p.4
Patient Emotional Status and Its Impact
What is the most important factor in emergency treatment?
Psychologic management of the patient.
p.6
Management of Irreversible Pulpitis
What is the management approach for molars with irreversible pulpitis?
Profound anesthesia, pulpectomy of the largest canal, and temporary dressing.
p.10
Indications and Contraindications for Antibiotics
What condition involves pulp necrosis?
A situation where systemic antibiotics are not indicated.
p.11
Diagnosis and Emergency Treatment Protocols
What is provided in Tables 2-1 and 2-2?
A summary of diagnosis and management of the endodontic emergency.
p.3
Etiologies of Endodontic Emergencies
What are the main etiologies of pulp or periapical tissue irritation?
Microbial, mechanical, and chemical factors.
p.1
Etiologies of Endodontic Emergencies
What should a student be able to identify regarding endodontic emergencies?
Etiologies of endodontic emergencies as they occur prior to treatment, between appointments, and after obturation.
p.6
Management of Irreversible Pulpitis
What is the management for anterior teeth and premolars?
Complete pulp extirpation followed by temporary dressing.
p.2
Distinction Between Emergency and Urgency
How long can a true emergency typically last?
Rarely more than a few hours to 2 days.
p.6
Management of Irreversible Pulpitis
What should be done if pain does not subside after initial treatment?
Call the next day to remove pulp from the other canal, as it may be the cause of pain.
p.1
Distinction Between Emergency and Urgency
What distinguishes a true emergency from urgency?
A true emergency requires immediate attention, while urgency may not.
p.9
Antibiotic Therapy in Endodontics
Why is proper drug dosage important in antibiotic therapy?
To cover likely causative bacteria and minimize the risk of resistant bacteria.
p.8
Management of Acute Apical Abscess
Where should the incision be made for a localized fluctuant swelling?
At the site of greatest fluctuation down to the level of apical bone.
p.8
Management of Acute Apical Abscess
What should be done to keep the wound clean?
Use hot salt-water mouth rinses to promote drainage.
p.2
Distinction Between Emergency and Urgency
What defines an Endodontic emergency?
A situation associated primarily with pain and/or swelling that requires immediate diagnosis and treatment.
p.2
Distinction Between Emergency and Urgency
What key question assesses the impact of a dental problem on daily activities?
Does the problem disturb your sleeping, eating, working, concentrating, or other daily activities?
p.4
Diagnosis and Emergency Treatment Protocols
When can endodontic emergencies occur?
Prior to therapy, during treatment, and after root canal treatment.
p.4
Patient Emotional Status and Its Impact
How can a clinician gain the confidence of the patient?
By providing attention and sympathy.
p.10
Indications and Contraindications for Antibiotics
When is topical administration of antibiotics indicated in endodontics?
In cases of replantation of avulsed permanent teeth.
p.7
Management of Irreversible Pulpitis
What is appropriate for patients with extreme tenderness on percussion?
A partial or total pulpectomy.
p.9
Antibiotic Therapy in Endodontics
When is antibiotic therapy usually unnecessary for localized swellings?
Except in patients with depressed host defense.
p.4
Patient Emotional Status and Its Impact
What is the first step in managing a patient during an emergency?
Establish and maintain control of the situation.
p.6
Diagnosis and Emergency Treatment Protocols
What is the diagnosis for irreversible pulpitis with symptomatic apical periodontitis?
Vitality: positive, Tenderness to percussion: positive, X-ray: normal to slight widening of periodontal ligament space or small radiolucency.
p.10
Indications and Contraindications for Antibiotics
When is adjunctive systemic antibiotic treatment not indicated during endodontic therapy?
In cases of symptomatic irreversible pulpitis.
p.1
Diagnosis and Emergency Treatment Protocols
What is required for diagnosing an endodontic emergency?
Case histories, appropriate radiographs, and/or clinical photographs.
p.9
Antibiotic Therapy in Endodontics
What are suitable alternatives for patients allergic to penicillin?
Erythromycin and clindamycin.
p.7
Pain Perception and Management Strategies
What can aid in the relief of symptoms for patients with extreme tenderness?
Reducing the occlusion to eliminate contact.
p.1
Patient Emotional Status and Its Impact
How does a patient's emotional status affect endodontic treatment?
It complicates diagnosis and treatment.
p.5
Management of Irreversible Pulpitis
What is the preferred treatment if time permits for irreversible pulpitis?
Complete cleaning and shaping of the root canals.
p.8
Management of Acute Apical Abscess
How should the incision be positioned for optimal drainage?
In a position that encourages drainage by gravity.
p.10
Indications and Contraindications for Antibiotics
What type of soft tissue trauma may require treatment?
Trauma requiring sutures or debridement.
p.5
Management of Irreversible Pulpitis
What is the tenderness to percussion in irreversible pulpitis?
Negative tenderness to percussion.
p.2
Distinction Between Emergency and Urgency
What is the main difference between urgency and emergency in dental situations?
An urgency represents a less severe problem, while an emergency is more severe and requires immediate attention.
p.3
Diagnosis and Emergency Treatment Protocols
Why is a systematic approach important in diagnosing dental issues?
To avoid misdiagnosis, improper treatment, and exacerbation of the problem.
p.2
Distinction Between Emergency and Urgency
What does it indicate if pain medication is ineffective for a dental issue?
It suggests that the pain may be due to a true emergency.
p.3
Pain Perception and Management Strategies
How do pain thresholds change?
They change significantly under various circumstances, influenced by past experiences and present anxiety levels.
p.10
Indications and Contraindications for Antibiotics
What characterizes a chronic apical abscess?
Teeth with a sinus tract and periapical radiolucency.
p.7
Management of Irreversible Pulpitis
What is the management for pulp necrosis?
Canal debridement followed by a temporary dressing.
p.1
Management of Irreversible Pulpitis
What are the steps involved in treating irreversible pulpitis?
Ideal emergency treatment steps include diagnosis, pain management, and possible referral.
p.9
Indications and Contraindications for Antibiotics
What is an indication for systemic antibiotics in endodontics?
Acute apical abscess in medically compromised patients.
p.3
Etiologies of Endodontic Emergencies
What can result from irritation of the pulp or periapical tissues?
Tissue injury, cell death, and inflammation.
p.3
Diagnosis and Emergency Treatment Protocols
What factors should not affect the systematic approach to treatment?
Patient emotional status, physical limitations, lack of time, and stress on the dentist and staff.
p.10
Indications and Contraindications for Antibiotics
What are the symptoms of symptomatic apical periodontitis?
Pain, pain to percussion and biting, and widening of the periodontal ligament space.
p.9
Antibiotic Therapy in Endodontics
What combination of antibiotics is recommended?
Penicillin and metronidazole.
p.1
Symptomatic Apical Periodontitis Management
What is involved in managing symptomatic apical periodontitis?
Steps include diagnosis, pain management, and treatment planning.
p.5
Management of Irreversible Pulpitis
What is performed in single-rooted teeth with limited time?
Partial pulpectomy, extirpating most pulpal tissue with a broach.
p.8
Management of Irreversible Pulpitis
What is the initial management for a localized diffuse soft tissue swelling?
Open the tooth and thoroughly instrument and irrigate the canal.
p.4
Pain Perception and Management Strategies
Why is treating the patient as an important individual crucial?
It helps in managing pain components and raises pain perception thresholds.
p.1
Pain Perception and Management Strategies
What factors affect pain perception and reaction?
Psychological and physiological factors.
p.7
Management of Acute Apical Abscess
What are the steps to resolve swelling in an acute apical abscess?
1 - Establish drainage through the root canal; 2 - Incise a fluctuant swelling; 3 - Prescribe antibiotics.
p.5
Etiologies of Endodontic Emergencies
What are possible etiologies of irreversible pulpitis?
Deep caries, extensive restoration, trauma, pulp capping.
p.9
Indications and Contraindications for Antibiotics
What are signs of systemic involvement that indicate the need for antibiotics?
Localized fluctuant swellings, elevated body temperature >38°C, malaise, lymphadenopathy, trismus.
p.8
Management of Acute Apical Abscess
What is a possible intervention if drainage through the tooth is not possible?
Establish soft tissue drainage through an incision and suture an indwelling drain into the incision wound.
p.6
Management of Irreversible Pulpitis
What is required for complete treatment of anteriors, premolars, and molars?
Complete pulp extirpation of all canals followed by a temporary dressing.
p.7
Management of Acute Apical Abscess
What factors influence the position of swelling in an acute apical abscess?
1 - Orientation of the tooth apex; 2 - Relationship of the site of perforation to muscle attachment.
p.1
Antibiotic Therapy in Endodontics
What is the rationale for prescribing antibiotics in endodontics?
To manage infections and prevent complications.
p.5
Management of Irreversible Pulpitis
What is a common misconception about chemical medicaments in pulp treatment?
That they help control or prevent additional pain.
p.7
Diagnosis and Emergency Treatment Protocols
What is a rare emergency diagnosis related to pulp necrosis?
Non-vital tooth with no tenderness to percussion.
p.9
Antibiotic Therapy in Endodontics
What should patients be instructed to do regarding their antibiotic course?
Adhere closely to the dosing schedule and complete the entire course.
p.5
Indications and Contraindications for Antibiotics
Are antibiotics indicated for irreversible pulpitis?
No, they are definitely not indicated.
p.3
Patient Emotional Status and Its Impact
What should clinicians do to reduce anxiety during treatment?
Obtain reliable information about the chief complaint and ensure cooperation during treatment.
p.10
Indications and Contraindications for Antibiotics
When is an acute apical abscess considered without systemic involvement?
When there are localized fluctuant swellings.
p.8
Management of Acute Apical Abscess
What is the first step in managing a localized fluctuant soft tissue swelling?
Administer soft tissue infiltration of anesthesia around the periphery of the infected area.
p.5
Management of Irreversible Pulpitis
What is the procedure for molars when time is limited?
Partial pulpectomy on the largest canals.
p.5
Management of Irreversible Pulpitis
What should be done after irrigation of the chamber or canals?
Place a dry cotton pellet and seal the access temporarily.
p.8
Management of Acute Apical Abscess
When should a patient be considered for immediate hospitalization?
If they show signs of toxicity, CNS changes, or airway compromise.
p.9
Indications and Contraindications for Antibiotics
What conditions warrant adjunctive systemic antibiotic treatment?
Progressive infections, such as rapid onset of severe infection, cellulitis, or osteomyelitis.
p.8
Management of Irreversible Pulpitis
What should be done if no drainage is achieved from the canal?
Instrument the apical foramen to encourage drainage from the periapical tissues.
