Description
Endodontic diagnosis and treatment planning are the significant processes in the treatment planning. The emergency patient presents with pain and possibly swelling, or with a displaced, fractured, or avulsed tooth.An accurate diagnosis of the patient's condition is essential before an appropriate treatment plan can be formulated for that individual
Summary Listen
- The lecture emphasizes the importance of accurate diagnosis in endodontics, stating it as the foundation for successful treatment. Success is defined by the absence of symptoms, functionality of the tooth, normal soft tissue, and restored lamina dura. Conversely, failure is marked by persistent pain, unchanged or enlarged lesions, or new lesions appearing after treatment.
- Diagnosis involves a stepwise process: observing the patient's demeanor, taking a detailed history, performing objective tests (e.g., cold, heat, EPT), and correlating findings with radiographs. A key aspect is patient communication, actively listening to their chief complaint and using their descriptions to guide the diagnostic process.
- Medical and dental histories are crucial, including medications that may affect test results (e.g., analgesics, psychiatric drugs) or existing conditions like Lupus. The dental history should include the onset, duration, and nature of pain, as well as any recent dental work or trauma.
- Clinical tests include palpation, percussion (horizontal and vertical), and thermal tests (cold and heat). Thermal tests, particularly cold tests, are useful for differentiating between reversible and irreversible pulpitis. In the presence of crowns, cold testing is preferred.
- Radiography, including CBCT, plays a significant role in identifying issues like PDL widening, apical lesions, pulp chamber size, carries, and root fractures. GP tracing helps identify the source of sinus tracts. Transillumination can aid in detecting fractures or cracks.
- Treatment planning considers the strategic value of the tooth, potential parental support, and the overall arch. Patient-related factors like cost and medical conditions (diabetes, hypertension) also influence treatment decisions. A key decision factor is if the tooth is restorable, and the prognosis of any endodontic treatment.
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