口腔学英文课件：Treatment of Pulpal and Periapical Diseases.pptx

口腔学英文课件：Treatment of Pulpal and Periapical Diseases.pptx

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TreatmentofPulpalandPeriapicalDiseases,Introduction,Endodontictherapyisasequenceoftreatmentforthepulpofatoothwhichresultsintheeliminationofinfectionandprotectionofthedecontaminatedtoothfromfuturemicrobialinvasion.Thissetofproceduresiscommonlyreferredtoasarootcanal.,Introduction,Rootcanalsandtheirassociatedpulpchamberarethephysicalhollowswithinatooththatarenaturallyinhabitedbynervetissue,bloodvesselsandothercellularentities.Endodontictherapyinvolvestheremovalofthesestructures,thesubsequentshaping,cleaning,anddecontaminationofthehollowswithtinyfilesandirrigatingsolutions,andtheobturation（filling）ofthedecontaminatedcanalswithaninertfillingsuchasguttaperchaandtypicallyaeugenol-basedcement.,WhyweneedRootCanalTreatment?

1-DuetodeepCaries,2-DuetoLeakedRestoration,3-DuetoTrauma,4-Excessiveforceduringortho.treatment,TreatmentPlanning,Treatmentdecisionsarebasedon:

?

PulpalandPeriapicaldiagnosis?

Restorabilityoftooth?

Periodontalconsiderations?

Difficultyofcase?

Systemconsiderations?

Financialconsiderations,EndodonticDiagnosisTheprocedureofacceptingapatient,recognizingthatheshehasaproblem,anddevelopingatreatmentplanthatwillsolvetheproblem.,PatientEducation,Thepatientmustunderstandhisresponsibilityinthetreatmentprocedure.Dentistshoulddiscusswiththepatienttheproceduresofthetreatmentaswellasthecost,beforethetreatment,Systemconsiderations?

UncontrolledDiabete?

Cancerandchronicleukemia?

Pregnancy,Treatment,?

Rootcanaltherapy?

Resinfyingtherapy?

Mumificationtherapy?

Apicalsurgery?

Intentionalreplantation,RootCanalTherapy,Themostwidelyusedtechniquetotreatpulpalandperiapicaldiseases：

ToremovetheinfectedsubstancesToobturatecanalinthreedimension,AnesthesiaandpaincontrolIsolationanddisinfectionofthesiteAccesspreparationDebridementandshapingthecanalObturation,OverviewofRootCanalTherapy,InstrumentsandAccessoriesforEndodonticProcedures,EndodonticexplorerEndodonticspoonexcavatorBroachesEndodonticfilesK-typeHedstrom,ColorsandSizesofEndodonticFiles,RubberstopsPaperpointsSpreadersPluggersGlickNo.1Millimeterruler,InstrumentsandAccessoriesforEndodonticProcedures,RotaryinstrumentsGates-GliddenburPessoreamerLentulospiral,InstrumentsandAccessoriesforEndodonticProcedures,IrrigationsolutionSodiumhypochloriteHydrogenperoxideParachlorophenol（PCP）,MedicamentsandDentalMaterialsinEndodontics,Gutta-perchapointsFormocresolRootcanalsealer,MedicamentsandDentalMaterialsinEndodontics,AnaesthesiainEndodontics,MostcommonlyusedanaestheticsolutionsLidocaine2%Maximumsafedosageof2%lidocaine4.4mg/kg（2mg/lb）Vasoconstrictorsinlocalanesthetics?

Prolongdurationofanesthesiaviaslowerrateofabsorption?

Decreasedrugtoxicityviaslowerrateofabsorption?

Decreasetissuehemorrhage,LocalAnesthesia,Anaesthesia,MaximumsafedosageofEpinephrine：

Inanormalpatient,Nomorethan0.2mgInacardiacpatient,Nomorethan0.04mgIna1:

100,000concentration,Methods,ConventionalblockanaesthesiaLocalinfiltrationSupplementalanesthesiatechniquesInferiorAlveolarNervePosteriorSuperiorAlveolarNerveInfraorbitalNerve,Anaesthesia,LocalinfiltrationAnaestheticsolutionisinfiltratedslowlyjustbeneaththemucosalsurfaceattheperiapicallevelandmassagedgentlytowardsthebone,afteradelayof30secondstoallowtheonsetofanalgesia,theneedleisdirectedagaintowardstheapex,insinuatingthepointbeneaththeperiosteum,afurther0.5mlofsolutionisinjectedslowly.,Anaesthesia,Supplementalanesthesiatechniques?

PeriodontalLigamentInjection?

IntraosseousInjection?

IntrapulpalInjection,ToothIsolation,RubberDamIsolationGreatlyreducesbacterialcontaminationduringrootcanaltreatmentPreventswallowingofinstrumentsPreventfromrotaryburs,NaOClaccidentsFaster,moreconvenientandlessfrustratingthantherepeatedchangingofcottonrollesandsaliva-evacuatingdevicesDONTPERFORMRCTWITHOUTRD!

Mustremaininplacefromaccesstofinish*,RubberDam,Isolationsetup?

Rubberdam（RD）?

RDframe?

RDpunch?

RDforceps?

RDClamp,RubberDamIsolation（singleisolation）,Rubberdam,FrameandrubberdamForcepsandPunchPunchholesAshno,0/1Ashno,9FerrierAshno,10/11No,7aWinglessClampForcepsandPunchclampingrestorationRemoval,Accessopening,obtainaccesstothecanalTheprimaryobjectiveofanaccessopeningistoprovidestraightlineaccesstotherootcanalsystem.ACCESSOPENINGBurs1157Roundburs#2or#4Endo-Z,AccessCavity,Accessopening,GeneralPrinciples,LocationShapePreoperativeradiograph,Accessopening,MaxillaryCentralIncisors?

Averagelength=22.5mm?

Conicaltaper?

TypeI=100%AccessOpening=Triangularshape,Accessopening,MaxillaryIncisors?

Enlargetheaccessopeningbywithdrawingtherotatingbur,RootCanalPreparation,1,Objective2,Instruments3,Workingleng