EMERGENCY ENDODONTICS Flashcards
1
Q
endodontic emergency
A
- pulpitis (reversible and irreversible)
- periapical infection
- cracked tooth
- mid and post treatment flare ups
- trauma involving the pulp
- iatrogenic damage involving the pulp
2
Q
what is pulpitis
A
inflammation of the pulp
3
Q
reversible pulpits symptoms
A
- pain brought on by hot cold or sweet
- short duration – does not linger for long after removal of the stimulus
- can be difficult to localise
- tooth may give an exaggerate response to sensibility testing
- radiographs generally normal appearance (no PA radiolucency)
4
Q
tx for reversible pulpitis
A
- removal of the causal factor eg caries, failed restoration etc
- consider placing a temp restoration such as Zn-Ox/eug (sedative dressing)
- monitor response to treatment
can place biodentine near the pulp, helpful to use in restorations
5
Q
irreversible pulpitis
A
- spontaneous pain
- pain persists (hours)
- pain triggered by heat and in the later stages relieved by cold
- kept awake at night
- tooth can be TTP, but not always
- pain can radiate
6
Q
tx of irreversible pulptis
A
ideally finish RCT in one session
pulp usually non infective at this point so little bacterial invasion therefore the pulp is almost sterile
7
Q
how to anaesthetise hot pulp
A
regional anaesthesia consider additional sources of innervation mulitple anaesthetics intraligamentary anaesthesia intra osseous anaesthesia
8
Q
periapical periodontitis (symptomatic)
A
TTP tender to palpation swelling and reddening musosa no repsonces to vitality testing pain can be severe esp in pressure or function can be constant or worsening can present for several hours
9
Q
tx of periapical periodontitis
A
RCT
but dont do in one go as canal is not sterile
- will have contamination as the pulp is non vital
10
Q
abcess
A
collection of pus
11
Q
acute apical abcess symptoms
A
swelling severe pain esp on pressure feeling of tooth elevated in socket mobility may be present pt may experience fever, malaise and lymphadenopahy
12
Q
tx of acute apical abcess
A
LA
access cavity to drain
- dont do open drainage as debris will get stuck and infeciton will be worse to treat
13
Q
when to use antibiotics
A
abcess with
- signs of spreading infection (diffuse swelling, trismus)
- signs of systemic involvement (fever, malaise, lymphadenopathy)
- certain patients who are severely medically compromise
14
Q
causes of cracked tooth syndrome
A
- masticatory incidents
- bruxism
- thermal cycling
15
Q
symptoms and diagnosis of cracked tooth syndrome
A
- pain on chewing
- sensitivity to cold and hot fluids
- pain difficult to locate
- fracture usually from mesial to distal
- pain on release on pressure
visial dectection of crack
