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dental health

dental health

Let's focus on dental health

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serica
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  1. serica serica 2017-05-17 03:58

    Successful dental endodontic treatment in the general dentist’s office is based upon proper case selection.Proper case selection will allow endodontics to be a profitable, enjoyable procedure and provide a valuable service to your patients that will build your practice.Failure to perform proper case selection will result in:1. Frustration2. Loss of patient confidence3. Loss of practice revenue4. Additional costs incurred with retreatment or repair of iatrogenic damageThe American Association of Endodontists has prepared an assessment form to help clinicians evaluate the level of difficulty associated with endo motor treatment to help the clinician decide when to refer.To summarize this assessment form, here’s a breakdown of the type of cases that are considered minimal, moderate and high difficulty level.MINIMAL DIFFICULTY1. Pt is healthy, cooperative, minimal pain and/or swelling2. Diagnostics are clear and pulpal/peripaical diagnosis made without complication3. Tooth is easily accessible for treatment. (anteriors/premolars w/ slight inclination or rotation)4. Canal is open, not calcified, mature apex, no resorption5. No previous RCT6. Root has slight curvature7. Periodontium is healthyMODERATE DIFFICULTY1. Pt has minimal health issues, anxious – but cooperative, moderate pain and/or swelling2. Diagnostics requiring additional evaluation (sinuses, TMD, electric pulp testing on calcified teeth)3. Tooth accessibility is difficult – 1st molars, moderate inclination, rotation, crown, bridge, extensive decay4. Canal is reduced in size, pulp stones, wide apex5. Prior RCT without complication6. Root has moderate curvature7. Moderate periodontal diseaseHIGH DIFFICULTY1. Complex health issues, difficulty cooperating, severe pain and/or swelling2. Diagnostics difficult – confusing complex signs & symptoms, chronic oro-facial pain3. Tooth accessibility is difficult – 2nd & 3rd molars, severe inclination, severe rotation, crown/bridges with alignment irregularities4. Canal is calcified (not visible), S or C-shaped, canal divides in middle or apical thirds, additional roots (3 rooted bicuspid), apex is open5. Prior RCT with complication6. Root has severe curvature7.History of traumatic injury (avulsion, horizontal fracture, luxation)Each clinician must evaluate the difficulty level and select cases that match his/her skill level and cases for which they have adequate instrumentation.  Pick cases that you can do in a timely manner, without complications.  As you become more and more comfortable, select slightly more difficult cases to challenge you, always being aware of that some cases are better managed under the microscope and with the aid of CBCT.