11/07/2014 1 Principles of diagnosis in Endodontics Diagnosis, pulpitis, perio-endo. Treatment planning & case selection Patients assessment Special tests which help us diagnose pulpal disease How reliable are they? Differential diagnosis of pulpal disease Aetiology of pulpal disease Patient Assessment • Medical history • Pain history • Extraoral examination • Intraoral examination – Palpation – Percussion – Mobility – Periodontal examination – Fibreoptic light – Pulp testing • Radiographic assessment • where • when, time of day/night • duration, frequency • character - patient’s own words • intensity - pain scale • aggravating factors • alleviating factors Pain History Examination Extraoral Asymmetry Facial swelling Lymph nodes Best viewed from above the patient Examination Intraoral Soft tissue OH Periodontal condition Incident of caries Missing or unopposed teeth Tooth wear, faceting limited opening ?
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11/07/2014
1
Principles of diagnosis in Endodontics
Diagnosis, pulpitis, perio-endo.
Treatment planning & case selection
Patients assessment Special tests which help us diagnose pulpal
disease How reliable are they?
Differential diagnosis of pulpal disease Aetiology of pulpal disease
Patient Assessment
• Medical history • Pain history • Extraoral examination • Intraoral examination
• Even more advanced - final restorations, castings
Definition of Endodontology
• A branch of dental science concerned with study of form, function, health of, injuries to and disease of the dental pulp and periradicular region and their treatment.
What is Endodontic treatment?
• Pulp therapy
• RCT (non-surgical)
• Chemo-mechanical preparation
• Irrigants and medicaments
• Files
• Obturation
• Surgical
Aims of Endodontic
treatment?
• REMOVE
MICRO-ORGANISMS
Treatment options
• Re-RCT
• Endodontic surgery e.g. Root end surgery (Apisectomy), Root resection, hemisection ...