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INTRODUCTION
practice of dentistry.
practice, some are seen with greater frequency. These are situations
- Vasodepressor syncope.
- Respiratory difficulty.
- Airway obstructions.
- Hyperventilation syndrome.
- Asthma.
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Other life threatening situations that occur with greater
administration of DRUGS.
Others are:
- Drug overdose.
- Drug allergy.
and effective relief because such care is essential part of daily practice.
pain has many causes, the adept clinician must diagnose the origin of
how to do it”.
DIAGNOSIS
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reactions to the patient is important for both pain and patient
problem and their defenses for coping with the situation must be
understood.
examination.
clinicians are:
(A) 1) Pain
2) Swelling
3) Lack of function
4) Esthetics
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The tests are as follows:
2. Percussion.
3. Palpation.
5. Radiographs.
- Cold
8. Anesthetic test
9. Test cavity
a) Pretreatment emergencies.
b) Interappointment emergencies.
c) Post-obturation emergencies
1) Acute Conditions
1. Reversible pulpitis
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2. Irreversible pulpitis.
3. Alveolar abscess.
4. Periodontal abscess
3) Fractures
Crown
Root
4) Avulsed tooth
5) Referred pain
- Hypersensitive dentin.
- Recurrent decay.
- Recent restoration.
- Necrotic pulp.
- Phoenix abscess.
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- Acute irreversible pulpitis - Localized.
- Non-localized
- Fracture of crown.
- Fracture of root.
- Avulsed tooth.
ACUTE PULPITIS
Definition:
stimuli.
Symptoms:
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Causes and Treatment
point.
like ZOE.
keeping the bur in contact with the tooth for a long time can cause
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Treatment Removal of metallic restoration and palliative
pulpitis.
Definition:
patient.
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Symptoms:
- It is spontaneous.
Causes:
pulpitis.
Non-vital
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A) Vital pulp
Procedure:
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B) Non-Vital Pulp
hot, cold or electric stimulation, they may still contain vital inflamed
tissue in the apical portion of root canal and also inflamed periapical
Radiographically:
- Phoenix abscess.
Definition:
the root apex of the tooth following death of pulp with extension of
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Causes (Non-vital pulp)
a) Bacterial involvement.
b) H/O trauma.
infrabony pockets.
SYMPTOMS
- Tenderness of tooth.
- Swelling.
- Sinus tract.
- Elevated temperature.
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- Gastro-intestinal disturbances.
- Malaise.
- Nausea.
- Dizziness.
- Lack of sleep.
TREATMENT
I – Debridement of canals.
II – Drainage of abscess.
one should stabilize tooth with finger pressure so that the pain is
reduced.
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Treatment procedure follows as:
Open root canals permit drainage and frequently eliminate the need for
and analgesics.
dried with paper points and a medicated temporary cotton pellet is kept
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done. According to them this stops the infiltration of new
microorganisms.
SWELLINGS ASSOCIATED
drainage.
tissue is a must.
every hour.
Cause
Necrotic pulp
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1) Its origin usually is an ACUTE EXACERBATION of infection
abscess.
swelling.
treatment.
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Most emergency are reactive phenomenon to pressure and
periradicular tissues.
According to Grossman
periradicular tissue.
- Intracanal medicament
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WALTON has suggested the possible factors related as
3) Host factors.
when they come to the dental office for emergency treatment. What is
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4) Administration of appropriate analgesics, prophylactic
HYPOCHLORITE ACCIDENT
Treatment:
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3) Since this may be hypersensitive reaction consider prescribing
an antihistaminic.
1) Crown fracture.
2) Root fracture.
3) Tooth avulsion.
- Fracture crown.
- Fracture root
Causes:
3) Trauma / blow.
Symptoms:
3. Hypersensitivity.
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DETECTION is made by:
1) Dental history.
2) Transillumination.
3) Placing a disc and making the patient bite, the disc acts like a
wedge on the cracked tooth and causes pain.
4) Dye.
TREATMENT
segment does not shear off under pressure, one should cement
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Because any traumatic accident can temporarily affect the usual
responses to the electric pulp test, cold test and test cavity, negative
test responses for pulp vitality are non diagnostic and should not be the
pulp is vital as vital pulp in the root canal of fractured tooth can
CROWN FRACTURES
1) Only enamel.
4) Untreatable.
ONLY ENAMEL
Open apex
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It apex is developed pulpectomy.
UNTREATABLE
ROOT FRACTURE
- Horizontal
Coronal third.
Middle third
Apical third.
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Horizontal fractures
The closer the root fractures to the apex the more favourable the
removed.
“stunned” state.
prognosis.
TOOTH AVULSION
problem.
Cause:
The longer the luxated tooth is out of its socket, the less likely it
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The instruction to the patients are:
Procedure
Ligated.
REFERRED PAIN
pathosis, the clinician knows that the pain can originate from many
other sources.
- Trigeminal neuralgia.
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- Migrane.
- Cardiac pain.
- Temporomandibular arthrosis.
- Periodontal abscess.
- Occlusal trauma.
- Muscle spasm.
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Other causes of referred or unusual pain are:
- Intensive radiation.
- Menstrual pain.
- Mode of action.
- Dosage.
- Indications.
- Route of administration.
- Toxicity
- Contraindications.
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ANALGESICS
- Aspirin.
- Acetaminophen.
- Naproxen.
- Ibuprofen.
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side effects than aspirin. It lacks anti-inflammatory effect of aspirin. It
300-400mg 4 times daily is more effective for severe pain relief than
aspirin. But it should not be used in patients with h/o peptic ulcer or
aspirin intolerance.
generally not used or are used with caution as it may depress the
ANTIBIOTICS
Antibiotics are life saving therapeutic agents which are used for
microorganisms. Therefore, the more lethal the antibiotic the less likely
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The most effective antibiotics for use in endodontic emergencies
is PENICILLIN.
endodontic infections.
to their larger physique and body wt and higher BMR, but according to
its less body wt. Therefore, the dosage reduces in accordance to the
250mg-500mg 6 hourly.
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Tetracycline is the least effective of all antibiotics for endo
emergencies.
CONCLUSIONS
emergency appointment.
REFERENCES :
- Grossman.
- Weine.
- Walton.
- Cohen.
- Ingle.
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