ENDODONTIC

TREATMENT PLAN
VITAL CASE
 The acute vital case is managed by a biologically
based approach.
 Pain maybe due to increased intrapulpal pressure
and inflammatory mediators such as
prostaglandins.
 Such cases can be managed by

Pulpotomy

Pulpectomy

Simple debridement
Partial instrumentation may result in increased
postoperative pain.

 Teeth should be closed with a temporary filling at the

end of the visit.
NON VITAL CASE
 A tooth which is non vital for some time may become
suddenly painful.
 Cause – imbalance in host – parasite relationship
 This is due to increase in virulence of bacteria,
change in flora or reduced host defense mechanism.
 The therapeutic goal is to reduce as much possible
the bacterial content in the root canal system and to
promote decompression of the periraduicular
tissues.
 Calcium hydroxide should be temporarily sealed into
the root canal.
RETREATMENT CASES
 They offer a challenge to the clinician
 It should be developed after the cause of failure
has been determined.
 Weigh other factors that affect the prognosis (root
fracture, defective restoration etc.)
 Retreatment usually requires surgical endodontics.
IMMATURE TEETH
 Primary and immature permanent teeth may have
pulpal pathosis caused by caries or trauma
 Preserving it is essential to prevent malalignment
 It can also predispose the patient to tongue habits,
impair esthetics and damage self esteem of
patient.
 Various pediatric endodontic procedures can be
done
ENDO-PERIO LESIONS
ENDODONTIC SURGERY
 It may be performed as initial treatment or
retreatment procedure.
SINGLE VISIT VS
MULTIVISIT
 Vital cases often go for single visit endodontics.
Patient in severe pain should not experience a long
visit including access, instrumentation and obturation.
 Treatment should be directed at alleviating pain.
 Cases with non vital pulp are more complex cases and
an antimicrobial dressing is essential in eradicating
infection.
 If a vital case has to be treated using multivisit
approach, clinician should allow 5 to 7 days between
canal instrumentation and obturation.
 Whereas in a single visit case , adequate time must be
scheduled for the clinician to complete the procedure.