Dental Emergency
Dr Cecilia Young 楊幽幽
Independent Researcher
Professional Education and Training
This was the powerpoint slides seminar for the Dental Emergency Workshop for Medical Practitioners and Emergency Physicians on March 8, 2012 For Clinical Skill Training Centre, New Territories West Cluster of Hospital Authority, Hong Kong.
The content was education material about dental trauma, dental infection including Ludwig Angina, Cavernous sinus thrombosis, cutaneous sinus tract, brain Abscess etc
Related articles and references:
1. Editorial - Ludwig angina - the longest distance in the planet
https://bit.ly/2N6fpeZ
2. 香港教師急需學習牙齒急救 2013年08月07日
https://bit.ly/2L7SKP9
3. 牙愈洗愈傷 純屬謬誤 2018年3月1日 東方日報
https://bit.ly/2zslbWs
4. 醫知健:撞 甩牙 應放回原位 – 2014年1月11日 太陽報
https://bit.ly/2JcU4y8
5. 恆齒 受創甩脫 救牙有法 – 2014年1月11日 東方日報
https://bit.ly/2uoG0My
6. 口腔臉頰創傷護理- 香港大學牙醫學院
https://bit.ly/2mewAQt
7. Ludwig Angina – To tell or not to tell?
https://bit.ly/2JeoDUf
8. Maxillofacial trauma and Psychological Stress
https://bit.ly/2NGTTPd
9. Effectiveness of educational poster on knowledge of emergency management of dental trauma-part 1.RCT
https://bit.ly/2NIIPRR
10. Effectiveness of educational poster on knowledge of emergency management of dental trauma-part 2. RCT
https://bit.ly/2ubv0D5
11. Emergency management of dental trauma knowledge of Hong Kong primary and secondary school teachers
https://bit.ly/2KZzV3v
12. 不足兩成教師懂搶救飛脫牙
https://bit.ly/2zrIXll
13. Extraction experience - 朱祖恩 : 事前詳細解釋 過程不到半小時
https://bit.ly/2LaXhjS
14. 口腔臉頰創傷護理- 香港大學牙醫學院
https://bit.ly/2umSBjH
Dental trauma is one of the most common presentation in the pediatrics clinic. The fears and anxiety of these patients make management difficult. If improperly managed, it could affect the patient self-esteem and quality of life.
This document provides an overview of the assessment of trauma. It begins with definitions of trauma and discusses the epidemiology of facial trauma. It then covers the incidence, etiology, examination, diagnosis, and initial approach to trauma. Key points include that trauma to the oral region accounts for 5% of all injuries, with dental injuries being the most common facial injury. A thorough history and clinical examination are important for diagnosis and treatment planning. The examination should carefully inspect all soft tissue and bone structures for injuries.
The document discusses root fractures, including:
- Root fractures are difficult to detect and require angulated radiographs.
- Symptoms range from mild mobility/displacement/pain to being symptomless, depending on how coronal the fracture is.
- Emergency care involves repositioning and stabilization for 12 weeks to allow for calcification.
- Treatment options for necrotic pulp include root canal treatment for both segments, only the coronal segment, or surgical removal of the apical segment followed by root canal. Hard tissue induction and root canal treatment is the recommended method.
This document provides an overview of traumatic dental injuries, including:
- Common causes of dental trauma like sports accidents, assaults, and biting hard objects.
- Garcia & Godoy's classification system for injuries which includes enamel fractures, crown fractures, root fractures, luxations, and avulsions.
- Diagnostic methods like clinical examination, vitality testing, and radiography to evaluate injuries.
- Descriptions and treatment approaches for different injury types such as direct pulp capping, pulpotomy, endodontic treatment, and reattachment of fragments.
- Factors that influence healing of injuries like distance between fragments and immobilization duration.
The document serves as a reference for
Traumatic injuries of teeth /certified fixed orthodontic courses by Indian d...Indian dental academy
Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
Traumatic Dental Injuries to Permanent TeethDrSusmita Shah
A comprehensive presentation of traumatic injuries to permanent teeth; this includes multiple classifications, risk factors, prevalence and management according to International Association of Dental Traumatology and Adreasen J O.
Dental trauma is one of the most common presentation in the pediatrics clinic. The fears and anxiety of these patients make management difficult. If improperly managed, it could affect the patient self-esteem and quality of life.
This document provides an overview of the assessment of trauma. It begins with definitions of trauma and discusses the epidemiology of facial trauma. It then covers the incidence, etiology, examination, diagnosis, and initial approach to trauma. Key points include that trauma to the oral region accounts for 5% of all injuries, with dental injuries being the most common facial injury. A thorough history and clinical examination are important for diagnosis and treatment planning. The examination should carefully inspect all soft tissue and bone structures for injuries.
The document discusses root fractures, including:
- Root fractures are difficult to detect and require angulated radiographs.
- Symptoms range from mild mobility/displacement/pain to being symptomless, depending on how coronal the fracture is.
- Emergency care involves repositioning and stabilization for 12 weeks to allow for calcification.
- Treatment options for necrotic pulp include root canal treatment for both segments, only the coronal segment, or surgical removal of the apical segment followed by root canal. Hard tissue induction and root canal treatment is the recommended method.
This document provides an overview of traumatic dental injuries, including:
- Common causes of dental trauma like sports accidents, assaults, and biting hard objects.
- Garcia & Godoy's classification system for injuries which includes enamel fractures, crown fractures, root fractures, luxations, and avulsions.
- Diagnostic methods like clinical examination, vitality testing, and radiography to evaluate injuries.
- Descriptions and treatment approaches for different injury types such as direct pulp capping, pulpotomy, endodontic treatment, and reattachment of fragments.
- Factors that influence healing of injuries like distance between fragments and immobilization duration.
The document serves as a reference for
Traumatic injuries of teeth /certified fixed orthodontic courses by Indian d...Indian dental academy
Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
Traumatic Dental Injuries to Permanent TeethDrSusmita Shah
A comprehensive presentation of traumatic injuries to permanent teeth; this includes multiple classifications, risk factors, prevalence and management according to International Association of Dental Traumatology and Adreasen J O.
The document discusses traumatic injuries to the permanent dentition, specifically crown fractures. It provides an overview of the etiology, incidence, classification, and management of dental injuries. Key points include that the incidence of dental trauma from accidents and sports has increased in recent decades, commonly affecting the front teeth of children and teenagers. Proper initial treatment is important to promote healing. Classification systems help describe the specific injury and guide clinical decision making.
The document provides guidelines for managing traumatic dental injuries in primary teeth. It discusses special considerations for injuries in primary teeth including their close relationship to developing permanent teeth. Treatment guidelines are presented for different types of injuries like fractures, luxations, avulsions and alveolar fractures. Clinical and radiographic examinations are important. Potential sequelae are outlined. Splinting may be used for alveolar fractures or intruded teeth. Antibiotics are usually not needed unless other injuries require surgery. Crown discoloration is common after luxation but root canals are not indicated unless infection is present.
This document discusses cracked tooth syndrome, including its classification, incidence, etiology, symptoms, diagnosis, and treatment. It begins with a brief history of cracked tooth classification from the 1950s onwards. Cracked tooth syndrome can be classified into different types including craze lines, cracked teeth, fractured cusps, split teeth, and vertical root fractures. Cracked teeth most commonly occur in those aged 30-50 years old and involve the mandibular molars. Symptoms include pain from cold or pressure. Diagnosis involves dental history, visual examination, tactile examination, bite tests, staining, transillumination, and sometimes radiographs. Treatment aims to stabilize the crack immediately with splints or crowns and may involve
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
traumatic injuries in children: trauma to teeth and softJeena Paul
This document discusses traumatic injuries to children's teeth and soft tissues. It notes that trauma occurs frequently in children, with the highest incidence between ages 2-3. Common causes of trauma include falls, accidents, and sports. Examination of injured children should involve a thorough history, clinical examination of soft tissues and teeth, and radiographs to check for fractures or displaced teeth/bone. Proper documentation of findings is important for diagnosis and treatment planning.
Accidents and injuries to primary and permanent anterior teethsepehre-bikaran
This document discusses the prevalence, diagnostic procedures, classification, and clinical management of dental injuries. It notes that dental trauma is common, occurring in 5-18% of injuries depending on age. Peak incidence occurs from ages 2-4 and 9-10 in boys and 2-3 in girls. Diagnosis involves a thorough history, clinical and radiographic examination. Injuries are classified by authors such as Andreasen and Ellis. Treatment depends on the specific injury but may include repositioning displaced teeth, splinting with wires or resins, pulpotomies, root canals, extractions and more. Prognosis depends on the severity of the injury and timeliness of treatment.
The document discusses dental luxation injuries, which involve disruption of the tooth and surrounding tissues from trauma. It describes different types of luxation including intrusive, extrusive, lateral, and concussive luxations. For each type, it outlines the typical clinical findings, recommended treatment approaches, and prognosis. Intrusive luxations have the tooth driven into the socket, while extrusive luxations see the tooth elongated out of the socket. Lateral luxations displace the tooth labially, lingually, mesially or distally. Treatment involves repositioning the tooth and splinting, with endodontics sometimes needed. Prognosis depends on healing of the periodontium and pulpal response.
Tooth Injuries| Tooth Trauma| Treatment of Tooth TraumaDr. Rajat Sachdeva
Tooth Trauma due to various etiology either causes structural loss or vitality loss.
Both can be recovered depending on type of trauma.
Horizontal, Vertical, Subluxation, Concussion, Avulsion are different types of fracture.
Method to treat them also depends on trauma.
RCT, Extraction, Splinting or sometimes no treatment needed if there is horizontal fracture at apical part.
Call us to book your appointment:-
+919818894041,01142464041
Follow our link:-
Google link:
https://business.google.com/dashboard/l/04970356233769420071
Facebook link for Dental Courses:
https://www.facebook.com/dentalcoursesdelhi/
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Blogger Profile :
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Facial Aesthetics Facebook Page :
https://www.facebook.com/facialaesthetics.delhi
Facial Aesthetics you tube channel :
http://www.youtube.com/channel/UCheM4wF9nWGXJYOmScvsQNw
Traumatic Dental Injuries to Permanent Anterior Teeth, Relation with Age and...Abu-Hussein Muhamad
This study examined the prevalence and characteristics of traumatic dental injuries among 9-12 year old Arab Israeli schoolchildren. A sample of 4,262 schoolchildren were clinically examined between 2012-2015. The overall prevalence of traumatic dental injuries was found to be 12.2%. Males experienced a significantly higher prevalence (8%) than females (4.2%). Enamel fractures were the most common type of injury. The prevalence of injuries was highest in 9 year olds and declined with increasing age. Males generally experienced more severe injuries than females. This cross-sectional study provides data on traumatic dental injuries among schoolchildren in the Arab Israeli community.
The document discusses traumatic injuries to primary teeth. It notes that 31-40% of boys and 16-30% of girls will suffer some dental trauma by age 5. The maxillary anteriors are most commonly affected and concussions, subluxations and luxations are the most common injuries. Trauma is typically caused by falls during play as young children have incomplete coordination. Predisposing factors include protruding upper incisors and insufficient lip closure. The document outlines the different types of injuries to the tooth, periodontal tissues, supporting bone, gingiva and oral mucosa that can occur. It provides details on the dental and medical history that should be obtained and examinations that should be performed when evaluating a traum
This document provides guidance on managing traumatic dental injuries in primary teeth. It discusses various types of injuries including enamel fractures, root fractures, luxations, and avulsions. For each injury type, it describes treatment objectives, options for treatment or observation, and follow-up recommendations. Conservative management is prioritized when possible to avoid harming the developing permanent dentition. While some injuries require extraction, others may be treated with pulpotomy, splinting, or simply monitoring for complications. Frequent follow-up is important to check for issues like infection, resorption, or eruption disturbances in the permanent teeth.
This document discusses dental trauma to primary teeth from extrusion and intrusion injuries. Extrusion involves partial displacement of a tooth from its socket, leaving the alveolar bone intact. Intrusion is more severe, with displacement of the tooth into the alveolar bone and comminution of the socket. Diagnosis involves visual examination and radiographs. Treatment depends on the severity of displacement and root development, and may include repositioning, extraction or monitoring for spontaneous re-eruption. Follow-up care including soft diets and hygiene instructions are also outlined.
- Traumatic injuries to primary and permanent teeth are common, with maxillary central incisors most frequently affected. Injuries range from enamel fractures to luxations and avulsions.
- Epidemiological studies show that approximately 1/3 of children experience dental trauma to primary teeth and 1/5 experience trauma to permanent teeth. Injuries most often occur from falls at home for young children and from sports for adolescents.
- Proper classification and diagnosis of dental injuries is important to determine appropriate treatment and management. Conditions range from concussion with no displacement to intrusive luxation with tooth displacement into bone.
This document discusses traumatic injuries to primary teeth. It covers the examination, treatment, and potential complications of various types of dental injuries in primary teeth. The types of injuries discussed include concussions, subluxations, extrusion, lateral luxation, intrusion, and avulsion. Treatment options are provided for different severities of injuries from smoothing enamel fractures to pulpectomies or extractions. Complications like pulp necrosis, root resorption, and effects on the permanent successor teeth are also outlined.
- The most common age for traumatic dental injuries is 1.5-2.5 years old, usually from falls or play-related accidents. Boys experience these injuries more frequently than girls. The maxillary incisors are most commonly injured.
- In the primary dentition, injuries often involve tooth luxations. In the permanent dentition, uncomplicated crown fractures are more typical.
- The goal in managing traumatic dental injuries is to delineate an approach for immediate or urgent care of the injury.
Classification of traumatic Injuries to anterior teeth of childrenCing Sian Dal
The document describes the World Health Organization's (WHO) classification system for traumatic injuries to primary and permanent anterior teeth in children. It outlines 12 classes of injuries ranging from enamel cracks or crazing (Class 0) to complete displacement of a tooth from its socket (Class 12). The classes are defined based on the structures involved (enamel, dentin, pulp) and type of displacement (intrusion, extrusion, lateral). The classification system provides a standardized way to categorize different levels of traumatic dental injuries.
Present a schedule for follow up of patients who have sustained dental injuriesRuhi Kashmiri
This document outlines follow-up schedules for different types of dental injuries to permanent and primary teeth. It provides guidelines for clinical and radiographic examinations over time based on the injury, from a few weeks post-injury to yearly checks for several years. Adhering to these schedules allows monitoring of healing and early detection of potential complications. Injuries are grouped by category such as hard tooth structures, supporting structures, and supporting bone fractures. Recommended follow-ups vary from no follow-up needed to weekly, monthly, 6-month, and yearly checks, depending on the specific injury and predicted healing timeline.
Introduction
Recap of Epidemiological triad
Strategies based on levels of prevention
Primary level
Secondary level
Tertiary level
Indian scenario
Recommendations
Conclusion
References
The document outlines the process for diagnosing and creating a treatment plan for a patient requiring a complete or removable partial denture. It details the steps involved in examining the patient which includes reviewing their medical and dental history, examining the mouth externally and internally, and taking radiographs. The treatment plan phase involves addressing issues like pain, extractions, and surgery before finalizing and delivering the denture.
Endodontics is the specialty of dentistry that manages the dental pulp and surrounding tissues. It involves diagnosing and treating issues like pulpal nerve damage, which can cause pain or sensitivity. Diagnostic tests are used to examine the tooth and determine the specific condition, such as pulpitis or a periradicular abscess. Common endodontic procedures include pulpotomy, pulpectomy, and root canal therapy which aim to preserve or remove the pulp and disinfect and fill the root canals. Surgical endodontic procedures like apicoectomy and retrograde restoration are needed when non-surgical root canal treatment fails or to address anatomical issues.
The document discusses traumatic injuries to the permanent dentition, specifically crown fractures. It provides an overview of the etiology, incidence, classification, and management of dental injuries. Key points include that the incidence of dental trauma from accidents and sports has increased in recent decades, commonly affecting the front teeth of children and teenagers. Proper initial treatment is important to promote healing. Classification systems help describe the specific injury and guide clinical decision making.
The document provides guidelines for managing traumatic dental injuries in primary teeth. It discusses special considerations for injuries in primary teeth including their close relationship to developing permanent teeth. Treatment guidelines are presented for different types of injuries like fractures, luxations, avulsions and alveolar fractures. Clinical and radiographic examinations are important. Potential sequelae are outlined. Splinting may be used for alveolar fractures or intruded teeth. Antibiotics are usually not needed unless other injuries require surgery. Crown discoloration is common after luxation but root canals are not indicated unless infection is present.
This document discusses cracked tooth syndrome, including its classification, incidence, etiology, symptoms, diagnosis, and treatment. It begins with a brief history of cracked tooth classification from the 1950s onwards. Cracked tooth syndrome can be classified into different types including craze lines, cracked teeth, fractured cusps, split teeth, and vertical root fractures. Cracked teeth most commonly occur in those aged 30-50 years old and involve the mandibular molars. Symptoms include pain from cold or pressure. Diagnosis involves dental history, visual examination, tactile examination, bite tests, staining, transillumination, and sometimes radiographs. Treatment aims to stabilize the crack immediately with splints or crowns and may involve
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
traumatic injuries in children: trauma to teeth and softJeena Paul
This document discusses traumatic injuries to children's teeth and soft tissues. It notes that trauma occurs frequently in children, with the highest incidence between ages 2-3. Common causes of trauma include falls, accidents, and sports. Examination of injured children should involve a thorough history, clinical examination of soft tissues and teeth, and radiographs to check for fractures or displaced teeth/bone. Proper documentation of findings is important for diagnosis and treatment planning.
Accidents and injuries to primary and permanent anterior teethsepehre-bikaran
This document discusses the prevalence, diagnostic procedures, classification, and clinical management of dental injuries. It notes that dental trauma is common, occurring in 5-18% of injuries depending on age. Peak incidence occurs from ages 2-4 and 9-10 in boys and 2-3 in girls. Diagnosis involves a thorough history, clinical and radiographic examination. Injuries are classified by authors such as Andreasen and Ellis. Treatment depends on the specific injury but may include repositioning displaced teeth, splinting with wires or resins, pulpotomies, root canals, extractions and more. Prognosis depends on the severity of the injury and timeliness of treatment.
The document discusses dental luxation injuries, which involve disruption of the tooth and surrounding tissues from trauma. It describes different types of luxation including intrusive, extrusive, lateral, and concussive luxations. For each type, it outlines the typical clinical findings, recommended treatment approaches, and prognosis. Intrusive luxations have the tooth driven into the socket, while extrusive luxations see the tooth elongated out of the socket. Lateral luxations displace the tooth labially, lingually, mesially or distally. Treatment involves repositioning the tooth and splinting, with endodontics sometimes needed. Prognosis depends on healing of the periodontium and pulpal response.
Tooth Injuries| Tooth Trauma| Treatment of Tooth TraumaDr. Rajat Sachdeva
Tooth Trauma due to various etiology either causes structural loss or vitality loss.
Both can be recovered depending on type of trauma.
Horizontal, Vertical, Subluxation, Concussion, Avulsion are different types of fracture.
Method to treat them also depends on trauma.
RCT, Extraction, Splinting or sometimes no treatment needed if there is horizontal fracture at apical part.
Call us to book your appointment:-
+919818894041,01142464041
Follow our link:-
Google link:
https://business.google.com/dashboard/l/04970356233769420071
Facebook link for Dental Courses:
https://www.facebook.com/dentalcoursesdelhi/
Facebook link for Dental Treatments:
https://www.facebook.com/sachdevadental/
You tube Link:
https://www.youtube.com/user/drrajatsachdeva
Linkedin link:
https://www.linkedin.com/in/drrajatsachdeva/
Slideshare:
https://www.slideshare.net/drrajatsachdeva
Twitter Page :
https://twitter.com/drrajatsachdeva
Instagram page :
https://www.instagram.com/surgicalmasterrajat/
Practo Profile :
https://www.practo.com/delhi/doctor/dr-rajat-sachdeva-dentist
Blogger Profile :
http://drrajatsachdeva.blogspot.com/
Facial Aesthetics Facebook Page :
https://www.facebook.com/facialaesthetics.delhi
Facial Aesthetics you tube channel :
http://www.youtube.com/channel/UCheM4wF9nWGXJYOmScvsQNw
Traumatic Dental Injuries to Permanent Anterior Teeth, Relation with Age and...Abu-Hussein Muhamad
This study examined the prevalence and characteristics of traumatic dental injuries among 9-12 year old Arab Israeli schoolchildren. A sample of 4,262 schoolchildren were clinically examined between 2012-2015. The overall prevalence of traumatic dental injuries was found to be 12.2%. Males experienced a significantly higher prevalence (8%) than females (4.2%). Enamel fractures were the most common type of injury. The prevalence of injuries was highest in 9 year olds and declined with increasing age. Males generally experienced more severe injuries than females. This cross-sectional study provides data on traumatic dental injuries among schoolchildren in the Arab Israeli community.
The document discusses traumatic injuries to primary teeth. It notes that 31-40% of boys and 16-30% of girls will suffer some dental trauma by age 5. The maxillary anteriors are most commonly affected and concussions, subluxations and luxations are the most common injuries. Trauma is typically caused by falls during play as young children have incomplete coordination. Predisposing factors include protruding upper incisors and insufficient lip closure. The document outlines the different types of injuries to the tooth, periodontal tissues, supporting bone, gingiva and oral mucosa that can occur. It provides details on the dental and medical history that should be obtained and examinations that should be performed when evaluating a traum
This document provides guidance on managing traumatic dental injuries in primary teeth. It discusses various types of injuries including enamel fractures, root fractures, luxations, and avulsions. For each injury type, it describes treatment objectives, options for treatment or observation, and follow-up recommendations. Conservative management is prioritized when possible to avoid harming the developing permanent dentition. While some injuries require extraction, others may be treated with pulpotomy, splinting, or simply monitoring for complications. Frequent follow-up is important to check for issues like infection, resorption, or eruption disturbances in the permanent teeth.
This document discusses dental trauma to primary teeth from extrusion and intrusion injuries. Extrusion involves partial displacement of a tooth from its socket, leaving the alveolar bone intact. Intrusion is more severe, with displacement of the tooth into the alveolar bone and comminution of the socket. Diagnosis involves visual examination and radiographs. Treatment depends on the severity of displacement and root development, and may include repositioning, extraction or monitoring for spontaneous re-eruption. Follow-up care including soft diets and hygiene instructions are also outlined.
- Traumatic injuries to primary and permanent teeth are common, with maxillary central incisors most frequently affected. Injuries range from enamel fractures to luxations and avulsions.
- Epidemiological studies show that approximately 1/3 of children experience dental trauma to primary teeth and 1/5 experience trauma to permanent teeth. Injuries most often occur from falls at home for young children and from sports for adolescents.
- Proper classification and diagnosis of dental injuries is important to determine appropriate treatment and management. Conditions range from concussion with no displacement to intrusive luxation with tooth displacement into bone.
This document discusses traumatic injuries to primary teeth. It covers the examination, treatment, and potential complications of various types of dental injuries in primary teeth. The types of injuries discussed include concussions, subluxations, extrusion, lateral luxation, intrusion, and avulsion. Treatment options are provided for different severities of injuries from smoothing enamel fractures to pulpectomies or extractions. Complications like pulp necrosis, root resorption, and effects on the permanent successor teeth are also outlined.
- The most common age for traumatic dental injuries is 1.5-2.5 years old, usually from falls or play-related accidents. Boys experience these injuries more frequently than girls. The maxillary incisors are most commonly injured.
- In the primary dentition, injuries often involve tooth luxations. In the permanent dentition, uncomplicated crown fractures are more typical.
- The goal in managing traumatic dental injuries is to delineate an approach for immediate or urgent care of the injury.
Classification of traumatic Injuries to anterior teeth of childrenCing Sian Dal
The document describes the World Health Organization's (WHO) classification system for traumatic injuries to primary and permanent anterior teeth in children. It outlines 12 classes of injuries ranging from enamel cracks or crazing (Class 0) to complete displacement of a tooth from its socket (Class 12). The classes are defined based on the structures involved (enamel, dentin, pulp) and type of displacement (intrusion, extrusion, lateral). The classification system provides a standardized way to categorize different levels of traumatic dental injuries.
Present a schedule for follow up of patients who have sustained dental injuriesRuhi Kashmiri
This document outlines follow-up schedules for different types of dental injuries to permanent and primary teeth. It provides guidelines for clinical and radiographic examinations over time based on the injury, from a few weeks post-injury to yearly checks for several years. Adhering to these schedules allows monitoring of healing and early detection of potential complications. Injuries are grouped by category such as hard tooth structures, supporting structures, and supporting bone fractures. Recommended follow-ups vary from no follow-up needed to weekly, monthly, 6-month, and yearly checks, depending on the specific injury and predicted healing timeline.
Introduction
Recap of Epidemiological triad
Strategies based on levels of prevention
Primary level
Secondary level
Tertiary level
Indian scenario
Recommendations
Conclusion
References
The document outlines the process for diagnosing and creating a treatment plan for a patient requiring a complete or removable partial denture. It details the steps involved in examining the patient which includes reviewing their medical and dental history, examining the mouth externally and internally, and taking radiographs. The treatment plan phase involves addressing issues like pain, extractions, and surgery before finalizing and delivering the denture.
Endodontics is the specialty of dentistry that manages the dental pulp and surrounding tissues. It involves diagnosing and treating issues like pulpal nerve damage, which can cause pain or sensitivity. Diagnostic tests are used to examine the tooth and determine the specific condition, such as pulpitis or a periradicular abscess. Common endodontic procedures include pulpotomy, pulpectomy, and root canal therapy which aim to preserve or remove the pulp and disinfect and fill the root canals. Surgical endodontic procedures like apicoectomy and retrograde restoration are needed when non-surgical root canal treatment fails or to address anatomical issues.
This document discusses various clinical considerations for diagnosing and treating diseased primary tooth pulps. It covers history and symptoms, clinical signs, radiographic interpretation, treatment options like indirect pulp therapy, pulpotomy, partial pulpectomy, and full pulpectomy. Factors like exposure size, bleeding, prognosis, and materials used are described. Overall it provides guidance on differentiating reversible vs irreversible pulpitis and selecting appropriate pulp therapy techniques for primary teeth.
Endodontic Treatment For Children by professor hasham khanJamil Kifayatullah
This document discusses endodontic treatment options for children, including the aims of endodontic therapy in primary and young permanent teeth, types of treatments such as indirect and direct pulp capping, pulpotomy techniques using various medicaments, and the advantages and difficulties of treatments in pediatric patients.
Here I present to you the basic concept and definition of endodontic diagnosis and treatment planning. It is presented to the level of mind of undergraduate students.
This case report describes the management of dental extrusion injuries in a 9-year-old female patient. Four teeth (31, 41, 42, 11, 21) were severely extruded or avulsed following a bicycle accident. The extruded teeth had fully formed roots and closed apices. The teeth were repositioned and splinted. Two avulsed teeth received endodontic treatment after replantation. The patient was followed clinically and radiographically for 18 months. Three of the extruded teeth responded to sensitivity tests after 12 months, while one tooth remained unresponsive but asymptomatic. The case demonstrates that pulps of traumatized teeth with closed apices may remain vital and monitoring is important to avoid unnecessary
In this brief lecture I will discuss most common endodontic emergencies that occur while practicing endodontics. The lecture is directed to the mind of undergraduate level.
I hope you enjoy it.
The document discusses various topics related to dental issues including:
1. Possible causes of internal resorption that sometimes occurs after pulpotomy procedures in primary teeth, including inflammatory responses and irritation from pulp capping materials.
2. Alveolar abscesses that occasionally develop months after pulp therapy and symptoms they may present as.
3. Contraindications for pulp treatment in primary teeth such as unfavorable family attitudes or teeth too close to exfoliation.
4. Techniques for pulpotomy including electro surgery and laser pulpotomy.
The document discusses various techniques for vital pulp therapy in children's teeth, including indirect pulp capping, direct pulp capping, and pulpotomy. Indirect pulp capping involves excavating caries near the pulp and covering the remaining dentin with a protective material like zinc oxide-eugenol. Direct pulp capping covers a small exposed pulp directly with calcium hydroxide and other materials. Pulpotomy removes coronal pulp but caps the radicular pulp to maintain vitality. Factors like the size and age of an exposure, symptoms, and radiographic findings help determine which technique may be most suitable. Maintaining pulp vitality avoids needing root canals or extractions in children's teeth.
- An 8-year-old girl fractured her upper right permanent central incisor after slipping and hitting her mouth on a table at school.
- Radiographs revealed a severe intrusive luxation of the tooth with an indistinct periodontal ligament space and an immature root with an open apex.
- The tooth was diagnosed with an intrusive luxation and showed early signs of pulp necrosis. It was treated with rapid orthodontic extrusion followed by pulp extirpation and root canal treatment once access to the canal was possible.
A dental abscess is a localized collection of pus caused by a bacterial infection associated with a tooth. There are several types of dental abscesses, including periapical abscesses at the tip of the root, gingival abscesses involving the gum tissue, and periodontal abscesses involving the bone near the tooth. Symptoms include severe toothache, swelling, fever, and pain when tapping or biting on the tooth. Treatment involves draining the abscess through root canal treatment, incision and drainage, or tooth extraction depending on the prognosis of the tooth and patient preferences. Leaving an abscess untreated can damage surrounding structures and potentially lead to tooth loss.
Causes of Dentophobia. There are many terms used to classify the idea of a dental phobia. It can be known as dental fear, dental anxiety, dentist phobia, odontophobia, or dentophobia. They all mean the same thing: an intense fear of visiting the dentist for dental care.
Restorative Dentistry For Children PAEDIATRIC DENTISTRYJamil Kifayatullah
This document discusses restorative dentistry for children. It covers the importance of maintaining a dry field for clear vision and preventing contamination during restorative procedures. It describes various methods for achieving a dry field, including cotton rolls, saliva ejectors, and rubber dams. It discusses the aims and general principles of restorative dentistry in primary teeth, including cavity classification, preparation, and choices of restorative materials. It also covers the use of preformed crowns for primary teeth, including stainless steel crowns and strip crowns. Finally, it discusses early childhood caries (ECC), including definitions, prevalence, risk factors, clinical presentations, consequences, and approaches for prevention and treatment.
This document discusses endodontic diagnosis and treatment planning. It begins with an introduction to endodontics and causes of pulpitis. Signs and symptoms of pulpitis are then outlined. The diagnostic process involves subjective history, objective examination, and tests like percussion, palpation, thermal sensitivity, electric pulp testing, and radiographs. Based on the diagnosis, a treatment plan is formulated which may involve root canal treatment, referral, or extraction. The document provides details on diagnosing and treating different pulpal and periapical conditions like reversible/irreversible pulpitis, abscesses, cysts, and necrosis.
This document discusses endodontic diagnosis and treatment planning. It begins by introducing endodontics and describing common causes of pulpitis like decay, trauma, and infection. Signs and symptoms of pulpitis include tooth pain from hot/cold, pressure, and swelling. Diagnosis involves subjective questions to the patient and objective examination of the tooth. Diagnostic tests include percussion, palpation, thermal sensitivity testing, electric pulp testing, and radiographs. Based on the diagnostic findings, the dentist determines if the pulp is normal, inflamed with reversible or irreversible pulpitis, or non-vital. The treatment plan is tailored to the diagnosis but commonly involves accessing the root canal, cleaning and shaping it, and filling
This document provides information on the diagnosis and management of displaced teeth. It discusses the types of displacement injuries including concussion, horizontal displacements, and vertical displacements such as intrusion and extrusion. Key points include that displacement injuries damage the pulp vascular bundle and periodontal ligament attachment. Proper management depends on knowledge of the injury characteristics and includes repositioning displaced teeth, splinting, and follow up care to monitor for pulp necrosis and resorption. Management may involve endodontic treatment or orthodontic correction depending on the severity of displacement and stage of root development.
This document discusses dental trauma classifications and management. It provides classifications for types of injuries like fractures and luxations. It also describes approaches for different traumatic injuries like pulp capping for exposed pulps, apexification for open apices, splinting for luxated teeth and observation for intruded primary teeth. Proper examination, history taking, cleaning and temporary restorations are emphasized along with follow up appointments to monitor healing.
This document discusses vital pulp therapy and treatments for caries in young permanent and primary teeth. It describes apexogenesis and apexification procedures used to encourage root development and closure. It defines rampant caries and early childhood caries, noting the involvement of proximal surfaces and cervical cavities. Causative factors discussed include inappropriate feeding habits, prolonged breastfeeding, and sucrose consumption. Prevention focuses on education, fluoride application, and dietary changes, while treatment involves caries removal, pulpotomies, pulp capping, and restorations.
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健康的牙齒可以說是一個人健康的象徵。要有健康的牙齒必須從幼年做起,兒童護齒已成為日常生活所不可忽視的學問。
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International Cancer Survivors Day is celebrated during June, placing the spotlight not only on cancer survivors, but also their caregivers.
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About this webinar: This talk will introduce what cancer rehabilitation is, where it fits into the cancer trajectory, and who can benefit from it. In addition, the current landscape of cancer rehabilitation in Canada will be discussed and the need for advocacy to increase access to this essential component of cancer care.
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This particular slides consist of- what is hypotension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
4. 4
If there is a dental injury, the impact site is the teeth, only the teeth and surrounding part
seemed to be injured, what should the patient do?
Go to the casualty in the nearest hospital on foot or by any transport 30.14%
Call an ambulance; go to the casualty in the nearest hospital 25.25%
Go to the nearest private doctor 7.74%
Go to the patient’s family doctor 5.22%
Go to a dentist 43.27%
Treat it by self 1.68%
Others 1.85%
Don’t Know 4.05%
The sum is more than 100% as teachers chose more than 1 option though it was supposed to choose 1.
Survey for HK Primary and Secondary school teachers. Cecilia Young et al
5. 5
If there is a dental injury, the impact site is the teeth, only the teeth and
surrounding part seemed to be injured, what should the patient do?
Proportion (%)*
Go to the casualty in the nearest hospital on foot or by any transport 25.39
Call an ambulance; go to the casualty in the nearest hospital 15.59
Go to the nearest private doctor 5.25
Go to the patient’s family doctor 2.45
Go to a dentist 44.66
Treat it by self 4.20
Others 0.35
Don’t Know 14.71
The sum is more than 100% as students chose more than 1 option though it was supposed to choose 1.
Survey for HK secondary students Cecilia Young et al
20. 20
fracture
• Some dentists choose filling (composite,
veneer or crown)
• Since you may not distinguish from a part
of root or a part of crown, put in milk,
physiological saline or saliva
• Refer to dentist immediately
22. 22
Luxation (moved but still in the socket)
1. reposition
2. close the month and clenching of
upper and lower teeth
• if interfere, stop
• since it is still inside the mouth, root surface
periodontal cells still moist with saliva
• refer to dentist immediately
26. 26
Left picture - replantation of upper right central incisor at age of 7
Right - since periodontal cells were dead,
ankylosis cause the surrounding bone not grow downward like other teeth,
therefore the caused infraocclusion of the upper right central incisor
JO Andreasen et al. Textbook and Color Atlas of Traumatic Injuries
the Teeth 4th edition P473
27. 27
Very severe infraocclusion due to
ankylosis
JO Andreasen et al. Textbook and Color Atlas of Traumatic Injuries to the Teeth 4th edition
28. 28
JO Andreasen et al. Textbook and Color Atlas of Traumatic Injuries to the Teeth 4th edition
29. 29
-Ankylosis of the upper right cental
incisor
- therefore, the bone around will not
grow like the others downward
for 4 years
- surgery put it down with ankylosis
bone for function and esthetics
- later the root will completely
replaced by bone, then it will
dislodged and an implant is
indicated ankylosis
prevented by immediate replantation
on site or prompt replantation
JO Andreasen et al. Textbook and Color Atlas of
Traumatic Injuries to the Teeth 4th
edition P.786
30. 30
JO Andreasen et al. Textbook and Color
Atlas of Traumatic Injuries to the Teeth 4th
edition
31. 31
JO Andreasen et al. Textbook and Color Atlas of Traumatic Injuries to the Teeth 4th edition
32. 32
Permanent teeth are lying under the
baby teeth
Baby teeth should not be put back, it
damages the permanent teeth
Permanent teeth should be replanted
34. 34
others
Cotton roll or gauze to stop bleeding
Put back the tooth is the best method to stop the
bleeding
Consider the airway
Put the tooth in milk, physiological saline or
saliva to treat
other problems.
35. 35
Avulsion (dislodged)
Reposition/ replantation
1. Confirm permanent tooth
2. confident
3. Calm patient
4. Plug the sink
5. Rinse with tap water for 10 seconds
(better with physiological saline)
6. Reposition immediately
40. 40
Leif Blomlof. Effect of storage in media with different ion strengths
and
osmolalities on human periodontal ligaments cells
Scand.J.Dent.Res.1981:89:180-187
47. 47
6 years old - 3rd time of dental trauma
- upper right Central incisor died
48. 48
The pulp died (at 6) before the root completion (the root
completion at around aged 9 if the pulp was not died).
49. 49
Male 34, trauma at aged 28,remain untreated for 6 years, c/o swelling
1st visit - swelling – pulp died, Root canal tx, pus coming out from drilled hole
- antibiotics - amoxycillin and metronidazole - abscess not fluctuant
- signed to come for review / Incision and drainage next day
2nd day, review/ incision and drainage for the abscess – pulpal origin
51. 51
F/25 Pain, swelling, lower second molar grossly caries, extraction, drainage at
gum, but still needed incision and drainage. Oral antibiotics-amoxycillin and
metronidazole.
signed – will call the clinic if not decreasing/ information academic use.
failed to appear the review next day. Replied to assistant much better.
52. 52
Carious lower left first molar extracted, pus come out from
the socket, incision and drainage at buccal
53. 53
Buccal space infection
Perforate outer cortical plate of jaw to buccinator
Buccal space connects – infraorbital space, periorbital tissue, facilitate spread of infection
55. 55
Infraorbital space infection
Medial – near the inner canthus of the eye
Lateral – lateral canthus of the eye
Complicated by septic thrombophlibitis enters angular vein and cavernous sinus
– resulting cavernous sinus thrombosis
57. 57
Orbital space infections
- Rare due to antimicrobial therapy
- Extension of dental infections from the
maxillary teeth or other nearby structures
to orbital space and tissue of the eyes
(rare but serious)
- Direct extension by way of fascial spaces
58. 58
Orbital abscess
- Buccal cortical plate is very thin
- Infection from upper premolars and molars
penetrate the buccal plate above or below the origin of buccinator
attachment then through vein to orbit
- Infection from upper teeth roots to sinus ─﹥ sinusitis
- Upper anterior teeth spread through facial, angular or opthalmic
veins or by direct spread produce orbital cellulitis
59. 59
Signs of orbital infection
• Swelling, chemosis (oedema of conjunciva), displacement of the
globe, decreasing visual acuity
• influencing extra-ocular movement, proptosis (forward displacement
of the eye), congestion, compression and constriction of the
diameter or infarction of the optic nerve, the retina and the choroids
causing optic neritis, optic atrophy and blindness
• If infection continues to spread along the optic canal and optic nerve
or the opthalmic vein, superior orbital fissure syndrome, orbital
apex syndrome, epidural and subdural empyema, meningitis,
cerebritis, cavernous sinus thrombosis, brain abscess and
death
61. 61
Major complications of severe
dental infection
• Cause septic thrombophlebitis
• Ascend into the cavernous sinus through
valveless veins coursing through the infraorbital
space
• Patient – with severe periobital and orbital
swelling, high fever, altered consciouness
• Involvement of optic foramen by infected
swelling can also resulted with pressure necrosis
of optic nerve and loss of vision
62. 62
Treatment of dental cavernous
sinus thrombosis
• Extraction (removal of the source)
• Incision and drainage
• Parenteral antibiotic therapy
- cross blood brain barrier,
- effective against oral streptococci and anerobes,
- penicillin and metronidazole
- ceftazidime and metronidazole if penicillin allergy
- clindamycin does not cross the blood brain barrier and
is not a first line choice for cavernous sinus thrombosis
• anticoagulation
63. 63
History taking
• Any recent toothache, erupting wisdom teeth or
recent dental procedure
• Trismus (limited opening of the mouth)
misdiagnosed as jaw problem
• All trismus patient should be assumed to have a
potential upper airway problem
• Inter- incisal less than 30mm – difficulties in
tubing
• Extra-oral examination - swelling
• Intra-oral examination – caries, pericoronitis
(most wisdom tooth), periodontal (gum) problem
65. 65
Septic Cavernous sinus thrombosis
M49, chronic alcoholism, severe right lower molar dental pain for 7
days ( ? or upper). High graded fever 5 days before, difficulty of
opening his mouth, and swelling of the right buccal area. progressed to
be right-sided temporofrontal area swelling and pain.
2 days later, he developed periorbital swelling, marked right-sided
visual loss. proptosis, chemosis, and progressive total ophthalmoplegia
in both eyes
67. 67
Emergency tx and dx (Septic Cavernous sinus thrombosis)
1. Emergency abscess drainage
2. Cetriazone and clindamycin
3. the pus culture showed Pseudomonas aeruginosa. changed to
ceftazidime and clindamycin
(better plus metronidazole – anaerobes)
4 After dental examination – upper right molar (no 16)
5. The infection spread upward to the vestibular space, the infratemporal
space, finally to the orbit and from here, bilaterally to the cavernous
sinuses. It has also been associated with the right pterygomandibular
space infection leading to the parapharyngeal space involvement.
6. His six teeth were extracted to get rid of the infection
Bilateral Septic Cavernous Sinus Thrombosis Following
the Masticator and Parapharyngeal Space Infection
from the Odontogenic Origin: A Case Report†
Weerawat Kiddee MD J Med Assoc Thai 2010; 93 (9): 1107-11
68. 68
Brain abscess (pyogenic)
Causes
- Rare (1 - 2% of all intra-cranial mass in western
countries, 8% in developing countries)1,2
- from blood or contiguity
- trauma, neurosurgical complication, dental, ear
infection,paranasal sinuses infection
- Nerologist, neuroradiologist, infectios disease
specialist
1. Loftus CM, Osenbach RK, Biller J. Diagnosis and management of brain abscess. In: Wilkins RH, Rengachary SS, editors. Neurosurgery. 2nd ed.,
vol 3. New York:McGraw-Hill; 1996. p. 3285e98.
2. Sharma BS, Gupta SK, Khosla VK. Current concepts in the management ofpyogenic brain abscess. Neurol India 2000;48:105e11.
69. 69
Brain abscess (pyogenic)
- CT (with contrast), MRI (recognize pyogenic abscesses fairly accurately)
• Radiological features alone are inadequate to differentiate pyogenic
brain abscess from fungal, nocardial or tuberculous abscess, inflammatory
granuloma (tuberculoma), neurocysticercosis, toxoplasmosis,metastasis,
glioma, resolving haematoma, infarct, hydatid cyst lymphoma and
radionecrosis.
• However, fever, meningism, raised ESR, multilocularity, leptomeningeal or
ependymal enhancement, reduction of ring enhancement in delayed scan
and finding of gas within the lesion favor a diagnosis of abscess.
- Most important the history – in case of dental origin – dental infection signs
and symptoms
point 1-3
Dattatraya Muzumdar
Brain abscess: An overview
International Journal of Surgery 9 (2011)
136e144
70. 70
Brain abscess (pyogenic)
Treatment
- remove the cause
- Drainage
- Resection of the abscess following
craniotomy
- Antibiotics
- +/- Anticonvulsant therapy (Legg advocate).
73. 73
Brain abscess M/54
Presentation: right hemiparesis and epileptic fits.
After the clinical, laboratory and imaging examination a
diagnosis of cerebral abscess of the left parietal lobe
was made (Figs. 1 and 2).
74. 74
Brain abscess M/54
search for source of infection, after examining the whole
body for possible ‘septic’ foci with the corresponding
clinical,imaging and laboratory investigations, the head and
neck area was found more suspicious.
thus opinions were requested. ENT colleagues could find
no cause for the infection.
Intraoral clinical and radiological examination, including a
panoramic radiograph and a Dentascan, confirmed the
presence of generalized periodontal (gum) disease,
multiple dental caries and periapical pathology (Fig. 3).
76. 76
Brain abscess M/54
Treatment included
(i) Immediate administration of high dose intravenous antibiotics
(ii) Craniotomy and resection of the abscess cavity (Fig. 4)
(iii) removal of the periodontally diseased and decayed teeth,
alveoloplasty, and construction of immediate upper and lower complete
dentures
Muscular power on the right side slowly improved
over the following weeks, and on the day of discharge
the patient presented with a slight improvement of
mobility and no more epileptic fits. Twenty-nine
months postoperatively, the patient had almost
recovered from the hemiparesis, although he complains
of slightly sub-optimal speechediate
78. 78
Mandibular dental infection
-Anterior to submandibular,
sublingual and submental
spaces
-Posterior to the tooth bearing
portion of the mandible in the
angle-ramus areas such as
messeteric and
pterygomandibular spaces
called masticator space
caused severe trismus
79. 79
Submandibular space infection
- Arises from mandibular molar teeth
- Presents as an inverted triangular
swelling, extended from the inferior
border of the mandible to the hyoid bone
and posterior belly of the digastric
muscles
80. 80
Infection can spread rapidly to
the contralateral side
-and to the sublingual space
superiorly, and submental space
anterioly.
-Lugwig’s angina – rapidly
progressive cellulitis involving
bilateral submandibular,
sublingual spaces and the
submental space
83. 83
Ludwig angina
- Potential life threatening infection
- Associated with potential airway
compromise
- May be very rapid
- Submandibular, sublingual, submental
spaces to styloid muscles through the
buccopharynegeal gap into the lateral
pharyngeal and retropharyngeal spaces
84. 84
Causes of masticator space
infection
- Infection of mandibular molar teeth
- Especially the third molar (wisdom tooth)
- Depress the tongue, open the mouth to
maximum, redden anterior tonsillar pillar,
edematous uvula.
85. 85
Major complications of severe
dental infection
• Airway obstruction
• Asphyxiation
• Infection can encircle the airway by
spreading rapidly to involve the lateral
pharyngeal and retropharyngeal spaces
• Rupture of an abscess causes aspiration
of pus
87. 87
diagnosis- Airway compromise – trismus, tongue elevation, difficulty in
swallowing, stridor and respiratory compromise, Spaces involved,
Precise etiology of infection
- Significant sublingual space infection/swelling – cannot elevate the
tongue to the vermilion border of the upper lip
- A retropharyngeal or lateral pharyngeal space abscess can result in
muffling (low, dull) of the voice
- Deviation of the head toward the opposite side could indicate a
lateral pharyngeal space swelling
- A retropharyngeal space abscess can cause patient to assume the
“sniffing position”, serves to straighten the upper airway
- An impending airway collapse should be suspected if patient is
sitting in a sniffing position, drooling and the use of accessory
muscle of respiration – should not place supine position
- senior anesthetic expertise is required immeditately
88. 88
review clinical records of patients diagnosed with Ludwig angina, Khon
Kaen Thailand 1996-2002
Be careful, no anaerobe culture is done. (anaerobe is
very common in periodontal - gum origin) – should
give metronidazole
89. 89
review clinical records of patients diagnosed with Ludwig angina, Khon Kaen Thailand 1996-2002
Dysphagia – painful swallowing
93. 93
conclusion
1. Maintaining a secure airway
2. Early surgical drainage and removal of the
source of infection – in severe case, cellulitis
and abscess should be drained.
3. Antibiotics in high IV dose are an adjunct
not primary treatment – gram+ve, gram-ve and
anaerobes – penicillin, clindamycin and
metronidazole
95. 95
• Caused by dental or deep cervical
infection such as tonsillitis or pharyngitis
• Spread through the cervical fascial planes
Descending necrotizing mediastinitis
96. 96
Descending necrotizing
mediastinitis
• Airway management is most important
• Involvement of cardiothoracic surgeon
• 1. Gram positive such as B- lactam or
vancomycin
• 2. and anaerobic coverage with clindamycin or
metronidazole
• 3. Third antibiotics for enteric gram –ve rods,
such as ticarcillin- clavulanate or gentamicin
97. 97
1998 and 2006, 10 patients with odontogenic origin, Deep neck infection, Department of ENT, U of Freiburg Germany
98. 98
1998 and 2006, 10 patients with odontogenic origin, Deep neck infection, Department of ENT, U of Freiburg Germany
105. 105
Indications
• a pulpal or periodontal abscess
• with clinical evidence of alveolar
penetration and soft tissue spread
• cellulitic processes (refer to OM Surgeon)
• Extraoral incision and drainage is
indicated for dental infections progressing
toward inevitable spontaneous extraoral
drainage (refer to OM surgeon)
106. 106
Local infiltration
Upper teeth
Buccal abscess
- Inject more apical to the abscess by infiltration (near root
apex)
- cut coronal to the mucobuccal fold (near crown)
- Cut near coronal part of the abscess
Palatal abscess
- Inject 1 cm medial to the tooth
- Cut the most coronal part of the abscess
107. 107
Local infiltration
Lower teeth
Buccal abscess
- Inject more apical/posterior to the abscess by infiltration (near
root apex)
- cut coronal to the mucobuccal fold (near crown)
- Cut near coronal part of the abscess
Lingual abscess
- Inject more apical/posterior to the abscess by infiltration
- Cut coronal to the lingual fold
- Never cut more than 1 cm from the cemento- enamel junction
114. 114
The gingiva under the calculus is inflammed, damaged,
bleeding
牙石下的牙肉被細菌侵害,發炎但看
不見
115. 115
Ultrasonic vibration to loosen the calculus without any
damage to gums
洗牙器不是鑽,只是震鬆牙石,圖中牙
石已被震鬆,過程沒有傷害牙肉
116. 116
gums damaged by plaque exposed not by
scaling process
取走牙石後,露出本來發炎的牙肉,
流血的問題才被發現
117. 117
Bleeding after scaling
• No treatment is needed but explanation
• Should brush along the gum line to
remove the plaque accumulation
• Bleeding disappear 7-10 days if proper
brushing
• Chlorhexidine mouthrinse help to
decrease bacteria, decrease inflammation
faster, therefore decrease bleeding faster
118. 118
Normal wound - a hole filled with
blood clot, some blood can be seen
due to moving/tearing of wound
and saliva
119. 119
Normal wound – pressure - there is a
clot forms in 4 minutes
– can use surgicel
120. 120
The wound is exactly the same size
of the original exposed crown
123. 123
Instruction after extraction
1. No food, No chewing for 4 hours due to injection, otherwise you bite and burn
yourself. You can DRINK cold drink if hungry
2. No hot food and hot drink for 1 whole day after extraction, otherwise it dissolves
the blood clot and causes bleeding. You can eat and drink room temperature food
and drink after the injection is gone.
3. No vigorous exercise, alcohol and heavy physical work, otherwise it causes
bleeding.
4. Absolutely no spitting and no rinsing after extraction for 1 whole day, otherwise it
tears the wound and the blood clot.
5. Please swallow or wipe off the saliva, otherwise it dissolves/mixes the blood clot
and bleeds again.
6. In bleeding occurs (not the saliva mixed with the blood clot), place cotton wool
rolls or cotton pads above the wound and bite hard for 15 minutes. Redo if
necessary. Make sure there is direct pressure on the wound.
Correct: gauzepresson wound, Incorrect: gauzeon teeth, no pressureon wound
pressurestopsbleeding
7. In pain occurs, take the painkillers 1-2 tablets.
8. Swelling is very normal after surgical removal of teeth, especially it starts next
morning after extraction. Keep calm; it will subside in 3-4 days in a normal
healing procedure.
9. Take soft food or fluid food until feel comfortable.
10. Brush and floss the teeth on the second day, especially the teeth adjacent to the
wound.
11. Absorbable suture is not suitable in mouth, you should come back for suture
124. 124
To stop bleeding
• Mechanical – pressure
• Absorbable dressing – gelfoam and surgicel
• Local Anesthesia with adrenaline
• Re-examine
1. granulation tissue – removal / Cauterization with silver
nitrate/ electrocautery
2. gingival tears – suture
3. a bone spur – blunt it or removal the sharp part with
rongeur or cover it with bone wax
4. partially transected vessel - An exposed and bleeding arteriole or
venule can be controlled with
cauterization (silver nitrate or
electrocautery) or the application of a
plain gut suture through the vessel.
128. References
128
JO Andreasen et al. Textbook and Color Atlas of
]Traumatic Injuries to the Teeth 4th edition
JO Andreasen et al. Textbook and Color Atlas of Traumatic Injuries to the Teeth 4th edition P473
JO Andreasen et al. Textbook and Color Atlas of Traumatic Injuries to the Teeth 4th edition
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129. • The whole content of this Powerpoint
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a paper.
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129