s9-Finals-Emergencies Flashcards
(36 cards)
Answer
Why are endodontic emergencies significant in dental practice?
They account for 60-80% of all dental emergencies.
What is the primary symptom of acute pulpitis?
Severe, spontaneous, lingering pain triggered by thermal stimuli.
How is acute pulpitis typically managed in an emergency?
Pulpotomy or pulpectomy, depending on pulp vitality.
What distinguishes acute pulpitis with apical periodontitis from simple pulpitis?
Tenderness to percussion due to periapical inflammation.
What is a key diagnostic feature of acute apical periodontitis?
Pain on biting or percussion, localized to the affected tooth.
How should acute apical periodontitis be managed if no time exists for full treatment?
Occlusal reduction and analgesics (NSAIDs).
What defines an acute periapical abscess without swelling?
Pus formation at the apex but no visible swelling.
What is the first step in managing an acute periapical abscess without swelling?
Drainage via root canal access and NaOCl irrigation.
How does an intraoral swelling in a periapical abscess present clinically?
Localized fluctuant swelling in the oral mucosa.
What is critical when managing an extraoral abscess?
Antibiotics (e.g., amoxicillin) + drainage if fluctuant.
What is a Phoenix abscess?
Acute exacerbation of a chronic periapical infection.
Why is occlusal reduction important in endodontic emergencies?
Reduces pain by relieving pressure on inflamed periapical tissues.
What did the CONSORT trial find about occlusal reduction?
It significantly reduces postoperative pain in irreversible pulpitis cases.
Why is NaOCl the preferred irrigant in endodontic emergencies?
It disinfects and dissolves necrotic tissue effectively.
Why should a dry cotton pellet be placed after pulp extirpation?
To avoid chemical irritation from medicaments.
Why must a temporary filling always be placed after emergency treatment?
Prevents recontamination and bacterial ingress.
What is the protocol for a first visit in chronic periapical abscess cases?
Complete cleaning/shaping; avoid CaOH if pus is present.
What is done during the second visit if mild pus persists?
CaOH placement after NaOCl irrigation.
When can obturation be performed in chronic infections?
Only after absence of pus and exudate.
What are the four main reasons for post-treatment flare-ups?
Overinstrumentation, facultative anaerobes, immunity, chemical mediators.
How does overinstrumentation cause flare-ups?
Pushes infected debris beyond the apex, triggering inflammation.
Why do facultative anaerobic bacteria contribute to flare-ups?
They thrive in low-oxygen environments post-treatment.
What chemical mediators are involved in post-op pain?
Prostaglandins, cytokines (e.g., IL-1β, TNF-α).
