O1A Pain Control during retreatment

  • what are the 11 steps to pain control during retreatment?
    • whats the use of a gow gates block
      • more effective , targets the site where there are more foramina
      • less blood vessles positive aspiration unlikely
    • Whats the best method for intra-osseous injections
      • pdl, takes the least specialized equipment and least risk

Synopsis

  • Pain management during treatment is crucial. Just one anesthetic technique during treatment won’t cut it for the majority of patients
  • Pre-appointment iburprofen can help if the inflammation isn’t already severe
  • we should have an 11 step flowchart to eliminating pain

O1B - Post Op Pain Management

  • what are the three D’s
    • Diagnosis
    • Dental Treatment
    • Drugs
  • What follows the three D’s
    • Review
    • Reassess
    • reconsider the management strategy
  • What combination is best for endo pain relief
    • paracetamol 1000 + ibuprofen 400
  • What intervals should we give these meds
    • alternate at 2 hourly intervals
    • to keep blood concentration high!

Synopsis

  • post op pain management depends on the diagnosis
  • generally post op pain is increased if there is pain during or before the treatment
  • the best combo to use is paracetamol + ibuprofen on an alternating 2 hourly interval
  • codeine isn’t very effective as people are poor metabolizers an most combos on the market are less then 30 mg (the generally regarded minimum effective dose )
  • be careful in patients who can’t have NSAIDs
  • ibuprofen is generally the most effective, theoretically because it blocks inflammatory precurors higher up in the pathway

O2. Antibiotics and Antifungals

  • what dental conditions are antibiotics necessary for
    • mostly facial cellulitis and sometimes abscesses
      • even in the case of abscesses, restricted blood supply and pus makes it difficult for abx to reach and tx plus drainaige can help a lot more!
    • what is correlated with abx perscription
      • fridays and more acute conditions, both of which are inappropriate!
  • what are the correct doses of antibiotics and which ones are most common for each condition?
  • Should we use broad-spectrum abx?
    • based on the data of common dental pathogens, we can prescribe specific abx , the benefit given by broad spectrum is not worth the bacterial resistance!

O3 Treatment Outcomes, Persistent Radiolucency’s, Options for Management

  • what are the criteria for a favourable outcomes, how about an unfavourable one
  • whats more important the RCF or the final restoration?

O4 EndoPerio

  • whats the best terminology for endo-perio?
  • what are the main communication pathways
  • what are the absolute essentials for diagnosing endo perio
    • why not do only 1 kind of pulp test?

O5 EndoSurgery

  • who can do endo surgery?
    • only endodontists
  • what should you do before endo surgery ? what should you try?
  • what are the kinds of surgical flaps? what are the best flaps for endo surgery?
    • best flaps are triangular and trapezoidal
  • whats the best retrograde root filling material

O6A Discoloured Teeth

  • what are the two different kinds of discolouration
  • What are the different sources of extrinsic discolouration? Intrinsic?
  • Why must we be careful of all added endo matreials to the pulp chamber
  • What alternatives are there to internal bleaching? Disadvantages?
    • disadvantages of internal bleaching
  • What is the best stack of materials to use? for bleaching

O6B Discoloured Teeth

  • what are the steps for internal bleaching
  • What are the most predictable outcomes (based on colour)

O7A Conservative Pulp

  • whats the difference between pulp exposure due to caries and that due to trauma?
  • does size and time of pulp exposrue (traumatic) effect prognosis?

Is a dentine bridge necessary ?? **Is it a sign of successful treatment ??

  • what materials can we ue

O7B Conservative Pulp II

  • what are the diagnosis cases wehre we should do endodontic treatment
  • what material to use?