dfyguhjiok

0:00

S… Speaker 1 (dfyguhjiok)

Welcome back, dear all. Hope you are all safe in your home. Today, our topic in this lecture is called the treatment plan. After we have known how to make a diagnosis for an endodontic case and how to select the case for endodontic treatment, now we are going to plan the management of the patient's dental problem. What should I do? From where should I begin? is our main concern in this lecture.

0:34

S… Speaker 1 (dfyguhjiok)

I make a treatment plan for each endodontic case. First of all, to determine the correct treatment to be done for this case and to avoid misdiagnosis for the case we have in our clinic. How to reach a specific treatment plan for each endodontic case? First of all, you should determine the patient's chief complaint. Then,

1:00

S… Speaker 1 (dfyguhjiok)

take accurate medical and dental history as we have mentioned before in the chapter of diagnosis, thorough examination using all the necessary diagnostic tests you all learned, evaluate all the necessary radiographs carefully,

1:17

S… Speaker 1 (dfyguhjiok)

Analyze the results you have to reach proper diagnosis. Then evaluate the difficulty of the case you have and the clinician ability to know whether you can treat this case or refer it for an endodontic specialist or refer it for extraction. And then the appropriate treatment plan is established finally.

1:40

S… Speaker 1 (dfyguhjiok)

You all know that untreated pulpal diseases lead to spread of infection to the periapical area causing periapical infection.

1:50

S… Speaker 1 (dfyguhjiok)

Pulpal-related diseases can be classified according to the site of inflammation into either pulpal diseases as vital pulp diseases or non-vital pulp diseases, and periapical diseases as acute apical periodontitis with vital disease or necrotic pulp, acute periapical abscess with necrotic pulp, or chronic periapical lesion with necrotic pulp.

2:14

S… Speaker 1 (dfyguhjiok)

classified according to the histological condition into vital cases, acute irreversible pulpitis and chronic irreversible pulpitis with or without epical periodontitis, or in non-vital cases as pulp necrosis, pulp necrosis with epical abscess, or pulp necrosis with chronic periapical abscess. Finally, according to the clinical condition into symptomatic and asymptomatic pulpal diseases. Can all the cases be treated with the same plan?

2:46

S… Speaker 1 (dfyguhjiok)

For sure, no. We have some factors that affect the treatment plan according to each case entering to your clinic. For example, emergency cases. These are cases with pain or swelling that need unscheduled appointment for quick treatment and for quick interference with the cases.

3:07

S… Speaker 1 (dfyguhjiok)

What are these emergency cases? For example, acute palpitus cases, acute palpitus with apical periodontitis, acute periapical abscess, and sometimes pulp necrosis may come to your clinic in an emergency situation. The first goal in these cases is to relieve the acute pain.

3:29

S… Speaker 1 (dfyguhjiok)

or to establish drainage of infection either by opening the tooth through excess cavity and violation of the apex to relieve the entrapped pus in the periapical area or by incision and drainage when there is fluctuant swelling. After relieving the stimulus, root canal treatment.

3:51

S… Speaker 1 (dfyguhjiok)

Can be set aside while the dentist conducts thorough examination of the case and established a customized treatment plan for the emergency cases. You should do the emergency treatment for it to relieve the signs and symptoms or to relieve the pain and swelling. Then evaluate the case as a whole and reach the proper treatment plan for this case.

4:22

S… Speaker 1 (dfyguhjiok)

In acute vital cases, all we know that increased intrapulpal pressure leads to release of inflammatory mediators that may reach to the periapical tissues, causing acute pulpitis with apical periodontitis. What is the emergency treatment for the acute vital cases? In acute pulpitis, if you have time and infection does not spread to the root canal system, then pulpotomy will be efficient as an emergency treatment in this case.

4:53

S… Speaker 1 (dfyguhjiok)

If you have time or infection spreads into the root canal system then pulpectomy.

5:00

S… Speaker 2 (dfyguhjiok)

mandatory you should remove all the pulp tissues starting from the coronal pulp tissue till the apical foramen or to the full working length you should know that if you enter a file inside the root canal system you should remove all the pulp tissues inside then temporary seal the tooth and schedule another appointment to prevent the entry of bacteria inside the tooth

5:29

S… Speaker 2 (dfyguhjiok)

In acute palpitis with apical periodontitis, you should remove all the pulp tissues. Palpectomy is mandatory. Then calcium hydroxide, intra-canal medication inside the root canal system is put between visits. Mandatory to do occlusal reduction to prevent the post-operative pain.

5:56

S… Speaker 1 (dfyguhjiok)

علشان كده لو البيشنت في الحالات دي بيعمل اوكلوجين ده بيسبب له pain on biting فبالتالي انا لازم اريليف التوث دي من الاوكلوجين خالص علشان البيشنت ما يحسش بالبين دوان between visits لحد ما اقدر ان انا اكمل الاندو تريتمنت بتاعتي واشيل كل الساينز و سيمتومز اللي ما كانت موجودة بلس ان انا لازم ادي انالجاسكس زي النانستيرويد الانتي امفلاماتري دراكس

6:23

S… Speaker 1 (dfyguhjiok)

a simple thing we know is aspirin or drugs that have been silicoxib material such as celibrex, maybe drugs that have been declofenac such as volterine and cataflam.

6:37

S… Speaker 1 (dfyguhjiok)

most commonly طبعاً الدواء اللي احنا عارفينه مشهور جداً البروفن اللي هو من الإيبوبروفن category وزي البروفن في حاجة اسمها أدفيل أقدر إن أنا أديها للبيشن دوان علشان أقلل البين لحد لما يكمل معايا الـ endotreatment بتاعتي After emergency you should schedule the treatment appointment to complete the endodontic treatment

7:07

S… Speaker 1 (dfyguhjiok)

لو انا عندي الكيس دي هعملها in a single visit لازم يبقى فيه adequate time علشان clinician أو dentist finish the procedures comfortably

7:22

S… Speaker 1 (dfyguhjiok)

And in this case, if I do single visit, and in case I need nerve block, I have to do scheduling for the patient, and I have to do 15 to 20 minutes extra for cleaning and shaping procedures and obturation, so the nerve block will make effect. If I do multiple visit treatment,

7:48

S… Speaker 2 (dfyguhjiok)

allow five to seven days between instrumentation and obturation is preferable to allow for pre-epical tissue recovery in acute non-vital cases

8:16

S… Speaker 2 (dfyguhjiok)

present microbiological challenge لأنه طبعاً بيبقى عندي في بكتيريا كتيرة جداً inside the root canal system many species لازم هتعامل معاها tooth that had asymptomatic necrotic pulp may suddenly become acutely symptomatic due to imbalance in the host microbial relationship الإمبالنس دوان ممكن يحصل due to A أو اكتر حاجة

8:43

S… Speaker 1 (dfyguhjiok)

In fact, when I took the root canal of the bacteria, you changed the root canal system of the micro-organisms. You made the entry to the new micro-organisms, as you mentioned in the chapter of microbiology with Dr. Ahmed Nijm.

9:11

S… Speaker 1 (dfyguhjiok)

أو حصل reduction في الhost defense mechanism فبالتالي بدأت تحصل signs and symptoms وتظهر في non vital cases طيب الtherapeutic goal في الكيس دي أول حاجة عندي أن أنا أعمل reduction للbacterial content inside the root canal system

9:29

S… Speaker 1 (dfyguhjiok)

ثاني حاجة ان انا اعمل دي كومبريشن للبريابيكال تيشوز علشان فور شور ان انا المايكرو ارجانيزمس اللي كانت في الروت كانال سيستم خرجت ثرو الابيكال فرامن للبريابيكال اريا واثرت على البيريابيكال تيشوز فبالتالي انا المين جول بتاعي علشان اعمل تريتمين للأكيوت نون فيتال كيسز ان انا اعمل دي كومبريشن للبريابيكال تيشوز وحاول ان انا اشيل الانفلاميشن والانفكشن الموجود في الاريا دي طيب الاميرجنسي تريتمين

10:00

S… Speaker 1 (dfyguhjiok)

I'm going to do it. First thing, the Necrotic Pulp, the Emergency Treatment, that I'm going to do Instrumentation and Copious Irrigation with Sodium Hypochloride. If I have pus oozing through the canal, I'm going to use the Irrigant to warm saline. I'm going to use Sodium Hypochloride to do coagletination with the pus that I'm going to be able to do it through the canal system.

10:28

S… Speaker 1 (dfyguhjiok)

In acute pre-apical abscess, the emergency treatment will give me an instrumentation and irrigation and establish drainage through the canal or by incision and drainage if I have fluctuate swelling.

10:42

S… Speaker 1 (dfyguhjiok)

وبحط calcium hydroxide between visits as addressing وبعدك بعمل sealing للتوث دي وتأكد ان لازم يبقى فيه complete seal وان temporary filling اللي انا حطاه دوا ما فيهوش اي leakage علشان ما اثرش على الكالسيم hydroxide اللي انا حطاه جوه دوا بدل ما يعمل الـ effect بتاعه الـ antimicrobial effect لأنا كده بدخل micro-organisms جديدة فبالتالي هو مش هيعمل الـ effect بتاعه ممكن كمال يحصل له wash out من

11:09

S… Speaker 1 (dfyguhjiok)

saliva and liquids that can be entered through the leaky temporary filling. In the acute non-vital cases, there is treatment that I have to add antibiotics and analgesics. Another thing, the endodontic treatment that I have to do as soon as possible.

11:34

S… Speaker 1 (dfyguhjiok)

Why do I do it as possible to prevent the bacterial penetration inside the canal?

12:03

S… Speaker 1 (dfyguhjiok)

And after that, I'll do the obturation after being completely asymptomatic, no signs or symptoms, no pain, no discharge, no foul odor. If I got a clean, I can do the obturation. Okay, I finished the emergency treatment, I'll do scheduling, and I'll do the endo treatment. In the case of non-vital cases,

12:34

S… Speaker 1 (dfyguhjiok)

it is preferable اني بقى فيه one week after instrumentation علشان اعمل بعديها الاوبتوريشن بتاعتي ليه بخليها one week to maximize anti-microbial effect بتاع الانتراكانال ميديكامنت اللي انا حطاه between visits

12:50

S… Speaker 1 (dfyguhjiok)

the maximum effect of it, we are going to put calcium hydroxide between visits, to give me the antimicrobial effect, so that the antimicrobial effect is going to be done, at least one week, to give me the effect of it, and I can do the obturation after that.

13:14

S… Speaker 1 (dfyguhjiok)

في حالات الأكيوت نون فيتال كيسز الكيسز دي يستحسن أن أنا أشوفها every 24-48 hours to monitor patient progress والtreatment progress اللي أنا عامله وفي نفس الوقت to control الأكيوت سيمتومز اللي البيشن دو كان دي أجاي لك بيها. You should avoid long delay between visits to prevent development of resistant microbial strains. زي ما احنا اتفقنا أنت كل ما بتفتح السنة.

13:43

S… Speaker 1 (dfyguhjiok)

treatment treatment, and then after that, and then after that, and then after that, and then after that, and then after that, and then after that, and then after that, and then after that, and then after that, and then after that, and then after that, and then after that, and then after that, and then after that,

13:57

S… Speaker 1 (dfyguhjiok)

وبالتالي مهما عملت بعد كده اي انتبيوتك او ممكن حتى لو استخدمت انتراكانال ميديكيشن ممكن ما يديش الايفكت بتاعك لو انت كنت صرعت في التريتمين بروسيديورز بتاعتك وفي الفيزيتز وقفلت الكيس دياً

14:15

S… Speaker 1 (dfyguhjiok)

طيب في حالات non vital pulp with apical perigantitis should I treat this case in a single visit أعمل access and cleaning and shaping or obturation ولا أخليها multiple visits وأجيب الpatient دوان أعمل cleaning and shaping وحط intracanal medication وبعد كده أجيبه بعد أسبوع أعمل obturation بتاعتي أو أن أنا أعمل cleaning and shaping على كذا visit كل دوان هنبتدي أن إحنا نعرف أنا ممكن أن أنا أعمل single visit ولا multiple visit technique

14:47

S… Speaker 2 (dfyguhjiok)

Actually, there are many researches that have been done on this story.

15:00

S… Speaker 1 (dfyguhjiok)

In fact, the root canal system. So I will do treatment for non-vital cases on multiple visit procedures. Three other researchers found that no difference in success and peri-epical healing between single and multiple visit treatments.

15:23

S… Speaker 2 (dfyguhjiok)

هما قالوا ايه في الحكاية ديان قالوا انا ممكن ان انا اعمل single visit technique او single visit endotreatment في الحالات بتاعة non vital pulp with apical periodontitis وقالوا ان انا لا مايهمنيش total elimination of bacteria من root canal system بس ال what matters with me

15:45

S… Speaker 2 (dfyguhjiok)

is the maximum reduction reduction, reduction, not elimination, not complete elimination, but they just try to get the number of bacteria inside the root canal system, I will do effective root canal filling, and satisfactory corona restoration, all of them will give me effective root canal treatment in a single visit, and I will leave the eye on it, so they will give me the eye on it.

16:11

S… Speaker 2 (dfyguhjiok)

قالوا أنا ممكن أن أنا أعمل single visit technique في حالات non vital cases with apical periodontitis وأخلص التريتمنت بتاعتي. بس actually أنا الحقيقة ما بحبسش حاجة زي دي علشان ما اضطرش أن أنا أدخل في flare-ups ممكن أن هي لا قدر الله تحصل بسبب cases ضيديا لأن أنا عندي زي ما اتفقنا أن أنا عندي multiple species

16:39

S… Speaker 2 (dfyguhjiok)

في حالات non vital cases with apical predentitis كتير جدا ممكن يحصل لي flare ups وممكن يحصل flare ups between visits في اي حالة من الحالات اللي انا ببتديها

16:53

S… Speaker 1 (dfyguhjiok)

what is the flare up? acute exacerbation after initiation or continuation of root canal treatment that needs unscheduled emergency treatment

17:11

S… Speaker 1 (dfyguhjiok)

any signs and symptoms or can be signs and symptoms and you had to release signs and symptoms but between visits, it happened signs and symptoms again. so something like this is needed to be unscheduled emergency interference. this flare-ups can happen.

17:33

S… Speaker 2 (dfyguhjiok)

Over-instrumentation. Pushing the internal and pulpal debris in the pre-epical area.

17:58

S… Speaker 2 (dfyguhjiok)

Over Extended Root Canal Filling. After ending treatment, the Gata Perka or Root Canal Filling was confined in the Root Canal Space, and it came to the Peripical Area, so it will make Flare Up.

18:13

S… Speaker 1 (dfyguhjiok)

Chemical Irritation, Pre-Epical Tissue. Chemical Irritation is from the Irrigents that you can use. You can also use Intracanal Medications. You can also use Pre-Epical Irritation. You can also use Steelers to use Pre-Epical Irritation. You can also use Pre-Epical Irritation.

18:32

S… Speaker 2 (dfyguhjiok)

Hyper-occlusion, you can do flare-up. Hyper-occlusion, you put it in Corona Restoration, but you don't have the occlusion, there's high spot, there's a high spot, there's a high spot in restoration, so you can do flare-up, you can do pre-epical or pre-dental tissue inflammation.

18:51

S… Speaker 2 (dfyguhjiok)

Microbiological factors. We are confident that we have root canal system if you had to do it. Microbiology or bacteria from the oral cavity. If you can do root canal treatment without you, you can do isolation. So you can do new species inside.

19:07

S… Speaker 2 (dfyguhjiok)

Mمكن انها تعمل flare up between visits. Mمكن root fracture كمان يعني لاي سبب من الاسباب انت عملت pressure جامد وانت بتعمل obturation. Root دوان حصل فيه fracture. تعمل لي flare up between visits او flare up بعد ما خلصت حتى ال endo treatment بتاعتك. طب ال emergency treatment للفلير ايه اللي بيحصل. Most of the cases ممكن ان هي تخلص بان انا قدي للpatient دوان analgesics.

19:38

S… Speaker 2 (dfyguhjiok)

and antibiotics, or that I am using occlusal adjustment, so that you can remove the signs and symptoms that happened from the flare. In case of resisting cases, they may require re-entry and establishment of drainage either through the canal or trefination in case of non vital cases.

20:00

S… Speaker 1 (dfyguhjiok)

if I have swelling trapped in bone, not fluctuate swelling, and I'm not able to do relief through the canal, so the treffination is, unfortunately, that you can get through the bone, so that you can release the entrapped per apical inflammatory exudates from treffination or entry through the bone that you did.

20:30

S… Speaker 1 (dfyguhjiok)

and give prophylactic antibiotics or give antibiotics in this case or in some cases where I said that I would give prophylactic antibiotics before treatment of the necrotic teeth before the treatment of the necrotic teeth so I can get the flare-ups but the fact

20:48

S… Speaker 1 (dfyguhjiok)

الحكاية دي او الابيني دوا فيه عالية علشان حكاية ان انا اخد على طول على طول على طول وانا ما عنديش لالانفكشن عالية لازم يكون فيه ورادنس وهوتنس في الاريا دي طالما ان انا ما عنديش دي ما اديش

21:11

S… Speaker 1 (dfyguhjiok)

And the opinion is that I'm going to prophylactic antibiotic so that I'm going to get the flare-ups. But actually, when I'm going to prophylactic antibiotic, I'm going to be able to do antibiotic resistance. And I'm going to get the antibiotics that I'm going to be able to do it later on the bacteria that I'm going to use.

21:34

S… Speaker 1 (dfyguhjiok)

the immature teeth, we know that the immature teeth is, if it happened to the permanent tooth trauma or carousness or pulp exposure, and in the case that the tooth is not completely rooted, and the apex can open, this is why I have a lot of problems in the case.

21:59

S… Speaker 1 (dfyguhjiok)

The case D is because I don't have an epical stop, I don't have an epical stop. I don't have an epical construction. I have to work with the files. I can do it with an epical test. I don't have control on the arrogance. It is confined inside the root canal system.

22:25

S… Speaker 1 (dfyguhjiok)

ممكن تعمل إراتيشن للتريدونتال أريا أو بريابيكال أريا بمعنى أصح ما عنديش في الأبتوريشن أنا ما قدرش أن أنا أتحكم في الجاتا بيركا النهية تبقى ومست ديكال عندي أن أنا بيبقى عندي في الحالات دي الأمرجنسي بتاعتي أنا ببقى

22:56

S… Speaker 1 (dfyguhjiok)

زي دي لازم ان انا هتدخل فيها وابتدي ان انا اعمل طيب لو انا داتلي حالة حصل فيها خلاص او وحصل انا على الاقل لازم احاول احافظ على دي لو كانت جايالي يبقى انا اول حاجة

23:19

S… Speaker 1 (dfyguhjiok)

هروح لها ان انا اعمل vital pulp therapy ان انا اعمل بقى pulp capping او ان انا اعمل pulpotomy او partial pulpotomy او اللي هي بيتقال عليها civic pulpotomy ان انت بتشيل جزء بس من pulp chamber مش بتشيل كل pulp chamber tissues بتشيل مثلا الاول واحد ميلي من pulp tissues اللي موجودة في pulp chamber وببتدي بعد كده احط dressing التاعي والcorona restoration واسيب التوث دي تكمل

23:50

S… Speaker 1 (dfyguhjiok)

root formation procedures بتاعتي. لو حالت immature permanent teeth with necrotic pulp. انا هتعمل معها ازاي?

24:01

S… Speaker 1 (dfyguhjiok)

Actually, I have two treatment options for immature, permanent teeth with necrotic pulp. The first thing I am going to do now, in the moment, in the moment, because as we agreed, I am going to do immature teeth. I want to try this tooth to initiate root development. I want to continue root formation.

24:28

S… Speaker 1 (dfyguhjiok)

عن طريق ان انا بعمل حاجه اسمها tissue regeneration procedure. tissue regeneration دوا هتاخدوها ان شاء الله في السنه الجايه ان بعمل initiation to initiate root canal formation. زي انا الحاله دي زي ما انتو شايفينها هي حصل trauma

24:55

S… Speaker 2 (dfyguhjiok)

in the moment when the route was open apex

25:00

S… Speaker 2 (dfyguhjiok)

ما حصلش closure للroot بدأت ان انا اعمل tissue regeneration procedures بتاع تديا والفلو اوب زي ما انت شايفين بدأ يحصل epical construction و completion للroot development معايا دي tissue regeneration process او

25:18

S… Speaker 1 (dfyguhjiok)

The second thing I can do is to do apecification. Apecification is the end procedure. I'm going to do it like this. I'm not going to do it like this. I'm not going to do it like this. No, I'm going to do it like this. I'm going to do it like this.

25:36

S… Speaker 2 (dfyguhjiok)

open apex , open apex , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin dintinal walls , thin d

26:09

S… Speaker 1 (dfyguhjiok)

بس انا اكون عاملة حسابي وعرفة كويس قوي انه هو هاي وكل حاجة يعني انا عندي عالية جدا في حالات بس مش عالي زي ما انا بعمل يعني لو انا هقارن بين في حالة انا بدي فيها

26:31

S… Speaker 1 (dfyguhjiok)

due to care is outroma وحالة تانية كانت previously treated وانا بعمل retreatment فيها هلاقي ان success rate بتاعة الحالة اللي انا بدأت فيها ال endotreatment من الاول اعلى من success rate بتاعة الحالة اللي انا بعمل فيها retreatment طب انا ممكن ان انا اقول ان انا هعمل retreatment في الكيس دي امتى او ايه هي ال considerations اللي انا لازم ابصلها قبل ما ادخل في حالة

27:05

S… Speaker 1 (dfyguhjiok)

اول حاجه لازم اعرف ايه هو ايه اللي خلى اللي اتعاملت دي سواء انا اللي عملتها او حد تاني اللي عملها حصل لها ابص بقى ان انا هل في عندي قبل كده

27:28

S… Speaker 1 (dfyguhjiok)

and I'm going to do evaluation of accessibility, I'm going to do the route channel or not, I'm going to do it before I'm going to do it. According to the considerations, I can say that I can do it with conventional therapy or conventional treatment with surgical interference.

27:58

S… Speaker 1 (dfyguhjiok)

أكتر حاجة ممكن أن أنا ألاقيها وبتساعدني جداً في حالات الريتريتمنت أن أنا أستخدم التنتل أوبوريتنج ميكروسكوب والألتراسونيكس علشان أعمل نون سيرجيكال ريتريتمنت والنون سيرجيكال ريتريتمنت دايماً هي always preferable than السيرجيكال تريتمنت وأول حاجة أنا بلجأ لها في حالات الريتريتمنت أن أنا أدخل نون سيرجيكالي الأول

28:25

S… Speaker 1 (dfyguhjiok)

Before shifting or sorting to surgical intervention in case D. Because I have non-surgical re-treatment success rate is higher than the surgical interference when I enter case like this. In case of re-treatment, I'm going to do intervention in case D. When I enter surgery, I'm going to do intervention in case D. When I enter surgery?

28:57

S… Speaker 1 (dfyguhjiok)

I would think that the filling case is initially treated properly and cannot be improved more than that by non-surgical retreatment. This is the case that you worked before that and you are sure that you had to do complete isolation, you are sure that you have to do a mixed canal, you are sure that you have to do a perforation, you are sure that you have to do complete

29:20

S… Speaker 1 (dfyguhjiok)

ceiling to root canal system in that I am a proper obturation, proper corona restoration, if I am confident that I am 99.9% in the case, I have failed. I have to enter surgical. I have calcifications in the root canal system and I am not able to do it by non-surgical means. I have to enter surgical.

29:47

S… Speaker 1 (dfyguhjiok)

There are sometimes prosthetic reasons that allow me to get into the surgical intervention.

30:00

S… Speaker 1 (dfyguhjiok)

treated and treated with post and core and coronal restoration crown. And if I did evaluation of the case, and I saw that if I did post and core, I can do more procedural errors. I can do fracture in this case. No, I can do it. I can do it. I can do it. I can do it. I can do it. I can do it. I can do it.

30:28

S… Speaker 1 (dfyguhjiok)

لو انا عندي large pre-epical lesion برضو هضطر ان انا ادخل surgically بعد ما اعمل ال endotreatment العادية بتاعتي الاول لو في عندي case انا عايزة ااخد biopsy من ال pre-epical area هضطر ان انا ادخل اعمل طبعا هعمل ال endotreatment بتاعتي الاول وبعد كده هدخل اعمل surgical intervention واخد ال biopsy من الكيس دي

30:53

S… Speaker 1 (dfyguhjiok)

The other thing, or the other thing, is the treatment plan that I have done. Pre-medications. Like patients who have damaged or are used prosthetic heart valves. We know that we have in case selection, that we have to take prophylactic antibiotics one hour before initiation of treatment.

31:17

S… Speaker 1 (dfyguhjiok)

حالات زي patients عندها myocardial infarction لازم برضو تاخد prophylactic antibiotic before treatment والtreatment الendodontic treatment بتاعتي ما اقدرش ان انا اتدخل غير لما يكون عدى 3 شهور من myocardial attack في حالات myocardial infarction patients لازم ان انا الappointments بتاعتي تبقى short for time وcomfortable علشان الpatient دوا هو بيبقى ready

31:45

S… Speaker 1 (dfyguhjiok)

مش مستحمل اي حاجه فبالتالي انا مش عايزه ان انا احط عليه زياده وممكن يحصله اي موجوده في الفيزيت فبالتالي انا بتجنب حاجه زيديا بان انا اخلي الابوينتمنس تاعتي شورت وكمفورتابل للبايشن

32:07

S… Speaker 1 (dfyguhjiok)

they need premedication ان هما يبقوا مضبطين blood pressure بتاعهم اللي هما بياخدوها الابوينتونس بتاعتي برضو تبقى short في حالات الhypertensive patients local anesthesia بقى انا اقدر ادي local anesthesia فيها vasoconstrictor بس يبقى minimum amount of vasoconstrictor مش هقول ان انا هدي plain anesthesia without vasoconstrictor خالص لانا ممكن ادي vasoconstrictor بس يبقى minimum

32:36

S… Speaker 1 (dfyguhjiok)

concentration. patients suffering from leukemia. they need prophylactic antibiotics علشان عندهم poor healing. avoid the treatment during the acute stages of leukemic disease. اقدر ان انا ادخل وعمل ال endo treatment بتاعتي لو ال patient دون بياخد chemotherapy. قبل ما ياخد الكيموثيرابي بتاعتي بتاعته ديا بone week اقدر ان انا ادخل وعمل ال endo treatment بتاعتي ويستحصل انها تكون in a single visit. بس اهم حدا.

33:12

S… Speaker 1 (dfyguhjiok)

in acceptable range the patients under corticosteroids or anticoagulant therapy they need to adjust their dose before each appointment

33:33

S… Speaker 1 (dfyguhjiok)

there must be, of course, we must make consultation with the physician who takes care of the patient, before the appointment, we must make adjustment for the condition before it comes, single visit or multiple visit, the story of the controversy that I'm going to enter, the case this is single visit or multiple visit, if I'm going to speak and say

34:07

S… Speaker 1 (dfyguhjiok)

I will decide to do single visit or multiple visits. Before that, there was a lot of research that I did. I have two basic questions and researches that I would say to them. The first question. Is single visit endodontic therapy more or less painful post-operatively than multiple visit therapy? The second question. Is single visit endodontic therapy more or less successful than multiple visit therapy?

34:46

S… Speaker 2 (dfyguhjiok)

Actually, they found no detectable difference between single visit and multiple visit.

35:00

S… Speaker 1 (dfyguhjiok)

visits, whether success rate or post-operative pain or flare-ups, or short-term post-operative complications. The two were made in the results that happened. So, do I do single or multiple visit therapy? We found that in single visit in the automatic therapy there are advantages many.

35:25

S… Speaker 2 (dfyguhjiok)

First thing is reduction number of appointments. You don't want to see patient that's a lot, and you don't want to see patient that's a lot. And this is something that's always going to make patient say no, I don't want to do treatment. I don't want to do treatment. I don't want to do treatment. I don't want to do treatment.

35:40

S… Speaker 2 (dfyguhjiok)

2. Eliminate cell chances to inter-appointment, microbial contamination, and flare up. We're not sure if I'm going to take the filling or temporary filling that is available in microorganisms. Eliminate the need to re-familiarize the root canal anatomy in every visit patient to be able to accomplish the endodontic procedures.

36:02

S… Speaker 2 (dfyguhjiok)

I don't know if you're a patient when you come to the patient, I'm going to see the direction of the channel. I'm going to enter the channel. I'm going to enter the channel. I'm going to enter the channel. I'm going to enter the channel. I'm going to enter the channel.

36:25

S… Speaker 2 (dfyguhjiok)

طبعاً لو أنا عملت single visit ممكن أقدر أستخدم الroot canal space دواً للretention بتاع البوست وconstruction of aesthetic temporary crown في حالات طبعاً لما يكون عندي مثلاً fractured anterior teeth ديان أنا بتبقى the aesthetics more important عندي فلو أنا عملت single visit endotreatment وعملت post and core temporary crown رجعت السنة دي للشكل اللي موجود لحد ما أعمل الفاينال crown بتاعي

36:53

S… Speaker 2 (dfyguhjiok)

طبعا هيبقى patient more satisfied بحاجة زي دي. advantages that single visit technique دي. هل هي يعني ليها advantages في المطلق؟ لا انا ستيل برضا عندي disadvantages

37:07

S… Speaker 2 (dfyguhjiok)

what are the disadvantages that I have? Oh God! If I had a flare-up in case that I made it to single visit, I didn't want to make treatment for me, because in the case of the treatment, when you get to shield and shield and shield and shield and shield and shield and shield and shield and shield and shield and shield and shield and shield and shield and shield and shield and shield.

37:32

S… Speaker 2 (dfyguhjiok)

Another thing to do is to make end treatment in a single visit, it will be a long appointment, long appointment day, maybe tiring and uncomfortable for some patients, especially though patients, they will not be able to remove them for a long time, or if they are limited mouth opening, they will be a problem in a single visit appointment, it will be a little bit easier for a single visit appointment, it will be a little bit easier, it will be a hour or a half hour.

38:06

S… Speaker 1 (dfyguhjiok)

I'm able to make single root canal treatment, single visit root canal treatment. What are the cases that I'm convinced that I can do single visit root canal treatment without any complications?

38:21

S… Speaker 1 (dfyguhjiok)

First thing, the vital cases, which is pre-operative apical periodontitis, I can accomplish single visit root canal treatment. Fractured anterior teeth, which we are talking about, is an important thing I can accomplish in single visit root canal treatment.

38:40

S… Speaker 2 (dfyguhjiok)

Medically compromised patients, especially those that I need to give them prophylactic antibiotics before initiation of treatment. It is possible that I will give them single visit treatment, so that I will give them prophylactic antibiotics before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it, before they get it,

39:03

S… Speaker 1 (dfyguhjiok)

patients who are physically unable to return for a second visit

39:30

S… Speaker 2 (dfyguhjiok)

they are not able to communicate with them and they are not able to communicate with them and they are able to communicate with them so they are able to communicate with them and they are able to communicate with them and they are able to communicate with them and they are able to communicate with them and they are able to communicate with them so that they are not able to communicate with them so that they are able to communicate with them so that they are able to communicate with them so that they are able to communicate with them so that they are able to communicate with them

40:00

S… Speaker 1 (dfyguhjiok)

طيب ايه هي الحالات اللي انا مقدرش ان انا اعمل فيها single visit root canal treatment حالات asymptomatic non vital teeth with apical redilucency ومعنديش sinus tract علشان يبقى فيه drainage للpre apical exudates اللي موجودة تحت حالات retreatment مقدرش ان انا اعملها in single visit

40:23

S… Speaker 1 (dfyguhjiok)

cases where the hemorrhage or the exudates coming from inside the canal cannot be controlled. What can be done and what should be done? Present two very different approaches for the endodontic treatment plan.

40:55

S… Speaker 1 (dfyguhjiok)

I have factors that affect the choice of the treatment plan. Whether I am doing root canal treatment in a single visit or multiple visits, like we have done, indications or contraindications, I will be able to know what factors affect the treatment plan. The first thing is the patient's systemic health, severity of the symptoms, and level of anxiety in the patient. Complexity of the root canal system and probability of procedural difficulties.

41:34

S… Speaker 2 (dfyguhjiok)

Thank you very much and see you soon in the last chapter in our term and wish you good luck.

ສັງລວມ

ຖາມ AI ກ່ຽວກັບການແປນີ້

dfyguhjiok

ສັງລວມ

ຖາມ AI ກ່ຽວ​ກັບ​ການ​ແປ​ນີ້

ຖາມ AI ກ່ຽວກັບການແປນີ້