This document discusses various methods for controlling pain and providing isolation during operative dentistry and endodontic procedures. It describes the goals of pain control and isolation, including alleviating patient fear and anxiety, achieving profound local anesthesia during treatment, and controlling postoperative pain. It covers various preoperative, intraoperative, and postoperative analgesic options. For isolation techniques, it discusses the advantages of rubber dam and provides details on rubber dam placement procedures, accessories, and potential errors. It also mentions other direct isolation methods like cotton rolls and indirect methods like high volume suction.
CONSIST OF INDTRODUCTION, PAIN DEFINITION , MECHANISM OF PAIN, THEORIES OF PAIN, PATHOPHYSIOLOGY OF PAIN, THORIES OF DENTIN HYPERSENSTIVITY , TREATMENT
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.
CONSIST OF INDTRODUCTION, PAIN DEFINITION , MECHANISM OF PAIN, THEORIES OF PAIN, PATHOPHYSIOLOGY OF PAIN, THORIES OF DENTIN HYPERSENSTIVITY , TREATMENT
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.
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
A absolutely minimalist way to describe each and every diagnostic aid in the beautiful stream of endodontics.
one has to understand the topic by going through the bible, "Grossman 13th Edition" along with the slides I've created.
Hope this helps.
by Dr. Ishaan Adhaulia
After reading this chapter, the student should be able to:
1. Understand the microbial etiology of apical
periodontitis.
2. Describe the routes of entry of microorganisms to the
pulp and periradicular tissues.
3. Recognize the different types of endodontic infections
and the main microbial species involved in each one.
4. Understand the bacterial diversity within infected root
canals.
5. Describe the factors involved with symptomatic
endodontic infections.
6. Understand the ecology of the endodontic microbiota
and the features of the endodontic ecosystem.
7. Discuss the role of microorganisms in the outcome of
endodontic treatment.
8. Understand the development and implications of
extraradicular infections.
Anesthesia for Restorative Dentistry and Endodontics LectureIraqi Dental Academy
This lecture discuss very important topic in dental practice and that is the science and art of dental anesthesia. This lecture discuss various techniques, precautions, and tips about dental anesthesia for restoration and endodontics.
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.
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
A absolutely minimalist way to describe each and every diagnostic aid in the beautiful stream of endodontics.
one has to understand the topic by going through the bible, "Grossman 13th Edition" along with the slides I've created.
Hope this helps.
by Dr. Ishaan Adhaulia
After reading this chapter, the student should be able to:
1. Understand the microbial etiology of apical
periodontitis.
2. Describe the routes of entry of microorganisms to the
pulp and periradicular tissues.
3. Recognize the different types of endodontic infections
and the main microbial species involved in each one.
4. Understand the bacterial diversity within infected root
canals.
5. Describe the factors involved with symptomatic
endodontic infections.
6. Understand the ecology of the endodontic microbiota
and the features of the endodontic ecosystem.
7. Discuss the role of microorganisms in the outcome of
endodontic treatment.
8. Understand the development and implications of
extraradicular infections.
Anesthesia for Restorative Dentistry and Endodontics LectureIraqi Dental Academy
This lecture discuss very important topic in dental practice and that is the science and art of dental anesthesia. This lecture discuss various techniques, precautions, and tips about dental anesthesia for restoration and endodontics.
This is a short presentation elaborating on Hot tooth and its management. It is a type of pre-treatment endodontic emergency. Most common failure for anaesthesia. Supplementary anaesthetic techniques are also briefed .
The administration of Local anesthesia is the greatest fear a child would encounter in the dental office. Hence it is important that dentists obtain pain control with minimum discomfort to the child. This Review VEDIO provides an overview about the various local anesthetic agents used in pediatric dental practice, dosage, complications and the recent advances
Dentists prescribe several categories of medications to manage a variety of oral diseases and conditions. Among these conditions are bacterial, fungal, and viral infections and pain.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
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Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
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comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
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PAIN CONTROL IN OPERATIVE DENTISTRY AND ENDODONTICS.pptx
1. Pain control and isolation in
Operative Dentistry &
Endodontics
Class by
Dr. Honap Manjiri Nagesh
Department of Conservative Dentistry and Endodontics
4. Classified as Business
Pain
control
Preoperative
Fear alleviation
Non opioid drugs
Opioid drugs
Intra operative
Local Anaesthesia
Pulpectomy/Pulpotomy/ Occlusal reduction/
Trephination/I&D
Post operative
Pharmacological agents
5. Classified as Business
Pre - operative
considerations
Fear alleviation
Many patients enter the dental office in
such a state of nervousness that they
even find taking radiographs
unbearable!
Anxiety is believed to play a role in
lowering pain thresholds
6. Classified as Business
Analgesics
• When definitive care cannot be delivered
immediately, oral analgesics offer convenient
and effective means to relieve even severe
dental pain.
7. Classified as Business
NSAIDs &
acetaminophen
• Convenient dosing, high safety profile,
and ready availability
• Functions by blocking the
cyclooxygenase (COX) 1 and 2
enzymes to prevent production of
prostaglandins involved in both pain
transmission and inflammation.
8. Classified as Business
Acetaminophen • Block prostaglandin synthesis
peripherally and interacts with
cannabinoid and serotonergic receptors
centrally.
• The manufacturer's maximum
recommended dosage of
acetaminophen is 3000 mg/day.
• Given the risk of hepatoxicity
associated with acetaminophen, the
lowest effective dosage is
recommended.
9. Classified as Business
Corticosteroids • Shown efficacy in treating severe dental
pain,
• corticosteroids like prednisalone and
dexamethasone have a higher side-
effect profile than NSAIDs
• Possess cross-reactivity when patients
are sensitive to these drugs.
• Their use is not routinely
recommended.
10. Classified as Business
Opioid class drugs • complexes of codeine, hydrocodone,
oxycodone, and tramadol.
• Act centrally on mu and kappa receptors to
alter pain perception.
• Though not as effective as the pain
relievers, these drugs produce feelings of
euphoria and reduce anxiety; thus, patients
in severe pain can rest and oftentimes
escape notice of their severe pain.
11. Classified as Business
Antibiotics ? • Antibiotics are not effective pain
relievers.
• Providers should limit their prescription
to situations with uncontrolled, systemic
spread of infection, or where medical
compromise warrants their use
prophylactically.
12. Classified as Business
Intraoperative
/
perioperative
pain
control
• Perioperative pain management in
endodontics centers around the achievement
of profound local anesthesia.
• It is paramount for the clinician to obtain
profound anaesthesia when providing
endodontic treatment.
13. Classified as Business
Local anaesthetic Definition of LA
Nerve conduction
MOA of LA
Available LA agents
Clinical Anaesthesia objective tests
Various routes/ supplemental techniques
Topical anaesthetics
Adjusts to potentiate the LA
Recent advances in delivery of LA
14. Classified as Business
Definition • Local anaesthesia is defined as a loss of
sensation in a circumscribed area of
the body caused by depression of excitation
in nerve endings or an inhibition of the
conduction process in peripheral nerves.
15. Classified as Business
Nerve
conduction
THE FUNCTION OF A NERVE
IS TO CARRY MESSAGES
FROM ONE PART OF THE
BODY TO BRAIN AND BACK.
THESE MESSAGES, IN THE
FORM OF ACTION
POTENTIALS ARE CALLED
IMPULSES.
ACTION POTENTIALS ARE
TRANSIENT MEMBRANE
DEPOLARIZATIONS
FROM A BRIEF INCREASE IN
THE PERMEABILITY OF THE
MEMBRANE TO SODIUM
16. Classified as Business
MOA of LA
Local anaesthetic agent interferes with
excitation process in a nerve membrane
in one of the following ways:
• Altering the basic resting potential of nerve
membrane
• Altering the threshold potential
• Decreasing the rate of depolarization
• Prolonging the rate of repolarization
18. Classified as Business
Clinical
Anaesthesia –
objective tests
• A common mistake is not objectively
testing if pulpal anaesthesia has been
achieved prior to initiating therapy.
• IANB with irreversible pulpitis had only
a 55% incidence of profound pulpal
anesthesia, even in the presence of
100% lip numbness, as reported by the
patient.
19. Classified as Business
Objective tests for
anaesthesia
• Objective tests - better assess the level of
pulpal anesthesia for all teeth.
• With a preoperative baseline of the pulp
sensibility level, the use of an electric pulp
tester (EPT) and/or the application of a cold
refrigerant
20. Classified as Business
• Objectively testing the treatment tooth
with an electric pulp tester
before and after administering local
anaesthesia to determine if pulpal
anaesthesia has been achieved.
21. Classified as Business
Clinical techniques • The literature supports specific techniques for
achieving pulpal anesthesia in teeth with
symptomatic irreversible pulpitis. Successful
pulpal anesthesia
• Maxillary teeth - infiltrations on the buccal
surfaces alone. No gains in anesthesia success
are obtained through the addition of a posterior
superior alveolar nerve block or palatal
anesthesia.
• Mandibular teeth - complex.
• Mandibular anterior teeth -infiltrations alone
• Premolars - combination of mental and inferior
alveolar nerve blocks (IANBs).
• Mandibular molars require block anesthesia,
usually with the addition of an adjunctive
anesthetic technique.
23. Classified as Business
Intraosseous
• The point of penetration is
identified. It should lie in attached
gingiva and is determined by
imagining two lines perpendicular
to one another. The horizontal line
passes along the buccal gingival
margins of the teeth. The vertical
line bisects the distal interdental
papilla of the tooth that is being
anaesthetised. The site of
perforation is 2 mm apical to the
intersection of these lines
25. Classified as Business
Adjuncts to LA • Local anesthesia alone may be insufficient for
perioperative pain control in some patients.
• Additional pharmacologic agents - increase its
efficacy.
• Nitrous oxide - itself acts as an analgesic and
can improve the efficacy of local anesthetic
solutions.
• Preoperative use of oral analgesics, including
dexamethasone, NSAIDs, and tramadol, may
improve effectiveness of IANB injections in
patients with symptomatic irreversible pulpitis,
although controversy exists.
• Benzodiazepines, however, do not potentiate
the effects of local anesthetics, and should only
be expected to reduce procedure-related
patient anxiety.
26. Classified as Business
Topical anaesthetics
• Ointments, gels, pastes, sprays
• Local anesthetics are absorbed at different rates
after application to mucous membranes, in the
mucosa uptake is as rapid as with intravenous
administration.
• Eutectic mixture of local anesthesia (EMLA) has
been developed to provide surface anesthesia for
intact skin.
surface anesthesia
for intact skin.
27. Classified as Business
Recent
advances
of
LA
delivery
• DentiPatch (lidocaine transoral delivery
system)
• Preinjection – 10- 15 minutes exposure prior
to injection - Root scaling/planing – apply 5-
10 minutes prior to beginning procedure.
27
28. Classified as Business
• PRESSURE SYRINGE :
Used in IL injection techniques,
especially in mandibular teeth
(types: pistol-grip, pen-grip).
28
29. Classified as Business
29
Jet injection works by forcing anaesthetic through mucosa under
pressure. The head of the device is placed firmly against mucosa and
then the trigger released. This forces the solution through mucosa to
produce anaesthesia.
33. Classified as Business
Management of hot tooth
The term ‘‘hot’’ tooth
generally refers to a pulp
that has been diagnosed
with irreversible pulpitis,
with spontaneous,
moderate-to-severe pain.
A classic example of one
type of hot tooth is a
patient who is sitting in the
waiting room, sipping on a
large glass of ice water to
help control the pain.
34. Classified as Business
Intraligamentary (Periodontal Ligament)
Injection
Intraosseous Injection
Mandibular Buccal Infiltration Injection with
Articaine
Intrapulpal Injection
35. Classified as Business
Treatment itself
Performing treatment for
hypersensitivity/
endodontic treatment and/
or Pulpotomy/ Occlusal
reduction/ Trephination/I&D
Treatment can significantly
reduce pre-treatment
odontogenic pain due to
acute pulpal inflammation
and / or trauma from
occlusion/ hypersensitivity
36. Classified as Business
Post
operative
pain
control
• The most consistent predictive factor for
postoperative endodontic pain is the presence
of preoperative hyperalgesia (i.e.,
spontaneous pain, reduced pain threshold
and/or increased perception to noxious
stimuli).19
37. Classified as Business
Post-operative
pain control
• The definitive treatment of endodontic
pathology is the optimal means to alleviate
severe pain, some degree of postoperative
discomfort is normal.
• Since postoperative pain is common and to
be expected, clinicians need to warn
patients to anticipate its presence and arm
them with strategies to minimize its impact.
38. Classified as Business
Post-operative
pain control
• Oral medications, including combination
therapy with ibuprofen and acetaminophen,
are most appropriate for the management
of postoperative pain.
• Opioid class drugs are less effective and
should be avoided if possible.
• Long-acting anaesthetics like bupivacaine
are useful adjuncts to ensure pain relief
through the acute postoperative period
when pain can be most severe.
• Bupivacaine possesses properties to
provide extended analgesia even beyond
its half-life, according to studies in the
medical literature.
39. Conclusion
Appropriate pain
management in operative
& endodontic therapy
requires clinicians to have
a good understanding of
local anesthesia,
conventional endodontic
treatment and clinical
pharmacology. Equipped
with these clinical skills,
the dentist or specialist
will be positioned to
successfully manage the
pain reported by their
endodontic patient.
41. Classified as Business
Flowchart
• Introduction
• Goals of isolation
• Advantages of isolation
• Methods of isolation
Direct methods
Indirect methods
• Conclusion
42. Classified as Business
Methods of isolation
Direct method :
• Rubber dam
• Cotton rolls & cellulose wafers
• Dri-angle
• Gauze piece
• Suction devices
• Gingival retraction cords
• Mouth props
• Mouth mirror
43. What is Rubber dam
Indication/Contraindication
Armamentarium
Placement of Rubber
dam
Removal of rubber dam
Maintenance of
Clamp/Retainer
Errors in Rubber dam
placement
Few recent advances
45. Rubber dam is a flat thin sheet of latex
or non latex that is held by a clamp
and a frame which is perforated to
allow the teeth to protrude through the
perforation while all other teeth are
covered and protected by the sheet.
Johannes Müller, Norman Tischer 2006 Quintessenz Verlags GmbH, Berlin
45
49. Classified as Business
Rubber dam Forceps
Rubber dam
retainer/Clamp
Rubber dam punch
Rubber dam Frame
Rubber dam sheet
Rubber dam armamentarium
50. Classified as Business
T
emplate:
Inked rubber stamp which helps in marking the dots on
the sheets according to the position of the tooth.
Holes should be punched according to
the arch and the missing tooth
50
51. Classified as Business
THIN 0.15mm/ 0.006inch
MEDIUM 0.2mm/ 0.008inch
HEAVY 0.25mm/ 0.010 inch
EXTRA HEAVY 0.30mm/ 0.012inch
SPECIAL HEAVY 0.35mm/ 0.014inch
Rubber dam sheet:
54. Classified as Business
Rubber dam retainer/ clamp:
4 prongs
2 jaws
1 bow
Clamps for the front teeth.
Clamps for the premolars
Clamps for the molars
56. Classified as Business
Retainers with serrated jaws : tiger clamps
Stabilization of broken down teeth
S-G Silker Glickman clamp
Anterior extension allows retraction of dam around a severely
broken down teeth
Clamp is placed on a tooth proximal to one being
treated
56
73. Classified as Business
Everting the margins:
a) The rubber dam is lying on the tooth surface and may
allow leakage.It should be everted into the gingival
crevice by the following ways:
73
b) stretching the rubber away from the tooth and drying the
mucosa with a stream of cold air, before
c) using a flat plastic
instrument to tuck the
rubber into the crevice.
80. Classified as Business
Cleaning of clamps after use:
Cleaning:
• Clamps should be rinsed & cleaned immediately after the procedure
• Failure to clean will decrease the life of clamp & can result in staining & corroding
• Rinse & remove excess material before ultrasonic cleaning
Allow clamps to dry
Sterilization:Important to remove excess restorative material from the clamp before sterilization as it
may damage the clamp
Autoclave – 15 min at 130°C/266°F
Inspect the clamp for wear, distortion or damage
Discard if distorted
85. Classified as Business
Split dam technique:
In this technique two holes
are punched in the dam
atleast 5mm apart that
corresponds to teeth anterior
and posterior to the teeth in
question.
The dam is then stretched
over the clamped tooth and
to the anterior tooth where
the dam is stabilized with the
wedjets.
• The dam between the holes is then
cut with scissors.
86. Classified as Business
In case of crowded teeth there is no enough space to
place the clamp in position, in such a situation rubber
dam is placed on to the tooth which is teased beneath
the contact area with the help of a floss and is
stabilized by two fragments of the dam instead of the
clamp.
Wedgets can also be used in place of dam.
Isolation for Crowded teeth:
87. Classified as Business
Modifications in designs:
Insti dam
• Natural latex dam with pre punched
holes and built in rubber frame
• Its compact size is just the right size
to fit outside the patient’s lips
• Radiographs may be taken without
removing the dam
88. Classified as Business
Handidam:
Has a built in foldable radiolucent frame and a plastic
tube inserted in prepared holes in rubber dam material to
keep the dam open.
Available in one size only
89. Classified as Business
Dry dam:
Dry Dam is a rubber dam laminated with paper on both
sides and attached straps.
Marked punch spots and the sturdy built in paper frame
makes it simple and fast to apply.
The patients lips and cheeks are protected by the moisture
absorbing paper reducing the risk of allergic reaction.
90. Classified as Business
Optra gate:
• Exclusively for isolating the upper and
lower anterior regions.
• It works by applying only lip and cheek
retraction, quadrant based.
• The device comes in three sizes and easily
placed to hold the mouth open providing
optimal anterior access.
91. Classified as Business
Cotton
rolls &
cellulose
wafers
• Available in different diameters, cut to
variant lengths & have plain or woven
surfaces
• Stabilized & held sublingually with
specific holders or with an anchoring
rubber dam clamp
• lateral to salivary gland orifices
• Cellulose wafers provide additional
absorbency
92. Classified as Business
Cotton rolls & cellulose wafers
Advantage – Slight retraction of cheeks aiding in visibility &
access
Precaution:
• Moisten the cotton rolls & cellulose wafers while removing to
prevent inadvertent removal of epithelium from cheeks, floor
of mouth or lips
93. Classified as Business
Gauze
piece or
throat
shields
• Indicated when there is danger of aspirating or
swallowing small objects, when rubber dam is
not being used
• Used in pieces of 2”x2” or larger
• Particularly important when treating teeth in
maxillary arch
94. Classified as Business
Gauze piece or throat
shields
• Gauze sponge unfolded & spread over the tongue&
posterior part of the mouth
Advantage –
• Better tolerated by delicate tissues
• Less adherence to dry tissues compared to cotton
95. Classified as Business
DRI-ANGLE
• A thin, absorbent, cellulose triangle
• Unique replacement on the cotton roll in the
parotid area
• Covers the parotid or Stensen's duct and
effectively restricts the flow of saliva
• Provides the required Dry-Field for Composites,
Bonding, Cementing
96. Classified as Business
SALIVA EJECTOR
• Saliva ejector prevents pooling of saliva
in the floor of the mouth
High volume evacuating
• equipment removes solid debris along
with water
HIGH VOLUME EVACUATOR
97. Classified as Business
TYPES OF SALIVA EJECTOR
• Metallic –
• Autoclavable
• Rubber tip to avoid irritating delicate tissues on floor of the
mouth
• Plastic – Disposable & inexpensive
98. Classified as Business
GINGIVAL RETRACTION CORD
• Used for isolation & retraction in direct
procedures of treatment of accessible sub
gingival area
• Diameter of cord should be selected such
that it is gently inserted into gingival
sulcus,
• Cord may be moistened with a non caustic
styptic before insertion (Hemodent)
99. Classified as Business
ADVANTAGES
• Help restrict excessive restorative materials from entering
the gingival sulcus
• Provide better access for contouring & finishing the
restorative material
• Prevent abrasion of gingival tissue during tooth preparation
• Used primarily to push the gum tissue away from the
prepared margins of the tooth, in order to create an accurate
impression of the teeth
100. Classified as Business
MOUTH PROP
• Can be potential aid
for lengthy
appointment on
posterior teeth
• Should maintain
suitable mouth
opening
Types –
• Block
• Ratchet
101. Classified as Business
INDIRECT METHODS
• Local anaesthesia
Drugs –
• Anti sialogogues (Atropine)
• Anti anxiety ( Diazepam)
• Local anaesthetics
Ibuprpfen The maximum recommended dosage of ibuprofen is 3200 mg/day, with common dosages ranging from 400 mg to 800 mg every 4 to 8 hours.2 Major side-effects include gastrointestinal upset and are dose dependent; thus, the lowest effective dosage should be utilized.3
Nonetheless, risks of misuse and addiction, and resultant rules and regulations limiting their use, suggest avoidance of these medications whenever possible.
Often, the only determination made to confirm if a patient is properly anesthetized is the subjective anesthesia level, as reported by the patient.
traditionally been confirmed by asking the patient if their lip feels numb, probing or sticking the gingiva around the mandibular tooth to be treated, or simply starting treatment and waiting for
a patient response.
In addition to verbal communication, written instructions can effectively help manage patient expectations and clearly define normal and abnormal conditions that may warrant contacting an available emergency provider.
Better longevity of restorations
Ergonomics
Aerosol control
Soft tissue protection
Better RCT survival
Medico legal ingestion of instrumnets
