Best Endodontist in Delhi

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ENDODONTIC EMERGENCIES
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Pain perception

• Chemical mediators
• Pressure

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Emergency/urgency(unscheduled office visit)

• Treatment

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System of diagnosis

• Medical and dental histories
• Subjective examination
• Objective examination
• Periodontal examination
• Radiographic examination

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Dental considerations

• Stress reduction protocol
• Maintain normal dietary habits
• Schedule dental appointments earlier in the day
• Use appropriate local anesthetics
• Antibiotic coverage is recommended

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Categories

• Pre-treatment emergencies
• Interappointment and post obturation emergencies
• Emergencies related to trauma

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Pre-treatment emergencies

• Obtaining profound anesthesia
• Intra- pulpal anesthesia
• Supplemental intraosseous injection

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Intra pulpal anesthesia
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X-tip anesthesia delivery system

• 1.8 ml of 2 lidocain with 1100,000 epinephrine
• Site 3-7 mm apical to the mucogingival junction
• X-tip 2parts drill guide-sleeve
• When conventional LA techniques are failed

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X-tip anesthesia delivery system
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Management of painful irreversible pulpitis

• Without acute apical periodonitis
• With apical periodontitis

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Without acute apical periodontitis

• treatment

• Complete cleaning and shaping

• Partial pulpectomy

• pulpotomy

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Acute pulpitis with apical periodontitis
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Management of pulp necrosis with apical pathosis

• No swelling
• Localized swelling
• Diffuse, more extensive swelling

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Acute apical abscess

• treatment

• Access cavity preparation

• Local infiltration should
• not be given

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Drainage through tissue and bone

• Post and core
• Sectional silver point
• Heavily calcified canal
• Presence of more than one abscess

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Inter appointment emergencies

• Recrudescence of a chronic apical periodontitis
• Recurrent periapical abscess
• Inter appointment flare ups
• Apical periodontitis
• Incomplete removal of pulp tissue

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Recrudescence of a chronic apical periodontitis

• Chronic lesion become acute after the first
  endodontic appointment
• Exact reason unknown
• Treatment

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Inter-appointment flare-ups

• The phenomenon
• Prevent the occurrence
• Manage the event

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Symptomatic endodontic infections
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Microorganisms as causative agents of flare-ups

• Apical extrusion of infected debris
• Changes in the endodontic micro biota or in
  environmental conditions
• Secondary intra - radicular infections
• Increase of the oxidation-reduction potential

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Apical extrusion of infected debris
Courtesy-j.f Siqueira
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Changes in endodontic microbiota in environmental
conditions
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Secondary intra-radicular infections

• Remnants of dental plaque,calculus,caries
• Leaking rubber dam
• Contamination of endodontic instruments
• Leakage through temporary or permanent
  restoration
• Fracture of tooth structure
• Recurrent decay, delay in placement of permanent
  restoration

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Secondary intra-radicular infections
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Increase of the oxidation-reduction potential
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Preventive measures

• Selection of instrumentation techniques that
  extrude less amounts of debris apically
• Completion of the chemo mechanical preparation in
  a single visit
• Use of irrigants
• Use of an anti-microbial intracanal medicament

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Selection of instrument techniques

• Involving linear filing motion /rotational action
• Crown down technique extrude less debris
• Copious and frequent irrigation

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Completion of chemo mechanical preparation in a
single visit

• Maximum removal of irritants
• Reduce the risks of inter-appointment discomfort

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Do not leave teeth open for drainage

• Establishment of drainage
• Complete chemo-mechanical preparation
• Placement of an intracanal medicament
• Coronal closure

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Expend all efforts in maintaining the aseptic
chain

• Prevent infection in vital cases
• Introduction of new microbial species in cases of
  infected necrotic pulps
• Secondary infections/ primary infections

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• Stunning Dentistry believe in delivering No
  Compromise Dentistry assisted with Top- notch
  technology. Our team of Internationally acclaimed
  specialists craft smiles with a personalized
  touch making sure our clients receive the best
  services in the world of dentistry.

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