牙体牙髓病诊断学课件.ppt

COLD TEST most common * Cotton pellet found to give more effective response bc holds more cold * Cold test CAN be performed on a crown or bridge! * For crowns u want to place closer to gingival as opposed to normal tooth toward incisal * New clincal requirements – no single canal competency, just single canal case Don’t necessarily have to have single canal to do multicanal case (including molar) so can use any of those for your experience * RETREATMENT VS. ROOT END SURGERY Quality of previous treatment Coronal leakage Restoration to be replaced Possible etiologic factor that could be corrected by retreatment Proximity of anatomic landmarks Extra-radicular infections * Technical interrelationship between Endodontics and other disciplines: - The need for crown lengthening - Building a foundation for fixed or removable prostheses - Interim restorations CRITERIA FOR ENDODONTIC TREATMENT PLAN SEQUENCING CROWN LENGTHENING FOUNDATION / INTERIM RESTORATION TIMING OF CORONAL RESTORATION REFERRAL TO AN ENDODONTIC SPECIALIST Complex root canal anatomy Severe canal calcifications Severe root curvatures Difficult radiographic visualization of the tooth apex Difficult access (limited mouth opening, severe crowding of teeth, many second and third molars) REFERRAL TO AN ENDODONTIC SPECIALIST Complicated traumatic injuries that require long-term treatment Difficult patient management Complicated retreatment, e.g. post removal, paste retreatments, molars Cases requiring surgical treatment Large periradicular lesions requiring biopsy Internal or external root resorption * Is your tests are not correlating with symptoms, wait and watch approach for 2 weeks until symptoms LOCALIZE * * Thermal test is #1 test for vitality of pulp Sinus tract tracing lets us know: if its endo or perio in origin 3 p’s useful for determinig periapical diagnosis * 3-4 mm apical and coronal portion as well is needed If pulp stones in chamber, much more tricky * Multiple angled radiographs impro