Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endotontics > Management of Endo Emergencies > Flashcards

Management of Endo Emergencies Flashcards

1
Q

use of pulpotomy

A

immature tooth more
- want to have apexogenesis

used in sympotomatic irreversible pulpitits as emergency treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

hyperplastic pulpitis aka

A

pulp polyp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

describe pulp necrosis

A

may still have pain due to the C fibers response
- even though not responding to the cold

due to caries, trauma, perio disease

circumfrenterial spread of inflammation

can follow reversible pulpitis if etiology is not removed

peri-apical status will dictate treatment (in regards to emergency treatment)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

emergency treatment likely depends upon?

A

the peri-apical / peri-radicular diagnosis of the tooth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

symptomatic peri-radicular periodontitis

A

inflammation in the pulp has extended through the apical foramen into the pero-radicular area

EXCLUDES the occlusal trauma and periodontal abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

can you do pulpotomomy with apical symptoms?

A

NO - so it is contra-indicated in symptomatic peri-radicular periodontitist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

intra-cranial medicament usually

A

calcium hydroxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

secondary acute peri-radicular eriodontitis

main causes?

A

secondary to the RCT
- overextension of endodontic instruments into peri-apical area

  • extrusion of fluids, tissue, bacteria (bacterial products) into peri-apical area
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

secondary acute peri-radicular eriodontitis presents?

A

likely history of RCT 1-2 days prior to therapy

spontaneous or continous pain

pain to chewing, percussion, palpation,

‘feels like tooth is higher than the adjacent teeth’

’ feels like pressure is building up in my jaw
- is there a swelling?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

secondary acute peri-radicular eriodontitis emergency treatment?

A
  • occlusal adjustemnt
  • investigate presence of additional canals
  • intra-canal corticosteroid paste
  • seal the access cavity again
  • trephination of buccal cortical plate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

symptomatic peri-radicular periodontitis is presentation of

A

one presentation of chronic peri-radicular periodontitis with developing symptoms

  • spontaneous pain
  • pain to chewing/ brushing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

describe acute peri-radicular abscess as it presents and associated with?

A

advanced acute periradicular periodontitis

decreased host resistance

increased virulence of bacteria

a “true” infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

pain present with acute peri-radicular abscess ? what do you need to consider

A

maybe – pain fibers located in the periosteum

look at the dental history
- history of pain?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

acute peri-radicular abscess systemic symptoms

A

fever/ lymphadenopathy/ sweating/ chills. GI disturbance

patient can feel and look sick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

acute peri-radicular abscess emergency treatemnt

A

management of odontogenic infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

which one is a true infection

A

acute peri-radicular abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

management of odontogenic infections breaks down into?

A

Patient health

anatomical features

microbial factors

with infection in the middle
- diagram with all these surrounding / influencing the infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

spread of odontogenic infection

A

through path of least resistance
- anatomic position in relation to the B and L cortical plates

relationship of apex of tooth to closest muscle attachment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

incision and drainage is what type of treatment?

A

surgical phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what does IAD do?

A
  1. decrease number of bacteria
  2. reduces tissue pressure
    - alleviates pain
    - improves circulation in area
  3. prevents spread of infection
  4. alters oxidation - reduction potential in tissue
  5. accelerates healing and prevents spread of infection
21
Q

avoid what in IAD

A

‘needle-track’ infections

22
Q

anesthesia in IAD?

A

use regional blocks or infiltration

23
Q

decontamination uses what in IAD?

A

betadine scrub

24
Q

describe incision in IAD?

A

incision of HEALTHY TISSUE

  • most dependent area
  • subperiosteal
  • 1/2 - 3/4 in lneght

’ rule of index finger’

25
Q

describe blunt dissection

A

part of IAD

  • curved hemostat
  • insert closed with beaks unblocked
  • open beaks to separate tissues
  • extend into adjacent spaces
26
Q

describe insertion of drain?

A

use sterile penrose tubing

suture to healthy tissue

allow to remain in place for 2-7 days

27
Q

when can you do endodontic therapy with IAD?

A

at time of surgical phase

- while the drain is in place

28
Q

removal of drain

A

24 hours after cleansing and shaping of root canal system

after resolution of infection

29
Q

employ antibiotic therapy when?

A

in a compromised host resistance

there has been systemic involvment

fascial space involvment

inadequate surgical drainage

30
Q

guidelines for antibiotic therapy

A
  1. select an antibiotic with an ANEROBIC SPECTRUM
  2. use larger doses for shorter periods of time
  3. collect specimens prior to intiation of antibiotics
  4. if available - utalize gram stain results to select intital antibiotic
31
Q

if no gram stain or culture and sensitivity results available what antibiotic should you use?

A

enicillin is antibiotic of choice

- acts on gram + and - and anerobic cocci

32
Q

describe penicillin use

A

first choice
spectrum is gram+/- aerobic cocci and most anaerobic rods

dosage

  • 1-2 gram loading dose
  • 500 mg every 6 hours for 5-7 days
33
Q

prescribe clindamycin when?

A

allergic to penicillin or when it has been 48 hours and pt. does not respond to the penicillin tx

34
Q

spectra and dosage of clindamycin

A

specrta
- gram - anaerobic rods
gram + aerobic streptococci

dosage
- 600 mg loading dose
150-300 mg every 6 hours for 5-7 days

35
Q

clindamycin can increase risk of? associated with which risk?

A

pseudomembranous colitis

36
Q

pseudomembranous colitis

A

overgrowth of C.diff – which is gram + spore forming anaerobic rod

growth is inhibited by lactobacillus, porphyromonas, peptostreptococcus

approx. 5% of healthy aduts carry C. diff in their intestines

20% of adults in hospitals are C. diff asymptomatic carriers

37
Q

pt’s more at risk for pseudomembranous colitis

A

elderly, inpatient in hospital, immunosuppressed

38
Q

pseudomembranous colitis most associated with which drug

A
  1. cephalosporin
  2. ampicillin
  3. clindamycin
39
Q

c. difficile produces?

A

Toxin a - entertoxin

toxin b- cytotoxin

40
Q

out-patient vs in-patient use of antibiotics results in pseudomembranous colitis

A

outpatient –> 1 in 3 of 100,000

IN PATIENT AT HIGHER RISK

in patient –> 1-10 of 1,000 inpatient

41
Q

3 forms of pseudomembranous colitis

A
  1. antibiotic associated diarrhea without colitis
    - not caused by overgrowth of C. diff
  2. antibiotic associated without pseudomembrane formation
    - so get no produciton of toxins
  3. antibiotic associated collitis with produciton of pseudomembranes
42
Q

antibiotic therapy can interfere with which drugs?

A

oral contraceptives

43
Q

metronidazole use?

A

indications/ spectrum

  • all anaerobic gram - rods
  • anerobic gram + cocci

if after a day and a half we can switch to this and add this to the regime instead of giving clindamycin

dosage
- 500 mg every 6 hours for 5-7 days

44
Q

NSAID analgesics

is use PRN?

A

ibuprofen (motrin)

  • one tablet one hour pre-operative
  • one tablet every 6 hours

NOT PRN

45
Q

use of applied heat?

A

intra-oral warm rinses

46
Q

reversible pulpitis emergency treatment

A

occlusal adjustment

or if faulty restoratino

  • remove and replace with temporay
  • zinc oxide eugenol based restoration
47
Q

emergency treatment for symptomatic irreversible pulpitis

A

pulpotomy - when can (immature tooth and open apex) - apexogensis

or pulpectomy

USE NSAIDS

48
Q

internal resoprtion falls under what category

A

asymptomatic irreversible pulpitis

49
Q

hyperplastic pulpitis associated with

A

pulp poly

- asymptomatic irreversible pulpitis

Endotontics (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions