etiologyFactors implicated in the causationof disease; may be local or systemic.

eucalyptus oil, N.F.An essential oilcontaining approximately 74 percenteucalyptol; used in some root canal sealerliquids and as a gutta-percha solvent.

eucaperchaA paste of gutta-perchadissolved in oil of eucalyptus; sometimesused as a root canal sealer or cementingmedium in obturating root canals.

eugenol, U.S.P.A phenolic compound withanodynic and antiseptic properties that

occurs as a colorless or pale yellow liquidand is the essential constituent of oil ofcloves; often combined with zinc-oxide orzinc-oxide base preparations to formvarious pastes and cements; sometimesused as an anodyne or as an intracanalmedicament after removal of a vital pulp.

evidence-based dentistryAn approach tooral health care that requires the judiciousintegration of systematic assessments ofclinically relevant scientific evidence,relating to the patients oral and medical

condition and history, with the dentistsclinical expertise and the patientstreatment needs and preferences.

evidence-based practiceIntegration ofbest research evidence with clinical expertiseand patient values. Best research evidencerefers to clinically relevant research,especially from patient-centered clinicalresearch; clinical expertise means the abilityto use clinical skills and experience torapidly identify each patients uniquehealth state and diagnosis, individual risks

and benefits of potential interventions,and personal values and expectations;and patient values refers to the uniquepreferences, concerns, and expectationsthat each patient brings to a clinicalencounter and that must be integratedinto clinical decisions if they are to servethe patient.

exostosisA benign bony growth projectingoutward from the surface of a bone.

exotoxinA toxic substance produced by

certain bacterial species and found outsidethe cell wall.

external enamel epitheliumSee outer enamel epithelium.

external oblique ridgeA smooth ridge onthe buccal surface of the body of themandible that extends from the anteriorborder of the ramus with diminishingprominence downward and forward tothe region of the mental foramen;changes very little in size and direction

throughout life.

external resorptionSee resorptionexternal resorption.

extracoronal bleachingSee bleaching, extracoronal.

extrusionMovement of a tooth in anincisal or occlusal direction; can beintentional, physiologic or traumatic; alsoextension of obturating materials beyondthe apical foramen.



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E/F FE/F F

root extrusion (forced eruption)Orthodontic movement of a tooth or rootin a coronal direction to expose a carious,resorptive or traumatic defect forrestoration.

extrusive luxationSee luxationextrusive luxation.

exudateFluid, cells and plasma proteinsthat have escaped from the vascular systemand accumulated in a tissue or tissues;usually the result of inflammation.

fibrinous exudateAn exudatecharacterized by an abundance offibrinogen that results in deposition offibrin at the site of injury.

hemorrhagic exudateAn exudatecharacterized by an abundance of redblood cells.

purulent exudateAn exudatecharacterized by an abundance ofpolymorphonuclear leukocytes resultingin pus formation at the site of injury.

serous exudateAn exudatecharacterized by an abundance ofproteinaceous fluid at the site of injury.

fatigueTransitional weakening of a materialdue to cyclic loading and unloadingcharacterized by fracture below itsultimate tensile strength (fatigue fracture).

fenestrationA window-like opening ordefect in the alveolar plate of bonefrequently exposing a portion of the root;usually located on the facial aspect of thealveolar process.

ferric sulfateAn acidic hemostatic agent.

ferruleA band or ring of restorativematerial surrounding the crown or root ofa tooth to provide strength.

fiberopticsGlass or plastic fibers that

conduct light; used to transilluminateteeth and tissues, and to detect cracks,canal orifices and fractured roots.

fibrinous exudateSee exudatefibrinous exudate.

fibroblastMost common cell type in thepulp, producing and maintaining thecollagen and ground substance.

fileA tapered and pointed metal instrumentwith cutting edges used to enlarge the

root canal by rotation or filing action;classified principally on activation method,alloy, cross-sectional shapes, taper, tipdesign and length of cutting flutes.

D-type fileA file made from a rhombuscross-sectional blank that results inalternating large and small flutes along itslength.

H-type file (Hedstrm file)A file withspiral edges arranged as a buttress-threadedscrew so that cutting occurs only on a

pulling stroke.

K-type fileA file with tightly spiraledcutting edges that cut when pushed, pulledor rotated; cross-sectional configurationsinclude diamond, square and triangular.

Ni-Ti fileA hand or rotary filemanufactured with superelasticnickel-titanium alloy that is available in avariety of different designs.

filing A dynamic movement of a file tooptimally effect canal debridement;predominantly a push-pull, rotationalmovement or a combination of the two.

fissural cystSee cystnonodontogenic cyst.

fistulaAn abnormal communicationpathway between two internal organsor from one epithelial lined surface toanother epithelial lined surface; not a

sinus tract.

flap, surgicalA section of tissue, such asgingival mucosa, that has been partiallydetached from the underlying tissue butretains uninterrupted blood supply throughan intact base; classified by positionapically positioned, lateral or vertical sliding;by geometric shapecurved (semilunar),rectangular, scalloped, trapezoidal ortriangular; or by location of the incisionintrasulcular, submarginal or vertical.

full mucoperiosteal flapA flap involvingan intrasulcular horizontal incision andincluding epithelium, attached gingiva,alveolar mucosa and periosteum; triangularand rectangular flaps are examples.

triangularAn intrasulcular incisionwith one vertical releasing incision.

rectangularAn intrasulcular incisionwith two vertical releasing incisions.

limited mucoperiosteal flapA flapinvolving a submarginal horizontal incisionthat includes epithelium, attached gingiva,alveolar mucosa and periosteum;submarginal and semilunar flaps areexamples.

submarginal flapA flap with thehorizontal incision in attached gingiva;

may have two vertical releasing incisions;generally rectangular or trapezoidal inshape; indicated when crowns are presenton anterior teeth and an adequate zoneof healthy attached gingiva is present.HS: Luebke-Ochsenbein flap

flare-upAn acute exacerbation of anasymptomatic pulpal and/or periradicularpathosis after the initiation or continuationof root canal treatment.

fluctuantA tactile sensation of fluid

motion noted during palpation of a massor swelling such as an abscess.

fluorosis, dentalA form of enamelhypoplasia. Mottling and discoloration ofenamel results from ingestion of excessiveamounts of fluoride during the appositionphase of tooth development. HS: Endemicfluorosis

focal infection theoryA hypothesis thatbacteria existing in a primary site, the focus,may gain entry into the circulatory system

and cause unexplained degenerativediseases elsewhere in the body.

focal sclerosing osteomyelitis (condensingosteitis, periradicular osteosclerosis,sclerosing osteitis, sclerotic bone)Adiffuse radiopaque lesion believed torepresent a localized bony reaction to alow-grade inflammatory stimulus, usuallyseen at the apex of a tooth (or itsextraction site) in which there has beena long-standing pulp pathosis.


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F GF Gforamen (pl. foramina)A natural opening

or passage, especially into or through abone; also describes openings in the rootstructure that communicate with thedental pulp and generally contain neural,vascular and connective elements.

accessory foramenAn orifice on thesurface of a root communicating with a

lateral or accessory canal.

apical foramenThe main apical openingof the root canal.

foreign body reactionA chronicinflammatory reaction to a foreign materialwithin a tissue; often characterized bygiant cells.

formaldehydeA disinfectant gas orsolution (HCHO) used as an antiseptic,disinfectant and histologic fixative.

formalinAn aqueous solution offormaldehyde.

formocresolA toxic mixture of 19 percentformaldehyde and 35 percent cresol in awater glycerin vehicle; has been used forpulpotomy of deciduous teeth and as anintracanal medicament for permanentteeth during root canal treatment.

fractureA split or break in bone, cartilageor tooth structure; classified according to

extent, location and type; listed in theWorld Health Organization traumaclassification as follows:

crown fracture with pulpinvolvementA complicated fractureinvolving enamel, dentin and exposure ofthe pulp.

crown fracture without pulpinvolvementAn uncomplicatedfracture involving enamel and dentin, butno pulp exposure.

crown-root fracture with pulpinvolvementA complicated fracture ofenamel, dentin and cementum with pulpexposure.

crown-root fracture without pulpinvolvementAn uncomplicated fractureof enamel, dentin and cementum with nopulp exposure.

enamel fractureA fracture involving theenamel only; includes enamel chipping andincomplete fractures (cracks).

root fractureLimited to fracturesinvolving roots involving cementum,dentin and pulp.

horizontal root fracture (oblique rootfracture)Fracture due to traumatic injuryconfined to the root in a transverse planeseparating the coronal and apical segments.

vertical root fractureFracture occursmost frequently in endodontically treatedteeth; characterized by a crack that beginsin the root and extends toward the occlusalsurface, usually buccal-lingual; may beassociated with an isolated periodontaldefect; radiographic detection may bedifficult due to superimposed obturationand restorative materials.

fremitusA palpable movement of a toothwhen subjected to occlusal forces.

furcation (furca)The anatomic area of amulti-rooted tooth where the rootsdiverge.

furcation canalSee canal, pulpfurcation canal.

fusionA double tooth resulting from theunion of two adjacent tooth germs.

galvanism (electrogalvanism)The flow ofdirect electric current between two ormore dissimilar metals; may occur in theoral cavity when metallic restorations ofdiffering compositions contact, resulting

in varying degrees of sensation.

Gates-Glidden drillA rotary, power-driven,flame-shaped bur with spiral inclinedcutting edges mounted on a slendernoncutting shaft and tipped with aguiding pilot point.

geminationA disturbance duringodontogenesis in which partial cleavageof the tooth germ occurs and results in atooth that has a double or twin crown;usually not completely separated; common

root and pulp space shared.

globular dentinSee dentinglobular dentin.

glucocorticoidsA group of steroidhormones that affect carbohydrate, fatand protein metabolism; these typicallypossess anti-inflammatory properties.

glutaraldehydeA colorless, toxic oil(C5H8O2) that is soluble in water,commonly used in a 2 percent solution

for disinfection, sterilization and tissuefixation.

glycosaminoglycans (mucopolysaccharides)Large unbranched polysaccharideside-chains that comprise the groundsubstance of the pulp.

hyaluronic acidA proteoglycan thatis a major constituent of the groundsubstance of connective tissue such asthe dental pulp.

chondroitin sulfateMajor proteoglycanpresent in teeth with active dentinogenesis.

graftA piece of living tissue or syntheticmaterial placed in contact with injuredtissue to repair a defect or supply adeficiency in that tissue.

allograftA graft between genetically

dissimilar members of the same species;examples include freeze-dried or freshbone.

alloplastA synthetic graft or inertforeign body implanted into tissue;examples include bioactive glasses andbioceramics.

autograft (autogenous graft)A graftfrom ones own body.

xenograftA tissue graft obtained from

another species; examples include bovinebone and natural coral.

granuloma See dental granuloma.

granulation tissueHealing tissue thatconsists of fibroblasts, capillary buds,inflammatory cells and edema.

granulomatous tissueA pathologic tissueresponse characterized by a distinctivemorphologic pattern of inflammationconsisting of macrophages that have

been transformed into epithelioid cellssurrounded by mononuclear cells, usuallylymphocytes.

growth factorsA diverse group ofpolypeptides that have important roles inregulation of regeneration, growth anddevelopment of a variety of tissues.


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G/H HG/H Hguided tissue (bone) regeneration

Barrier technique using materials such asTeflon or collagen to regenerate lostperiodontal structures by excludingepithelium and the gingival corium fromthe root surface in the belief that theyinterfere with regeneration.

gutta-perchaThe purified coagulated

exudate from the Palaquium gutta tree,commonly called the mazer woodtree, of the Burma and Malay archipelago.Both gutta-percha and natural rubberare high molecular weight stereo-isomersof polyisoprene. Natural rubber,cis-polyisoprene, exists with its CH2groups (the chain-forming links betweenthe individual isoprene units) on the sameside of the double bond; whilegutta-percha, trans-polyisoprene, existswith its CH2 groups on opposite sidesof the double bond. Gutta-percha exists

in two crystalline forms, the naturallyoccurring alpha form and the beta formfound in most commercial formulations.Dental gutta-percha points are reportedto contain approximately 1922 percentgutta-percha, 14 percent plasticizingwaxes and resins, 5975 percent zincoxide, 117 percent metal sulfates forradiopacity and trace amounts of organicdyes for coloration. Since the late 1950s,material compounded in the United Statesfor gutta-percha points has been madefrom balata, a nearly identical latex

derived from the Mimusops Globsa treeof South America.

gutta-percha point (gutta-percha cone)Apliable, radiopaque cone available invarious sizes used to obturate root canalsin conjunction with sealers.

halothaneAn inhalation general anestheticagent that may be used to dissolvegutta-percha; chemical name is2-bromo-2-chloro-1,1,1-trifluoroethane.

Hanks balanced salt solutionA balancedelectrolyte solution commonly used forcell and tissue culture; has been shownto prolong the viability of periodontalligament cells in cases of tooth avulsion.

haptenA substance that by itself is notantigenic, but, when combined with abody protein, may induce an immuneresponse.

hardnessThe mechanical property ofresistance to surface indentation.

heat, appliedThe application of heat toincrease circulation or bring about thelocalization of infection or relief ofmuscle spasm.

heat, test (hot test)The use of hotgutta-percha, hot water, a rotating rubbercup or commercial heating device toidentify and reproduce a chief complaintof pain to heat upon application.

Hedstrm fileSee fileH-type file.

hematomaA localized collection ofextravasated blood, usually clotted, thatforms in a tissue, organ or space.

hemisectionThe surgical separation of amultirooted tooth, usually a mandibularmolar, through the furcation in such a waythat a root and the associated portion ofthe crown may be removed.

hemolysisThe breakdown of red blood cellsand the release of hemoglobin that maybe metabolized into the blood pigmentshemosiderin and bilirubin, which arebrown in color; may contribute to toothdiscoloration following pulp necrosiswhen the process occurs in the pulp.

hemorrhagic exudate

See exudatehemorrhagic exudate.

hemostasis (hemostatic agent)The process(or agent) whereby bleeding is controlled.

Hertwigs epithelial root sheath (HERS)A double layer of cells, the inner andouter enamel epithelium, that proliferatesand grows around the dental papilla,inducing differentiation of odontoblastsfrom cells at the periphery of the dentalpapilla and defining the shape of the root;root sheath fragments form a fenestrated

network around the tooth with growth;cells in this residual network known asepithelial rests of Malassez.

HIPAA (Health Insurance Portability andAccountability Act)A law, effectiveApril 2003, that implemented standardsintended to streamline the flow ofinformation integral to the operation ofthe health care system while protectingconfidential health information frominappropriate access, disclosure and use.

histamineA compound found in all cellsthat results from breakdown of the aminoacid histidine; responsible for vasodilatationthat may affect the pulp during an acuteinflammatory process.

histiocyteLarge phagocytic cell; memberof the mononuclear-phagocyte systemalso known as macrophage.

hollow tube theoryA hypothesis thattissue fluids can diffuse into a root cana lsystem containing a necrotic pulp,breakdown and subsequently recirculatecausing inflammation in tissues surroundingthe canal orifice; research supports thepremise of tissue fluid circulation, but,unless the tubular contents arecontaminated with bacteria or other

antigenic material, significantinflammation does not occur.

horizontal shiftSee buccal object rule.

horn, pulpExtension of pulp tissue intoocclusal or incisal projections followingthe cusp tips or developmental lobes.

H-type fileSee fileH-type file.

hydrocodoneA semisynthetic narcoticanalgesic and antitussive agent that is

similar to, but more potent than, codeine.

hydrogen peroxideA clear, colorless,unstable liquid (H202) with disinfectantand bleaching properties commonlymarketed in solutions of 335 percentthat exhibits variable levels of tissueirritation; used as an irrigant, a bleachingagent and to prepare the tooth surfacepreoperatively, prior to disinfection withiodine or other disinfectants.

hydrodynamic theoryA hypothesis

that maintains the inward or outwardmovement of fluid through the dentinaltubules activates sensory nerve fibers inthe dentin or the pulp to produce pain;fluid movement can be in response todehydration, osmotic changes, mechanicalprobing or thermal changes.

hydroxyapatiteAn inorganic compound[Ca10(PO4)6(OH)2] found in bone andteeth; there are synthetic forms used inbone grafting and for coating dentalimplants.


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H/I IH/I IhyperalgesiaIncreased pain sensation or

lowered pain threshold that accompanyan inflammatory reaction.

hypercementosis (cementum hyperplasia)An excessive deposition of cementum onthe root surface; commonly found inPagets disease.

hyperemiaAn increased volume of bloodwithin dilated vessels in an organ or tissue;used as a histophysiologic term to describeincreased blood flow in the pulp.

hyperplastic pulpitis, chronic (pulppolyp)A form of chronic pulpalinflammation usually following carious ortraumatic exposure; characterized byproliferation of dental pulp tissue fromthe exposed pulp chamber, filling thecavity with a pedunculated or sessile,pinkish-red, fleshy mass; usually covered

with epithelium.

hypersensitivityThe short, exaggerated,sharp painful response elicited whenexposed dentin is subjected to thermal,mechanical or chemical stimuli.

hypocalcificationReduced or deficientcalcification of mineralized tissue, such asbone, dentin, enamel or cementum.

hypochlorite accidentExtrusion of sodiumhypochlorite into the periradicular area

during root canal irrigation, causingsevere pain, swelling, ecchymosis andpotential paresthesia.

immunoglobulinsSerum proteins (gammaglobulins), also known as antibodies,secreted by plasma cells; play an importantrole in immunity against microbial irritants.They belong to one of the following main

isotypes: IgG, IgA, IgM, IgE and IgD.

immunohistochemistry A histologictechnique used to demonstrate thepresence of specific molecules (usuallyproteins) in tissue sections or cell smearsby binding the molecule to a specificantibody. The antigen-antibody complex isattached to an enzyme that further bindswith a fluorescent or a visible light dye forvisualization.

implantMaterial inserted or grafted into

the tissues of a host.

endodontic implant (endosseousimplant)A metallic rod placed in thecanal of the root of a tooth and extendinginto osseous tissues to stabilize the toothin the dental arch.

endosseous (endosteal) implantAnimplant of alloplastic material such astitanium, sapphire or hydroxyapatite,often of a screw design, inserted intosurgically prepared cavities in the alveolar

bone to serve as support for a dentalrestoration or prosthesis.

osseointegrated implantA directstructural and functional connectionbetween bone and the surface of animmobile, load-bearing implant.

incision and drainage (I&D)A surgicalopening created in soft tissue for thepurpose of releasing purulent orhemorrhagic exudate.

inclusion cystSee cystnonodontogenic cyst.

indirect pulp capSee pulp capindirect pulp cap.

induratedFirm or hard; term usually usedin reference to soft tissues that havebecome hardened from edema associated

with inflammation, infection or neoplasticchanges.

infarctionSudden insufficiency of arterialand venous supply leading to ischemiaand necrosis; pulp infarction might occurfollowing traumatic injuries.

infectionInvasion and proliferation ofpathogenic microorganisms in body tissuesand the reaction of the tissues to theirpresence.

infection, focalSee focal infection theory.

inflammationThe cellular and vascularresponse of tissues to injury.

acute inflammationA response thatis abrupt in onset and short in durationcharacterized by the exudation of fluid,serum proteins, inflammatory mediatorsand cells, mainly polymorphonuclearleukocytes into the area of injury; maybecome chronic if the injurious agent

persists.

chronic inflammationA response thatis slow in onset and of long-standingduration characterized by proliferation offibroblasts and vascular endothelium andan influx of lymphocytes, plasma cells,macrophages and inflammatory mediators.It may be primary or preceded by acuteinflammatory response.

inflammatory resorptionSee resorptioninflammatory resorption.

informed consentAn agreement by thepatient to have treatment rendered by theprovider after the risks of the treatment,the results of no treatment, the alternativesto treatment and all prognoses have beenexplained.

infraction, crownAn incomplete crack ofthe enamel without loss of tooth structure.

injection, intra-osseousA technique inwhich the anesthetic solution is injecteddirectly into the cancellous bone.

injection, intrapulpalSee intrapulpal injection.

injection, periodontal ligament(intraligamentary injection, ligamentaryinjection, PDL injection)A low volume,high pressure injection of local anestheticthrough the periodontal sulcus into the

periodontal ligament. The anestheticsolution is actually forced into the alveolarbone and therefore the PDL injectionshould be classified as an intra-osseousinjection.

inner enamel epithelium (internal enamelepithelium)A layer of cells in the enamelorgan between the dental papilla and thestratum intermedium. Under the influenceof the dental papilla, these cellsdifferentiate into ameloblasts.

instrumentationCleaning and shapingof the root canal space using hand- orengine-driven instruments.

intentional replantationSee replantation, toothintentionalreplantation .

interferonsA group of glycoproteins thathave important antiviral or immunemediating properties.

interglobular dentin

See dentininterglobular dentin.


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I K/LI K/LinterleukinsA group of cytokines produced

by a wide variety of inflammatory ornoninflammatory cells, but mainlylymphocytes and macrophages; importantin mediating or suppressing the immuneresponse; may aid or modulate boneresorption.

internal matrix techniquePlacement of

barrier during perforation repair to preventextrusion of restorative materials.

internal resorptionSee resorptioninternal resorption.

intertubular dentinSee dentinintertubular dentin.

intracanal medicamentA chemical agentsealed within the root canal system; usedbetween appointments as an anodyneand/or antimicrobial agent.

intracoronal bleachingSee bleachingintracoronal bleaching.

intraligamentary injectionSee injection, periodontal ligament.

intraosseous injectionSee injection, intra-osseous.

intrapulpal injectionA technique inwhich the anesthetic solution is injecteddirectly into the pulp under pressure.

intrusive luxationSee luxationintrusive luxation.

iodine potassium iodideAn intracanalmedicament/irrigant composed of iodine2 percent (w/w), potassium iodide 4 percentand distilled water 94 percent, that exhibitsantimicrobial action with minimal toxicityand tissue irritation.

iodine, tincture of5 percent iodine inalcohol; used to disinfect tooth surfacesprior to access preparation.

iodoformCHI3 triiodomethane; a topicalantimicrobial agent.

iodophorA 1 percent iodine combinationwith a surfactant carrier, such aspolyvinylpyrrolidone, that is applied asa slow release antimicrobial agent.

irregular dentin

See dentintertiary dentin.

irreversible pulpitisA clinical diagnosisbased on subjective and objective findingsindicating that the vital inflamed pulp isincapable of healing.

irrigantsLiquids used for intracanalirrigation; examples include sodiumhypochlorite, saline, chlorhexidine,hydrogen peroxide and EDTA.

irrigationWashing by a stream of fluid;

intracanal irrigation facilitates physicalremoval of materials from the canal andintroduction of chemicals for antimicrobialactivity, demineralization, tissue dissolution,bleaching, deodorizing and hemorrhagecontrol.

irritation dentinSee dentintertiary dentin.

ISO (International Standards Organization)An international nongovernmentalorganization whose objective is the

development of international standards; acommittee, TC106-Dentistry, is responsiblefor the standardization of terminology,test methods and specifications for dentalmaterials, instruments, appliances andequipment.

isotonicRelates to an equal osmoticpressure to interstitial or intracellular fluids;an important requirement for media usedto transport traumatically avulsed teeth.

isthmusSee anastomosis.

kininsInflammatory mediators that areproduced when plasma or tissue kallikreinscontact kininogen; bradykinin andneurokinin A are examples of the kininsthat may reduce the pain threshold in

pulpal inflammation.

kloroperkaA paste made by dissolvinga powder consisting of zinc oxide,gutta-percha and rosin in chloroformand used as a cementing medium forgutta-percha points during theobturation procedure.

lamina duraThe layer of compact boneforming the wall of a tooth alveolus seenin dental radiographs as a thin radiopaqueline surrounding the roots of teeth; loss ofcontinuity and changes in its width and

radiopacity may indicate pathosis.

Langerhans cellsDendritic, clear cells thatmay participate in antigen processing andpresentation in periradicular inflammation.

laser (light amplification by stimulatedemission of radiation)A device thatconcentrates high energies into anintense narrow beam of nondivergentmonochromatic electromagnetic radiation;used in surgery, cauterization and for avariety of diagnostic purposes; various

types available depending on the laserwavelength, probe characteristics andthe laser energy; types include thecarbon dioxide, Nd:YAG, argon andxenon chloride excimer lasers.

laser Doppler flowmetrySee pulp test.

lateral canalSee canal, pulplateral canal.

lateral compaction (condensation)See obturation techniquelateralcompaction.

lateral luxationSee luxationlateral luxation.

lateral periodontal cystSee cystlateral periodontal cyst.

ledgeAn artificial irregularity created onthe surface of the root canal wall thatimpedes the placement of instruments tothe apex of an otherwise patent canal.


K L


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L ML MlentuloA flexible, loosely spiraled, wire

instrument that can be mounted in thedental handpiece or used by hand; thisrotating instrument carries paste materials,such as root canal sealers or medicaments,into the root canal.

lingual (palatal) groove defectAdevelopmental groove occasionally present

on the lingual surface of maxillary incisors;may be deep enough to communicatewith the pulp, causing pulp necrosis due tothe invasion of bacteria; may contribute toisolated periodontal defects due to loss ofattachment in the area.

lipopolysaccharide (endotoxin)Cell wallmolecule from Gram-negative bacteriathat consists of a variable polysaccharideand a conserved lipid; induces an intenseinflammatory response, and, if absorbedsystemically in large quantities, can cause

septic shock.

liquefaction necrosisDeath of a tissue inwhich cells and tissue elements becomepartly or completely liquefied.

lubricantsUsed during root canalinstrumentation, particularly with rotaryinstruments, to enhance negotiation ofthe canal and to minimize friction andthe risk of file separation.

Ludwigs anginaSevere, life-threatening

infection, usually of odontogenic origin;arises if there is bilateral involvementof the submental, sublingual andsubmandibular spaces; is characterized bypainful swelling of the floor of the mouth,tongue elevation, dysphagia, dysphoniaand (at times) compromises the airway.

luxationDisplacement of a tooth from itsoriginal position in the alveolus, withouttotal avulsion, resulting from acute trauma.

extrusive luxationA partial axialdisplacement of the tooth out of its socket.

intrusive luxationAn axial displacementof the tooth into the alveolus accompaniedby comminuted apical fracture of thealveolar socket.

lateral luxationA displacement of thetooth in a direction other than axially,usually accompanied by fracture of thealveolar socket.

subluxationAn abnormal loosening ofthe tooth in the alveolar socket withoutdisplacement.

lymphocyteImmunocompetent cell withlarge circular nucleus that mediates avariety of specific and nonspecific immunereactions.

B-cellLymphocytes that are primarilyresponsible for the mediation of humoralimmunity through production of antibodies.

NK-cellNatural killer cells are a type oflymphocyte involved in innate immunityagainst viruses and antibody-dependentcellular cytotoxicity.

T-helper cell (CD4 Positive)Lymphocytesthat mediate specific immune responsesby stimulation of B-cells, other T cells andactivation of macrophages. Two mainvariants are currently recognized:TH1and TH2. The former has a cytokineprofile that produces a pro-inflammatory

response, whereas the latter producescytokines that activate B-cells and maycontribute to the reduction of theinflammatory response and theinhibition of TH1 cells.

T-suppressor/cytotoxic cell (CD8Positive)Cells that mediate lysis ofvirus infected cells, tumor cells andgraft rejection, and other forms ofcell-mediated hypersensitivity.

lymphokineA cytokine produced by alymphocyte, such as IL-2.

macrophageLarge phagocytic cells thatmediate the innate immune responses byproducing cytokines, bactericidal enzymes,oxygen-reactive molecules and growthfactors; participate in antigen presentation

to lymphocytes; arise from circulatingmonocytes and constitute a group ofheterogenous cells in various tissuesof the body known as themononuclear-phagocyte system.

major apical diameterThe area of theapical foramen where the walls are farthestapart, usually located in the cementum.

malarRelated to the cheek or thezygomatic bone.

MalassezSee epithelial rests of Malassez.

mantle dentinSee dentinmantle dentin.

marsupialization (decompression)Thecreation of a pouch; in endodontics, thesurgical exteriorization of a large cyst byresection of a wall and insertion of a tubeor other type of drain to decompress thelesion during healing. HS: Partsch Ioperation

martensitic phaseSee austeniticphaseA crystalline phase transformationthat occurs in nickel titanium alloy as aresult of cooling or the application ofstress.

master apical fileThe largest file used tothe full working length of the completelyprepared root canal.

master apical rotaryThe largest rotaryinstrument used to the full length of thecompletely prepared canal in some rotarypreparation systems.

master point (master cone)The largestgutta-percha point that can be placedeither to full working length or to within ashort distance of working length (usually

0.5 mm or less), of the completely preparedroot canal prior to obturation by eitherlateral or vertical compaction.

mast cellA connective tissue cell that isinvolved in anaphylactic reactions byproducing histamine.

mechanical pulp exposureSee pulpexposuremechanical pulp exposure.

mechanical pulp testSee test cavity.

medicament (medication)An agent usedfor medicinal value; commonly refers tointracanal, interappointment agents usedfor palliative or antimicrobial purposes.

meta-analysisStatistical process commonlyused with systematic reviews; involvescombining the statistical analyses andsummarizing the results of severalindividual studies into one analysis. Whendata from multiple studies are pooled, thesample size and power usually increase.

metacresyl acetate (Cresatin)A colorless,oily liquid with a characteristic phenolicodor exhibiting varying degrees of toxicityand having mild, nonspecific antibacterialand antifungal actions; used as a rootcanal medicament.

microbial cultureSee culture, microbial.


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M NM AAE GLOSSY NmicroleakageThe ingress of oral fluids

along any interface between a toothsurface, restoration, cement or root canalfilling material; concept of microleakagealso applicable to the passage ofperiradicular tissue fluids coronally alongany interface between a root canalsurface and its obturating materials.

mineral trioxide aggregate (MTA)Acement-like material used as a root-endfilling material, for perforation repair andpulp capping, and as a root-end barrier inteeth with an open apex.

minor apical diameterSee apical constriction.

mobilityMovement of tooth in its socketresulting from an applied force, usuallymeasured on an increasing scale of 13,or measured by the amount of horizontal

and/or vertical mobility in millimeters.

modulus of elasticity (Youngs modulus)Measure of stiffness of an object, definedas the amount of strain resulting fromapplying a given stress.

morbidit

glossary of en do terms web

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