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Case 5
Dr. Hassan M. Abouelkheir
BDS, MSC, PhD
 Male patient aged 54 years old .Male patient aged 54 years old .
 He complains of pain in lower firstHe complains of pain in lower first
molar teeth #19. pain started one daymolar teeth #19. pain started one day
back which is agrivated by hot or coldback which is agrivated by hot or cold
drinks.drinks.
 Pain killers does not relief pain.Pain killers does not relief pain.
 Past medical history :Past medical history :
 Chronic cough with copious sputum &Chronic cough with copious sputum &
mild dyspnea.mild dyspnea.
 He take MethylxanthineHe take Methylxanthine
Case 5
Case 5
 Hospitalization in 1995 due to carHospitalization in 1995 due to car
accident and fracture of left wrist butaccident and fracture of left wrist but
he recoverd completely.he recoverd completely.
 Family history:Family history:
 Father has diabetes mellitus type 2 &Father has diabetes mellitus type 2 &
mother has osteoarthritis.mother has osteoarthritis.
 Psycho social History:Psycho social History:
 He is novelist . He smokes 2 packet ofHe is novelist . He smokes 2 packet of
cigarettes per day for more than25cigarettes per day for more than25
years.years.
Case 5
 Dental History:Dental History:
 Amalgum restoration on tooth #19Amalgum restoration on tooth #19
since 2 years back .since 2 years back .
 He has gain of wt.He has gain of wt.
Case 5
 What is the suspected diagnosis of theWhat is the suspected diagnosis of the
case?case?
 Acute or chronic pulpits.Acute or chronic pulpits.
 Periodontal disease.Periodontal disease.
 Periapical infection.Periapical infection.
 Other lesion.Other lesion.
Group I
 Diseases induced by smokingDiseases induced by smoking::
 Lung cancerLung cancer
 Pregnancy and smoking effectsPregnancy and smoking effects
 Precancerous lesions.Precancerous lesions.
Group 2
 What are the types of pulpitis?What are the types of pulpitis?
 Acute suppurative pulpitis.Acute suppurative pulpitis.
 Acute non suppuratice .Acute non suppuratice .
 Chronic pupitisChronic pupitis
 Chronic hyperplastic pulpitis .Chronic hyperplastic pulpitis .
 Treatment planes.Treatment planes.
Group 3
 Non steriods Anti-inflammatory Drugs?Non steriods Anti-inflammatory Drugs?
 ClassificationClassification
 Side effectsSide effects
 Cox1 & cox2Cox1 & cox2
 Mode of action.Mode of action.
 PrecautionsPrecautions
 Dental management of pt takingDental management of pt taking
NSAIDS.NSAIDS.

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Case 5

  • 1. Case 5 Dr. Hassan M. Abouelkheir BDS, MSC, PhD
  • 2.  Male patient aged 54 years old .Male patient aged 54 years old .  He complains of pain in lower firstHe complains of pain in lower first molar teeth #19. pain started one daymolar teeth #19. pain started one day back which is agrivated by hot or coldback which is agrivated by hot or cold drinks.drinks.  Pain killers does not relief pain.Pain killers does not relief pain.  Past medical history :Past medical history :  Chronic cough with copious sputum &Chronic cough with copious sputum & mild dyspnea.mild dyspnea.  He take MethylxanthineHe take Methylxanthine Case 5
  • 3. Case 5  Hospitalization in 1995 due to carHospitalization in 1995 due to car accident and fracture of left wrist butaccident and fracture of left wrist but he recoverd completely.he recoverd completely.  Family history:Family history:  Father has diabetes mellitus type 2 &Father has diabetes mellitus type 2 & mother has osteoarthritis.mother has osteoarthritis.  Psycho social History:Psycho social History:  He is novelist . He smokes 2 packet ofHe is novelist . He smokes 2 packet of cigarettes per day for more than25cigarettes per day for more than25 years.years.
  • 4. Case 5  Dental History:Dental History:  Amalgum restoration on tooth #19Amalgum restoration on tooth #19 since 2 years back .since 2 years back .  He has gain of wt.He has gain of wt.
  • 5. Case 5  What is the suspected diagnosis of theWhat is the suspected diagnosis of the case?case?  Acute or chronic pulpits.Acute or chronic pulpits.  Periodontal disease.Periodontal disease.  Periapical infection.Periapical infection.  Other lesion.Other lesion.
  • 6. Group I  Diseases induced by smokingDiseases induced by smoking::  Lung cancerLung cancer  Pregnancy and smoking effectsPregnancy and smoking effects  Precancerous lesions.Precancerous lesions.
  • 7. Group 2  What are the types of pulpitis?What are the types of pulpitis?  Acute suppurative pulpitis.Acute suppurative pulpitis.  Acute non suppuratice .Acute non suppuratice .  Chronic pupitisChronic pupitis  Chronic hyperplastic pulpitis .Chronic hyperplastic pulpitis .  Treatment planes.Treatment planes.
  • 8. Group 3  Non steriods Anti-inflammatory Drugs?Non steriods Anti-inflammatory Drugs?  ClassificationClassification  Side effectsSide effects  Cox1 & cox2Cox1 & cox2  Mode of action.Mode of action.  PrecautionsPrecautions  Dental management of pt takingDental management of pt taking NSAIDS.NSAIDS.