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Pulp and periapical pathosis

The aim of the diagnosis is to determine. Necessity of medicaments (antibiotic prevention)?Which tooth should be treated?What treatment should be applied?Making a fillingRoot canal treatmentExtraction of the tooth. Basic principle of the diagnosis. Anamnesis - Health history (medical, dental) - 1., 3.FeverPain (subjective examination, tentative diagnosis)Oral investigationInspection (fistula, swelling, open pulp chamber) - 2., 3.clinical testsvitality tests 14

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Pulp and periapical pathosis

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    1. Pulp and periapical pathosis (Principles and Practice of Endodontics, Walton and Torabinejad) Powerpoint 2002 presentation www.konfog.sote.hu /Klinika bemutatása/munkatársaink/ Vág János/pulpalpathosis_en

    2. The aim of the diagnosis is to determine Necessity of medicaments (antibiotic prevention)? Which tooth should be treated? What treatment should be applied? Making a filling Root canal treatment Extraction of the tooth

    3. Basic principle of the diagnosis Anamnesis - Health history (medical, dental) - 1., 3. Fever Pain (subjective examination, tentative diagnosis) Oral investigation Inspection (fistula, swelling, open pulp chamber) - 2., 3. clinical tests vitality tests - 2., 3. percussion - 2., 3. Mobility - 2., 3. X-ray - 2., 3. selective anesthesia - 2. sharp, shooting / dull psinsharp, shooting / dull psin

    4. Vitality test cold test: ethyl chloride

    5. Aetiology of the pulp and periapical pathosis Microbial: dental caries Mechanical: operative procedure (iatrogenic), trauma Chemical: pulpal (acid etching, bond), periapical (irrigation)

    6. The pathway of the pulp and periapical pathosis set out from caries

    7. Pulpal pathosis General symptoms of the inflammation rubor calor tumor (oedema) dolor functio laesa The special anatomical aspects of the pulp: enclosed chamber

    8. Classification of pulpal diseases (according to symptoms and treatment) Reversible pulpitis Irreversible pulpitis Hyperplastic pulpitis Pulpal necrosis

    9. Reversible pulpitis Anamnesis: pain stimulated by cold and sweet, tooth can be fixed Clinical examination: vitality test: positive, „short” respond Treatment: removing of the exciting agent making a filling (or pulp capping)

    10. Irreversible pulpitis Anamnesis: generally asymptomatic or mild or severe spontaneous pain difficult to localise Clinical examination: vitality test: „long”, sharp respond Treatment: root canal treatment

    11. Hyperplastic pulpitis - in young people, chronically inflammed pulp Anamnesis: asymptomatic Clinical examination: vitality test: positive open pulp chamber within polypous tissue Treatment: root canal treatment

    12. Pulpal necrosis Anamnesis: asymptomatic Clinical examination vitality test: negative Treatment: root canal treatment

    13. Does any radiological symptom link to „simple” pulpal pathosis? Rare exceptions: calcification and internal resorption

    14. Periapical pathosis

    15. Aetiology non-treated pulpal disease trauma (hyperocclusion) irrigants instrumentation

    16. Symptoms of periapical pathosis generally Anamnesis: acute: pain, swelling chronic: mild or no symptoms Clinical examination: vitality test: usually negative Radiological symptoms

    17. Classification of periapical pathosis Acute apicalis periodontitis Chronic apical periodontitis Condensing osteitis Acute apical abscess („closed”) Suppurative apical periodontitis („open”)

    18. Acute apical periodontitis Anamnesis: symptoms of pulpitis or necrosis + pain on bite Clinical examination: pain on percussion X-ray: thickening of periodontal ligament space Treatment: root canal treatment, (adjustment of occlusion)

    19. Chronic apical periodontitis Anamnesis: asymptomatic or slight discomfort Clinical examintaion: little or no pain on percussion X-ray: interruption of lamina dura or apical radiolucency Treatment: root canal treatment reidiou’peikreidiou’peik

    20. Radiogram of healthy periodontium and chronic apical periodontitis

    21. Acute apical abscess („closed”) Anamnesis: severe discomfort, swelling, fever Clinical examination: swelling, localisation? X-ray: radiolucent lesion (localisation) Treatment: root canal treatment, drainage, (antibiotics)

    22. Suppurative apical periodontitis („open”) Anamnesis: asymptomatic (drain), swelling Clinical examination: fistula, swelling X-ray: radiolucent lesion (localisation with guttapercha) Treatment: root canal treatment

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