Documente Academic
Documente Profesional
Documente Cultură
AND SWELLING
(management of abscess and
cellulitis)
PREPARED BY:
Dr ATIKA HASHMI
HOUSE OFFICIER
OBJECTIVE:
Introduction.
Causes.
Risk factors.
Symptoms.
Management.
Prevention.
Conclusion.
References.
FLARE-UP:
It can defined as pain and/or swelling
of the facial soft tissues and the oral
mucosa in the area of endo-donticaly
treated tooth that occur within the few
hours (12-48 hours) or a few days following
the root canal treatment.
Chemical
Microbial
factors
Mechanical factors
factors
1.MICROBIAL CAUSES:
extrusion
of debris
Secondary Incomplet
intra
e
radicular instrumen
infection
tation
2.MECHANICAL FACTORS:
Over instrumentation .
Extrusion of filling materials.
Incorrect working length .
Inadequate removal of pulpal tissue.
3.CHEMICAL FACTORS:
Apical extrusion of intra-canal
medicaments.
Extrusion of irrigating solution .
Over extended Root fillings.
Predisposing
factors
Age
Allergies.
Preoperativ
e pain
Tooth
type
Treatmen
t
Procedur
es.
Gender
pulpal
status
Predisposing factors
Flare-up rarely occur in older patients due to
the narrowing of the diameter of the root
canal and decreased blood flow in the
alveolar bone resulting in weaker
inflammatory response.
Post-operative pain is more common among
women than men .
MAGEMENT OF FLARE-UP:
1. Reassurance of patient.
2. Complete debridement of canal system.
3. Incision and drainage.
-To evacuate of pus, microorganisms, and toxic
products from the peri -radicular tissues.
-It releases the peri radicular tissue pressure and
provides significant pain relief.
4. Ca (OH)2 therapy.
5. Intra-canal medicaments:
Clinical studies have demonstrated that post-treatment pain is neither
prevented nor relieved by medicaments such as formocresol , camphorated
paramonochloro-phenol , eugenol , iodine , potassium iodide.
The use of steroids, nonsteriodal anti-inflammatory drugs (NSAIDs), or a
corticosteroidantibiotic has been shown to reduce post-treatment pain.
6. Relief of occlusion.
7. use of irrigating solution.
8. Re-instrumentation.
PREVENTION:
1. Selection of instrumentation techniques.
2. Copious irrigation enhanced removal of
pulpal debris.
3. Completion of procedures in a single visit.
4. Use of intra canal medicaments.
5. Not leaving teeth open for drainage.
6. Maintaining the asepsis during procedure.
DENTAL ABSCESS:
A dental abscess is an loacalized infection of the
mouth, face, jaw, or throat that begins as a tooth
infection.
The original cause may be from a ;
Deep cavity.
Periodontal (gum) disease.
A cracked tooth.
Trauma or sometimes even due to recent dental
procedures such as extractions and implants.
MANAGEMENT:
1. Patient counseling and reassurance is
done.
2. Give antibiotics.
3. Make a hole in the tooth to drain the pus
and relieve the pain.
4. Do a root canal to remove the infected
pulp.
COMPLICATION OF ABSCESS:
MANAGEMENT OF CELLULITIS:
CONCLUSION
Flare-ups are an undesirable occurrence in the course
of endodontic treatment that causes distress to
both the patient and operator.
Flare-up rate after endodontic treatment is 1.4-16% .
Clinicians should employ appropriate measures in an
attempt to prevent the occurrence of flare-ups and
should be able to treat the flare-up efficiently , when
they do occur.
REFERENCES:
1.Iqbal M, Kurtz E, KoH M, Incidence and factors related to flare-ups in a graduate endodontic programme International
Endodontic Journal, (42), 2009, 99-104.
2.Morse DR, Koren LZ, Esposito JV, Goldberg JM, Belot RM, Sinai IH et al, Asymptomatic teeth with necrotic pulps and
associated periapical radioluscencies: relationship of flare-ups to endodontic instrumentation, antibiotic usage and stress in
three
different time periods, International journal of Psychosomatic research, (33), 1986, 5-87.
3. Sathorn C, Parashos P, Messer H, The prevalence of post-operative pain and flare-up in single- and multiple- visit
endodontic
treatment : A systematic review, Internayional Endodontic Journal, (41), 2008, 91-99.
4. Dean Baugh, James Wallace, The role of apical instrumentation in root canal treatment: A review of the literature, Journal
of
Endodontology, 31(5), 2005, 333-340.
5. J.F.Siqueira Jr, Aetiology of root canal treatment failure: why well-treated teeth can fail, International endodontic journal,
(34),
2001, 1-10.
6. Lin LM, Pascon EA, Skribner J, Gaengler P, Langeland K. 1991, Clinical, radiographic and histopathological study of
endodontic
treatment failures, Oral surg oral medicine oral pathology oral radiology and endodontics, (71), 603-611.
7. Siqueira JF Jr, Uzeda M, Fonseca MEL. 1996, Scanning electron microscopic evaluation of in vitro dentinal tubules
penetration by
selected anaerobic bacteria, Journal of Endodontology, (22), 308-10.
8. Atlas RM, Principles of microbiology. 2nd edition, 1977, Dubuque, IA, USA, WCB Publishers.
9. Fabricius L, Dahlen G, Ohman AE, Moller AJR, predominant indigenous oral bacteria isolated from infected root canals
after
varied times of closure, Scandinavian journal of dental research, (90), 1982, 134-144.
10. J.F.Siqueira Jr, microbial causes of endodontic flare-ups, International endodontic journal, (36), 2003, 453-463
11. Sundqvist G, Ecology of the root canal flora, Journal of endodontics,(18), 1982, 427-430.
12. Siqueira JF Jr, Lima KC, Staphylococcus epidermidis and Staphylococcus xylosus in a secondary root canal inf