October 24, 2019

DARNA
DIAGNOSIS, CASE SELECTION,
TRETAMENT PLAN AND PAIN CONTROL IN
ENDODONTICS
THEME: SALAMAT DOC

MEMBERS:
HEIDI ROSE REMBULAT
MARY-LYN PEARL IGNACIO
KARISSA JOY FAJILAN
CLARISSE DEL ROSARIO
CARLO EBALYE
SEAN HONG
2019-2020
 SALAMAT DOC!

CAST:

CARLO EBALYE as ALVIN THE CHIPMUNKS

CLARISSE DEL ROSARIO as BERNADETDET
HEIDI ROSE REMBULAT as CHERYL ASIM
MARY-LYN PEARL IGNACIO as DR. PERLA
WHITE
KARISSA JOY FAJILAN as DR. LILIBETH
MANGAHAS
SEAN HONG as DR. WILLIE HONG
 SALAMAT DOC!

Intro: DARNA
• Christmas Song*
CARLO EBALYE (ALVIN THE CHIPMUNKS) : Good
afternoon Kapamilya
CLARISSE DEL ROSARIO (BERNADETDET) : Good
afternoon kapamilya and sayo partner, malapit na ang christmas handa
ka na ba sa mga pang regalo mo?
CARLO EBALYE (ALVIN) : Oo partner ready na ako. Okay magsimula
na tayo sa ating topic.
CLARISSE DEL ROSARIO (BERNADETDET) : today we
will talk about diagnosis and case selection and treatment
plan.
CARLO EBALYE (ALVIN THE CHIPMUNKS) : to know
more about our topic for today. Let’s all watch this..
….video presentation….
CLARISSE DEL ROSARIO (BERNADETDET) : and
today cheryl asim is live at san juan in the dental
mission
 CARLO EBALYE (ALVIN THE CHIPMUNKS) : hello
cheryl (live)
 **commercial**
:CARLO EBALYE (ALVIN THE CHIPMUNKS) :
And to continue our topic , we have a guest
doctor who will talk about more about the
treatment plan and pain control.

CLARISSE DEL ROSARIO (BERNADETDET) :

doc willie hong and doc lilybeth mangahasss..

**papasok papuntang set**

 CARLO EBALYE (ALVIN THE
CHIPMUNKS) : welcome dok take a seat.
 CLARISSE DEL ROSARIO
(BERNADETDET) : goodafternoon doc
(shake hands) so after talking about
diagnosis we will now proceed with
treatment planning… so doc what are the
possible factors to consider for planning
the treatment?
 DOC LILYBETH:
 CARLO EBALYE (ALVIN THE
CHIPMUNKS) : doc before RCT the
patient needs a oral prophylaxis and
restorative management right?
 DOC LILYBETH:
 CARLO EBALYE (ALVIN THE
CHIPMUNKS) : Thankyou doc mangahas
for imparting us your knowledge about
treatment planning.
 CLARISSE DEL ROSARIO
(BERNADETDET) : okay now let’s talk
about pain control.
 CARLO EBALYE (ALVIN THE
CHIPMUNKS) : is RCT painful? Can I feel
pain during, before and after the
procedure?
 DOC WILLIE HONG:
 CLARISSE DEL ROSARIO
(BERNADETDET) : so doc as you said
how many hours does the effect of
anesthesia last?
 DOC WILLIE HONG:
 CARLO EBALYE (ALVIN THE
CHIPMUNKS) : Thankyou for the both of
you for coming and sharing your
knowlegde about the treatment plan and
pain control.
DIAGNOSIS
Root canal treatment also known as endodontic
therapy, endodontic treatment, or root canal
therapy is a treatment sequence for the infected pulp of
a tooth which results in the elimination of infection and the
protection of the decontaminated tooth from
future microbial invasion. Root canals, and their
associated pulp chamber, are the physical hollows within a
tooth that are naturally inhabited by nerve tissue, blood
vessels and other cellular entities. Together, these items
constitute the dental pulp.
Endodontic therapy involves the removal of these structures,
the subsequent shaping, cleaning, and decontamination of
the hollows with small files and irrigating solutions, and
the obturation (filling) of the decontaminated canals.
DIAGNOSIS
There are several diagnostic tests that can aid in the
diagnosis of the dental pulp and the surrounding tissues.
These include:
• Palpation (this is where the tip of the root is felt from
the overlying tissues to see if there is any swelling or
tenderness present)
• Mobility (this is assessing if there is more than normal
movement of the tooth in the socket)
• Percussion (TTP, tender to percussion; the tooth is
tapped to see if there is any tenderness)
• Transillumination (shining a light through the tooth to
see if there are any noticeable fractures)
• Tooth slooth (this is where the patient is asked to bite
down upon a plastic instrument; useful if the patient
complains of pain on biting as this can be used to localise
the tooth)
• Radiographs
• Dental pulp tests
CASE SELECTION

Proper selection of cases avoids pitfalls during

treatment and helps to ensure success.
22% of failures- error in case selection
CASE SELECTION
FACTORS- may influence the treatment outcome

• Pulpal status
• Procedural Accidents
• Crown / root fractures
• Periodontal Status
• Occlusal discrepancies
• Size of periradicular rarefaction
CASE SELECTION
FACTORS- may influence the treatment outcome

• Pain threshold
• Level of canal obturation
• Time of post treatment evaluation
• Degree of canal calcification
• Accessory communication
• Presence of root resorption
CASE SELECTION
FACTORS- may influence the treatment outcome
• Radiograph Interpretation
• Periarticular Pathosis
• Root canal anatomy
• Thorough debridement
• Apical Seal
• Disinfection and asepsis
• Systemic status
• Clinician’s skill
CASE SELECTION
FACTORS- may influence the treatment outcome
• Radiograph Interpretation
• Periarticular Pathosis
• Root canal anatomy
• Thorough debridement
• Apical Seal
• Disinfection and asepsis
• Systemic status
• Clinician’s skill
CASE SELECTION
FACTORS- may influence the treatment outcome
• Radiograph Interpretation
• Periarticular Pathosis
• Root canal anatomy
• Thorough debridement
• Apical Seal
• Disinfection and asepsis
• Systemic status
• Clinician’s skill
 TREATMENT PLANNING
- A carefully sequenced series of services designed to eliminate
or control etiologic factor.
- Means developing a new course of action that encompasses
the sequel of treatment to serve patient’s need.

Factors to consider for treatment planning:

A. Choice of treatment
- both the course and ultimate success of the treatment
follow the accuracy and comprehensiveness of the diagnosis.
-Consider the patients preference when making decisions for
the treatment
 B. Difficulty of the procedure
-the difficulty of surgical and non-surgical
procedure should be assessed before
undertaking the treatment.
 C. Scheduling
-time requirements should be discusses with the
patient beforehand to plan a realistic and feasible
schedule.
PAIN CONTROL
 Anesthesia is needed to control the pain
while doing the endodontic procedure.
The common anesthesia that is used is
lidocaine with 1:100000 epinephrine. The
local anesthesia may differ depends to the
patients health condition.
 The effect of local anesthesia last from 45
mins to 1 hour.
 Post operative procedure should take any
analgesics like mefenamic acid.