The inferior alveolar nerve block is the most frequently used injection technique for achieving local anesthesia in root canal treatment of mandibular teeth. During root canal treatment, profound pulpal anesthesia must be achieved for both patient benefit and making the procedure less stressful for the dentist. The inferior alveolar nerve block has been shown to fail in 44% to 81% of the time (1). This failure could be attributed to several reasons, like anatomical variation of the nerve, decreased local pH, activation of nociceptors like tetrodotoxin, capsaicin-sensitive, transient receptor potential vanilloid type 1 channels (TRPV1 )
MEDIATORS OF PULP INFLAMMATION
Inflammatory changes within the pulp worsen as the carious lesion approximates the pulp. This leads to an influx of neutrophils and release of inflammatory mediators like prostaglandins, interleukins, substance P, bradykinin, and calcitonin gene-related peptide (2). Although pulp inflammation produces a number of inflammatory mediators, prostaglandin is one of the most studied. Generally the mediators sensitize the peripheral nociceptors within the pulp of the affected tooth, which increases pain production and neuronal excitability (2). Prostaglandin is an end-product of arachidonic acid metabolism which is produced via the cyclooxygenase (COX) pathway (3). Prostaglandin leads to activation and sensitization of peripheral nociceptors which in turn leads to sprouting of nerve terminal in the pulp (4). This then upregulates the expression of sodium channels in the nerve cells like tetrodotoxin (TTX) (4). TTX is four times resistant to the blockade of lidocaine and moreover their expression is doubled in the presence of prostaglandins (4). Prostaglandins also act by sensitizing nerve endings to bradykinins and histamines which increases pain and tenderness during inflammation (3).
HOT TOOTH
Hot tooth generally refers to a tooth which has been diagnosed as irreversible pulpitis, with spontaneous, moderate to severe pain, and does not respond to local anaesthesia (2). IANB has a failure rate of 15% in patients with normal tissue (5) whereas it fails in 44-81% of teeth with irreversible pulpitis (6). Essentially, it is not a failure of technique in these cases. The pulpal anaesthesia does not occur due to presence of inflammatory mediators as discussed earlier. Rate of failure in maxillary infiltration is also as high as 30% in teeth with irreversible pulpitis (5). Therefore inability or difficulty to achieve anesthesia in patients with irreversible pulpitis remains as barrier for a successful endodontic treatment.
DRUGS USED AS PREMEDICATION
Several drugs of the NSAID class have been recommended as a premedication to enhance success of local anaesthesia in teeth with hot pulp.
three years and must pass an additional Board Examination, which equips them to perform complex and simple endodontic procedures, including Root Canal Therapy. Root canal therapy is a fairly common procedure that relieves tooth pain and saves the natural smile. Endodontists also perform procedures including endodontic retreatment, surgery, cracked tooth treatment, and they respond to various dental traumas. The branch of dentistry that performs these procedures is called “endodontics”, which involves
and of the periapical tissue Endodontic modalities include non-surgical root canal treatments such as primary root canal treatment, secondary root canal treatment (retreatments) and surgical periradicular treatments. Non-surgical root canal treatment aim to eradicate the bacteria in all the root canals. This can be achieved by removal of the infected pulp tissue, mechanical shaping, disinfecting the canals and filling the canals with an appropriate material then restoring the coronal tooth with a definitive
INTRODUCTION: A fundamental aim of endodontic treatment is to prevent or cure apical periodontitis. Consequently, the central aim of root canal treatment has been directed to the elimination of bacteria and their substrates from the pulp canal system. Preparation of the root canal through a combination of mechanical instrumentation and antibacterial irrigation is the critical stage in canal disinfection. This is followed by placement of a root canal filling and coronal restoration to prevent potential
The Endodontics procedures of a Therapy Root Canal Dreyonna Carroll Anthem Institute The endodontics procedures of rotary canal therapy or root canal is a procedure that is performed by a specialized general dentist, and or a endodontist. The patient develops consistent ,severe pain, discoloration, or sensitivity from food and even to touch in , or around a certain area of a tooth, and is diagnosed by a specialist to receive rotary therapy. This is if the tooth can be saved, meaning it is not
(Root Canals) Root Canal Therapy “Root canal” can be a scary term for some people. At Always About Smiles, we use modern technology to make root canals simple and painless. We’ve answered some commonly asked questions about our root canal therapy — feel free to contact our office with any additional concerns. Why might I need a root canal? Root canals are needed when a tooth becomes infected. That means a buildup of bacteria has reached the internal tissue of the tooth. You may notice this infection
The root canal is a procedure in which and endodontist or dentist will perform to remove an infection from the pulp of the tooth canal. There are many indications to show that the patient will need this work completed such as pain, tenderness and sensitivity to warm and cold tempetures. When the endodontist is doing the procedure he will use many different tools such as endodontic explorers, files, peso reamers and gutter purcha. Once complete the patient will be a little sore but the initial pain
be in need of a root canal therapy. Visit your dentist at the earliest. When your tooth is badly decayed or infected, a root canal therapy or treatment becomes necessary in order to save that tooth. If you let such a tooth left untreated, it will cause great discomfort. It may also necessitate the need to extract such a tooth altogether! For that reason, it is vital to see your dentist at the earliest, who can save your natural tooth with a root canal therapy. A root canal treatment, in a nutshell
and today, professionals trained in this specialty can help save teeth and repair any inherent damage. Common endodontic procedures include root canal therapy, fixing of broken teeth and repairing dental trauma. Endodontics is a subspecialty of dentistry that specifically deals with problems of the tooth pulp. Endodontists specialize in the diagnosis, treatment and prevention of disorders or injuries to the pulp in order to save the tooth. Some of the structures that accompany the tooth pulp include
infection occurs primarily by the intimate anatomic and vascular interactions between the pulp and the periodontium. As such, when we as dentists see these periapical lesions affecting the periodontium and the apical tissue, proper diagnosis and treatment is of utmost importance if we are to give the affected tooth a hopeful prognosis. Abscess Definition An abscess is an enclosed collection of liquefied tissue, known as pus, somewhere in the body. It is the result of thebody's defensive reaction
the tooth, usually by production of acid by hydrolysis of the food debris accumulated on the tooth surface by the bacteria. A correct diagnosis of the pulp conditions is important in treatment planning. The indications, objectives and types of pulpal therapy depend on the diagnosis of the pulp. Diagnosis and treatment planning for pulpal therapy in paediatric patient include an appropriate medical and dental history, clinical tests (palpation, percussion and mobility testing) and radiographic
Implant Procedures [Implants are used to give a strong foundation to the new teeth/tooth. It requires a long procedure to get fixed. They require same care as of the natural tooth.] Prosthodontics Fixed &Removable Denture [A set of false teeth are called dentures. Dentures are used to replace the missing tooth/teeth. Dentures are chosen when the bridges fail in the task of replacing the missing tooth.] Dentures are of different types. It can be made of acrylic, fibreglass, metal or a combination
“It is better to keep your mouth shut and appear stupid than to open it and remove all doubt.” Mark Twain The Root Cause Amalgam fillings impact the body from a chemical point of view, but the effect that mercury filings have on the energetic system of the body is also significant. The body is electrical in nature and the acupuncture meridian system is one of many systems that acts as a conduit of the CHI or life energy of the body. Each tooth is connected to an organ via the acupuncture meridian
are questions that your dentist will ask you as he or she tries to determine whether or not you have a cracked tooth. A crack in a tooth is not always visible to the eye, and sometimes cracks don’t even show on x-rays. But an early diagnosis and treatment is critical if you want to prevent this problem from becoming more complicated and costly, or worst case scenario, end up losing your tooth. What Causes a Tooth to Crack? Teeth can crack due a number of reasons, such as chewing or biting on hard
aches. People thought worms burrowed holes into their teeth causing a variety of pain. The amount the worm moved determined how painful the toothaches were and if the toothaches stopped that would mean the worm died. Patients pain determined the treatment of the tooth worm. Minor pain resulted in a direct a mixture of beeswax and henbane seed, a mild narcotic, on a piece of iron and smoked into the cavity with a funnel. The filling of the cavity with henbane and gum mastic would follow the smoke.
spinal canal. This problem is much more common in people over the age of 60. However, it can occur in younger people who have abnormally small spine canals as a type of birth defect. The problem usually causes back pain and leg pain that comes and goes with activities such as walking. The purpose of this information is to help you understand: the anatomy of the spine related to spinal stenosis the signs and symptoms of lumbar spinal stenosis, how the condition is diagnosed, and the treatments available