RCT provides pain relief and should not be performed during the first or last trimester of pregnancy. It is best to perform RCT during the second trimester while the patient is lying on their side. Lidocaine and epinephrine can be used but epinephrine requires caution. Appointments for diabetic patients should consider their meal times and medications. Only high risk patients for infective endocarditis receive prophylactic antibiotics for certain high risk dental procedures. True contraindications for endodontic treatment include vertical root fractures identified using fiber optic lights.
RCT provides pain relief and should not be performed during the first or last trimester of pregnancy. It is best to perform RCT during the second trimester while the patient is lying on their side. Lidocaine and epinephrine can be used but epinephrine requires caution. Appointments for diabetic patients should consider their meal times and medications. Only high risk patients for infective endocarditis receive prophylactic antibiotics for certain high risk dental procedures. True contraindications for endodontic treatment include vertical root fractures identified using fiber optic lights.
RCT provides pain relief and should not be performed during the first or last trimester of pregnancy. It is best to perform RCT during the second trimester while the patient is lying on their side. Lidocaine and epinephrine can be used but epinephrine requires caution. Appointments for diabetic patients should consider their meal times and medications. Only high risk patients for infective endocarditis receive prophylactic antibiotics for certain high risk dental procedures. True contraindications for endodontic treatment include vertical root fractures identified using fiber optic lights.
RCT provides pain relief and should not be performed during the first or last trimester of pregnancy. It is best to perform RCT during the second trimester while the patient is lying on their side. Lidocaine and epinephrine can be used but epinephrine requires caution. Appointments for diabetic patients should consider their meal times and medications. Only high risk patients for infective endocarditis receive prophylactic antibiotics for certain high risk dental procedures. True contraindications for endodontic treatment include vertical root fractures identified using fiber optic lights.
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ENDO 101
RCT doesn’t cause pain; it relieves it
PREGNANT PATIENT NOT advisable to perform rct during 1st and last trimester Its BEST to perform it during 2ND TRIMESTER o If retreatment remove old gp and use apex locator don’t fill unless okay na mag xray o Do not treat in supine position - nakatagilid sya dapat.
Lidocaine – category B drug (FDA) okay for preggy..
Epi – Category C drug (use with caution) *aspirate always to prevent to flow intravascularly
leongs Premolar – tx: easy pulp exposure
2 ways to manage (dahan dahan igrind then place gi liner) (place flowable composite to support protruberance) ( pag nabali prematurely do RCT – bacterial infection)
DIALYSIS – do endo after dialysis session
STROKE – no elective dental procedure after 6 months
DIABETIC PATIENTS Appointmenys should be scheduled with consideration to their meal time and medication Prophylactic antibiotic are not indicated for endodontic surgery in well-controlled blood sugar levels *only patients with the highest risk of infective endocarditis are to receive prophylactic antibiotics - px with prosthetic heart valves, congenital heart disease, cardiac transplantation who develop cardiac valvulopathies.
PROPHYLACTIC ANTIBIOTICS FOR HIGH RISK PROCEDURE
• Extractions • Intraligamentary local anesthesia 2gms amox PO 1hr before the • Endodontic surgery procedure • Endodontic instrumentation beyond the apex • Extractions or • Intraligamentary local anesthesia • Endodontic surgery 600mg clinda PO 1hr before • Endodontic instrumentation beyond the apex procedure (allergy to penicillin) MEDICATIONS • Pantoprazole (for GERD) • Doxofylline (bronchodilator for asthma and COPD) • Diltiazem (for HTN, angina and arrhythmia) • Isosorbide (for angina pectoris) • Citicoline (for stroke) • Clopidogrel (antiplatelet to reduce risk of stroke and CVD) • Sitagliptin (for DM) • Aspirin (for prevention of blood clot and stroke) • Rosuvastatin (statin for the prevention of CVD) • Gliclazide (for DM) • Insulin degludec (for DM; long acting) • Insulin glulisine (for DM; rapid acting)
INDICATION/CONTRAINDICATION
TRUE CONTRAINDICATION Fracture line – fiber optic light to check fractures (one side is bright, and one side is dark) *more gingival swelling – perio prob/ fracture (vertical) *more apical swelling – for endo *multiple sinus tracts – vertical root fracture
FALSE CONTRINDICATIONS Lentulo – prone to breakage (DONT USE) Nickle titanium – Material for curved canals Canal calcification use heat treated files (c pilot files) Sealer puff – wait and see after recall
ENDO DRUGS
PULPITIS – No point for antibiotic, access prep.. use articataine, or pulpX.
NO antibiotic treatment for traumatic injuries
For antibiotic – trismus, increased swelling, cellulitis, lymphadenopathy, medically compromised,
rheumatoid arthiris
ADJUNCTIVE ANTIBIOTICS FOR ENDODONTICS
PEN V o 1000mg (LD) o 500 mg every 4-6hrs for 3-7 days AMOXICILLIN o 1000mg (LD) o 500 mg every 8 hrs for 3-7 days AMOXICILLIN AND CLAVULANIC ACID o 1st drug of choice for sinusitis o 1000mg (LD) o 500 mg every 8hrs for 3-7 days AMOXICILLIN AND METRONIDAZOLE o Add metronidazole if healing does not subside after 2-3 days o Used in dental infection of bacterial origin periradicular abscess, periodontal abscess, pericoronitis CLINDAMYCIN o 600mg LD o 300mg every 6 hrs for 3-7 days o Given if the patient’s condition is not improving after 2 – 3 days, Initial loading dose of metronidazole is 1,000 mg, followed by 500 mg every 6 hours for 3 - 7 days
Heat Heat test test Same as cold Same as cold test test
