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بسم الله الرحمن

الرحيم

U N I V E R S I T Y O F M O S U L

C O L L E G E O F
D E N T I S T R Y
D r. E m a d F a r h a n A l k h a l i d i
2020 -2021
D e p a r t m e n t o f
C o n s e r v a t i v e
D e n t i s t r y

O An endodontic emergency is defined as pain

or swelling caused by various stages of
inflammation or infection of the pulpal or
periapical tissues .
O as compared to Less critical urgency which
indicates a less severe problem in which
next visit may be scheduled for convenience
of both patient as well as the dentist

Classification of

Endodontic emergencies
O Before treatment
 Cracked tooth syndrome
 Symptomatic reversible pulpitis
 Symptomatic irreversible pulpitis
 Symptomatic apical periodontitis
 Acute exacerbation of asymptomatic apical
periodontitis(phoenix abscess)
 Acute alveolar abscess
 Cellulitis

endodontic emergencies presenting during

treatment
O Severe pain and swelling following an
endodontic treatment may arise as a
result of mechanical injury or
chemical injury or microbial injury to
the root canal system. The
mechanical and chemical injuries are
mostly of iatrogenic origin , but the
inter appointment pain due to
microbial injury is the predominant
factor

Hot tooth

Endodontic Flare - Ups
is a complication of endodontic treatment
which is defined as an acute exacerbation of
aymptomatic pulpal or periapical pathoses
after the initiation or continuation of root canal
treatment characterized by pain and/or
swelling that may arise following initial
debridement of the root canals or even after
obturation . The severity of a flare -up varies
according to the severity of the patient ’s pre -
operative pathosis , signs and symptoms

Etiology

1 .Microbial factors
Causeinterappointment
pain as a result of
imbalance in host -bacteria
relationship induced by
intracanal procedures due
to presence of pathogenic
bacteria like
Porphyromonas
endodontalis ,
Porphyromonas gingivalis ,
and Prevotella species
O Some situations during the
endodontic treatment can
facilitate microorganisms to
cause interappointment pain.
These include apical extrusion
of debris; incomplete
instrumentation leading to
changes in the endodontic
microbiota or in
environmental conditions; and
secondary intraradicular
infections.

2 .Non Microbial factors

3 .Inflammatory factors
O Mechanical and chemical
injury to the peri radicular
tissue would also result in
inflammatory reaction
causing pain. Mechanical
irritation includes mainly
over instrumentation and
overextended filling
materials. Chemical irritation
includes apical extrusion of
irrigants or intracanal
medications . The larger the
amount of overextended
material, the greater is the
intensity of damage to the
periradicular tissues
O Bacteria that suddenly
gain access to the
periradicular tissues
are faced with two
immediate lines of
defense, represented
by the complement
system and by
phagocytes
(neutrophils and
macrophages) present
in the chronically
inflamed tissue

Management of Postobturation Emergencies

O Reassurance of the patient,
O Prescribe analgesics
O Check occlusion
O incision of the fluctuant tissue is perhaps
the only reasonable emergency treatment,
provided if the root canal filling is adequate.

U N I V E R S I T Y O F M O S U L

C O L L E G E O F
D E N T I S T R Y
THE END
Thank you
2020 -2021
D r. E m a d F a r h a n A l k h a l i d i


رفعت المحاضرة من قبل: Sultan Alsaffar
المشاهدات: لقد قام عضوان و 34 زائراً بقراءة هذه المحاضرة






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