An endodontic emergency is a situation requiring immediate treatment due to severe pain and/or swelling. It may involve rescheduling normal appointments. Key factors in diagnosing an emergency include whether the problem is disturbing sleep, eating or concentration. Accurate diagnosis involves determining the cause, such as microbial infection, mechanical trauma or chemical irritants. Non-surgical emergency treatment may involve pulpotomy, pulpectomy or incision and drainage, while surgical treatment includes incision or trephination. Definitive treatment, antibiotics and analgesics are aimed at resolving the underlying etiology and symptoms.
Endodontic emergencies include Pre-treatment emergency of which hot tooth is a commonly encountered situation.
This ppt is contains concise pickup notes on Hot tooth.
Smear layer is a controversial topic in the field of operative dentistry and endodontics. This presentation includes composition, concepts, structure, advantages, disadvantages, and removal methods of smear layer.
Endodontic emergencies include Pre-treatment emergency of which hot tooth is a commonly encountered situation.
This ppt is contains concise pickup notes on Hot tooth.
Smear layer is a controversial topic in the field of operative dentistry and endodontics. This presentation includes composition, concepts, structure, advantages, disadvantages, and removal methods of smear layer.
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.
Management of tmd symptoms with photobiomodulation therapyNishu Priya
Conservative approaches, such as soft diets, anti-inflammatory drugs and photobiomodulation therapy (PBMT) or low-level laser therapy (LLLT), have been used to manage TMD.
Lasers have proven to be successful in clinical settings and treatments of soft tissues, musculoskeletal pain, bone regeneration, dentinal hypersensitivity, and provide reduction in symptoms and improved function.
The mechanism of action in PBMT is via absorption of light, with deeply penetrating wavelengths ranging from 630 nm to 1300 nm, to stimulate tissues with direct irradiation to achieve analgesic and anti-inflammatory effects.
The output energy in PBMT does not affect skin temperature and is classified as a soft laser, which increases lymphatic flow, reduces edema and prostaglandin E2 (PGE2) and cyclooxygenase (COX) levels.
A systematic review for pain management reported placebo vs LLLT for practical and clinically relevant parameters using 700nm to 1200nm.
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Flare ups described as occurrence of pain, swelling or combination of both during the course of root canal therapy which result in unscheduled visit by the patient
Seminar of U.V. Spectroscopy by SAMIR PANDASAMIR PANDA
Spectroscopy is a branch of science dealing the study of interaction of electromagnetic radiation with matter.
Ultraviolet-visible spectroscopy refers to absorption spectroscopy or reflect spectroscopy in the UV-VIS spectral region.
Ultraviolet-visible spectroscopy is an analytical method that can measure the amount of light received by the analyte.
Multi-source connectivity as the driver of solar wind variability in the heli...Sérgio Sacani
The ambient solar wind that flls the heliosphere originates from multiple
sources in the solar corona and is highly structured. It is often described
as high-speed, relatively homogeneous, plasma streams from coronal
holes and slow-speed, highly variable, streams whose source regions are
under debate. A key goal of ESA/NASA’s Solar Orbiter mission is to identify
solar wind sources and understand what drives the complexity seen in the
heliosphere. By combining magnetic feld modelling and spectroscopic
techniques with high-resolution observations and measurements, we show
that the solar wind variability detected in situ by Solar Orbiter in March
2022 is driven by spatio-temporal changes in the magnetic connectivity to
multiple sources in the solar atmosphere. The magnetic feld footpoints
connected to the spacecraft moved from the boundaries of a coronal hole
to one active region (12961) and then across to another region (12957). This
is refected in the in situ measurements, which show the transition from fast
to highly Alfvénic then to slow solar wind that is disrupted by the arrival of
a coronal mass ejection. Our results describe solar wind variability at 0.5 au
but are applicable to near-Earth observatories.
THE IMPORTANCE OF MARTIAN ATMOSPHERE SAMPLE RETURN.Sérgio Sacani
The return of a sample of near-surface atmosphere from Mars would facilitate answers to several first-order science questions surrounding the formation and evolution of the planet. One of the important aspects of terrestrial planet formation in general is the role that primary atmospheres played in influencing the chemistry and structure of the planets and their antecedents. Studies of the martian atmosphere can be used to investigate the role of a primary atmosphere in its history. Atmosphere samples would also inform our understanding of the near-surface chemistry of the planet, and ultimately the prospects for life. High-precision isotopic analyses of constituent gases are needed to address these questions, requiring that the analyses are made on returned samples rather than in situ.
Nutraceutical market, scope and growth: Herbal drug technologyLokesh Patil
As consumer awareness of health and wellness rises, the nutraceutical market—which includes goods like functional meals, drinks, and dietary supplements that provide health advantages beyond basic nutrition—is growing significantly. As healthcare expenses rise, the population ages, and people want natural and preventative health solutions more and more, this industry is increasing quickly. Further driving market expansion are product formulation innovations and the use of cutting-edge technology for customized nutrition. With its worldwide reach, the nutraceutical industry is expected to keep growing and provide significant chances for research and investment in a number of categories, including vitamins, minerals, probiotics, and herbal supplements.
Richard's entangled aventures in wonderlandRichard Gill
Since the loophole-free Bell experiments of 2020 and the Nobel prizes in physics of 2022, critics of Bell's work have retreated to the fortress of super-determinism. Now, super-determinism is a derogatory word - it just means "determinism". Palmer, Hance and Hossenfelder argue that quantum mechanics and determinism are not incompatible, using a sophisticated mathematical construction based on a subtle thinning of allowed states and measurements in quantum mechanics, such that what is left appears to make Bell's argument fail, without altering the empirical predictions of quantum mechanics. I think however that it is a smoke screen, and the slogan "lost in math" comes to my mind. I will discuss some other recent disproofs of Bell's theorem using the language of causality based on causal graphs. Causal thinking is also central to law and justice. I will mention surprising connections to my work on serial killer nurse cases, in particular the Dutch case of Lucia de Berk and the current UK case of Lucy Letby.
Observation of Io’s Resurfacing via Plume Deposition Using Ground-based Adapt...Sérgio Sacani
Since volcanic activity was first discovered on Io from Voyager images in 1979, changes
on Io’s surface have been monitored from both spacecraft and ground-based telescopes.
Here, we present the highest spatial resolution images of Io ever obtained from a groundbased telescope. These images, acquired by the SHARK-VIS instrument on the Large
Binocular Telescope, show evidence of a major resurfacing event on Io’s trailing hemisphere. When compared to the most recent spacecraft images, the SHARK-VIS images
show that a plume deposit from a powerful eruption at Pillan Patera has covered part
of the long-lived Pele plume deposit. Although this type of resurfacing event may be common on Io, few have been detected due to the rarity of spacecraft visits and the previously low spatial resolution available from Earth-based telescopes. The SHARK-VIS instrument ushers in a new era of high resolution imaging of Io’s surface using adaptive
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2. Endodontic Emergency
IT IS A SITUATION ASSOCIATED WITH PAIN
AND/OR SWELLING THAT REQUIRES
IMMEDIATE DIAGNOSIS AND TREATMENT.
IT MAY INVOLVE RESCHEDULING OF THE
NORMAL APPOINTMENTS.
3. DIFFERENCE BETWEEN
URGENCY AND EMERGENCY
An urgency represent a less
severe problem.
An emergency is more severe and
requires immediate attention Now.
A Rule of the true emergency
:One tooth is the offender.
4. Key questions to differentiate between
emergency and urgency
Is the problem such that it disturbs your sleeping,
eating, working, concentration? → An emergency
condition affects these activities.
How long has it been bothering you? →Short
duration emergencies, with pain of long duration are
urgencies.
Have you taken any pain medication, Did it help?
→Medications are usually ineffective during an
emergency condition.
7. Chemical mediators
1-Direct:
By activating nociceptors causing spontaneous pain
Or by lowering their pain threshold
2-Indirectly:
By increasing vascular permeability & producing
edema
8. Pressure:
Edema results in increased fluid pressure, which
mechanically stimulates pain reseptors.
11. 3D’s of Successful Management
Diagnosis
Definitive Dental Treatment
Drugs
12. Diagnosis
Determine the CC
An accurate medical
history
Complete a thorough
exam, with all necessary
tests
Perform a radiographic
exam
Analyze the results
Establish the treatment
plan
22. Etiology
After listening to the patient, begin to determine
the etiology of the chief complaint:
Contents of the root canal
Dentist controlled factors
Host factors
23. Contents of the root canal
Pulp tissue
Bacteria
Bacterial by-products
Endodontic therapy materials
25. Hyperocclusion
Research have found
that patients most
likely to benefit from
occlusal reduction are
those teeth whose
initially present with
symptoms.
Indiscriminant
reduction of occlusal
surface is not indicated
Pre-Op Pain
Pulp vitality
Percussion sensitivity
Absence of a
periradicular
radiolucency
Combination of these
symptoms
33. Rationale for Incision for drainage
Decreases number of bacteria
Reduce tissue pressure
Alleviates pain/trismus
Improves circulation
Prevents spread of infection
Alters oxidation-reduction potential
Accelerates healing
34. Management of Acute Pulpitis:
Diagnosis:
Pain: +ve
Vitality: +ve
Tenderness to percussion :
Radiographic changes:
No change from normal
Deep caries,
extensive restoration,
trauma, pulp capping may be seen.
37. Management of Acute pulpitis with
apical periodontitis:
Diagnosis:
Vitality: +ve
Tenderness to percussion: +ve
The tooth feels high and/or loose
and that the teeth will not close
together.
X-ray: Normal to slight widening of
periodontal ligament space to small
radiolucence.
38. Management
Minimal Time: Molar
Profound Anesthesia: May need an additional
carpule.
Pulpectomy of the largest canal ( distal of lowers
and palatal of upper).
Temporary dressing.
May need to call the next day to remove pulp from
the other canal, pain will not subside if the other
canals are the cause of pain.
40. Lots of time:
Complete pulp extirpation of all
the canals must be done followed
by a temporary dressing.
41. Management of Pulp Necrosis:
Rarely seen as an emergency
Diagnosis:
Non vital tooth( may be one or more of its root
canal).
No tenderness to percussion.
Periapical radiolucency seen on the radiograph.
42. Management:
1- Canal debridement followed by a
temporary dressing.
2- Extraction of non restorable tooth.
(Analgesics and antibiotics may be
required).
43. Acute apical Abscess:
The position of the swelling will
depend on:
1- Orientation of the tooth apex.
2-Relationship of the site of perforation
to muscle attachment on the maxilla
and mandible.
48. Acute apical abscess producing a facial swelling
Tooth drainge of an apical abscess
49. To resolve swelling:
1)Establish drainage through the root canal.
2)Establish drainage by incising a fluctuant
swelling.
3)Prescribe antibiotics.
50. Management of a localized soft tissue
swelling:
* If it is fluctuance, it indicate that pus is present,
soft tissue infiltration of anesthesia around the
periphery of the infected area.
* Incise at the site of greatest fluctuance down to
the level of apical bone.
51. • A vertical incision offers improved post
operative healing compared with a
horizontal incision.
• Place the incision in a position to
encourage drainage by gravity.
52. •Dissect gently through the deeper
tissues and explore all parts of
abscess cavity.
•The wound should be kept clean
with hot salt-water mouth rinses
to promote drainage.
53. Diffuse swelling:
• From endodontic point of view, the
tooth is opened, and the canal is
thoroughly instrumented and irrigated,
if no drainage is achieved, the apical
foramen is instrumented through to
encourage drainage from the periapical
tissues.
54. • In the absence of drainage through
tooth, soft tissue drainage might be
established through incision. The drain
is sutured into incision wound to
ensure tissue drainage.
55. The patient who show sign of
toxicity, CNS changes, or airway
compromise should be considered
for immediate hospitalization.
56. Guidelines for Antibiotic Therapy
Select antibiotic with anaerobic spectrum
Use a larger dose for a short period of time
57. Antibiotic therapy:
• For localized swellings the antibiotic
therapy is usually unnecessary (except
with patient with depressed host
defense).
• For diffuse swelling antibiotic are
indicated.
58. 1st choice: penicillin VK
Initial dose 1-2 g then 500mg every
6 hours for 7-10 days
The combination of penicillin and
metranidazole (250mg) is
recommended 7-10 days.
59. Clindamycin are suitable alternatives for
patients who are allergic to amoxicillin.
The dose 300mg followed by 150 to 300mg
every 6 hours for 7-10 days.
(some times signs of colitis)
60. As a general rule:
Antibiotic therapy should be
considered for patients who
have signs and symptoms of
infection, such as cellulites,
fever, or lymphadenitis.
61. FFlleexxiibbllee aannaallggeessiicc ssttrraatteeggyy
Aspirin like drug
indicated
Ibuprofen
200-400mg
Aspirin like drug
contraindicated
Aspirin like drug
contraindicated
Ibuprofen
400-600mg
Ibuprofen
400-600mg
Acetaminophen
650-1000mg
Acetaminophen
650-1000mg
Acetaminophen 650-1000mg
Plus
equivalent of Codeine 60 mg
Acetaminophen 1000mg
Plus
equivalent of Oxycodone 10 mg
Ibuprofen 400-600mg
Ibuprofen 400-600mg
Plus
Plus
Acetaminophen 650-1000mg
Acetaminophen 650-1000mg
Ibuprofen 600-800mg
Plus
Acetaminophen 1000mg
Sever Moderate Mild