Pt c/o nil
1 cartridge (2.2ml lignospan) 2% lidocaine hydrochloride 1:80k adrenaline R/L ID block/ b&p infiltrations
Caries removed, restored with caoh base & amalgam filling wedged with matrix band.
Occlusion checked with articulating paper.
Caries removed, restored with acid etch, bond & comp shade A3. Smoothed comp polishing burs/flex discs.
Pt happy.
Infected Socket: pt c/o pain from socket after xla, on mouth opening, radiates along jaw & up to ear. exam – e/o & i/o swelling, trismus, halitosis, infected socket – no blood clot, exposed bone. pt is a smoker. Advised no smoking until infection subsides.
Advised hot salty mouthrinses &
Prescribed metronidazole 200mg 3 days. prescription no. - no alcohol.
Rinsed with Corsydol & placed Alvogyl in socket.
Pt happy.
RCT:
UL6 –
Pt c/o pain quad, sensitive to hot/cold, pain on biting, HPC 2 wks ago, increasing in severity, dull ache & sharp shooting pains, well localised, radiates along jaw, no swelling, no discharging of pus or bad taste in mouth.
Special tests ttp+, ethyl chloride+ Diagnosis irreversible pulpitis/non-vital/abscessed/acute periapical periodontitis.
Treatment plan xla vs rct. Pt opts for rct.
Preop rad – excellent quality rad, periapical radiolucency/deep caries
1 cartridge (2.2ml lignospan) 2% lidocaine hydrochloride 1:80k adrenaline R/L ID block/ b&p infiltrations, rubber dam placed, temp removed/ 3 canals accessed, w/l pa taken- excellent quality rad, w/l - db mm @ size 30 from top of crown mb mm @ size 30 from top of crown p mm @ size 30 from top of crown
Step back to size 60. Profuse bleeding/pus from canals. Irrigated with sodium hypochlorite. m/p pa taken – excellent quality rad, accepted/unacceptable
Obturation with GP & sealapex, heat sealed & sealed with GIC.
Obturation rad – excellent quality rad, acceptable/unacceptable
Temporised with leadermix/CaOH, cotton pledget, coltosol.
Restored with amalgam filling wedged with matrix band.
Occlusion checked with articulating paper.
Pt happy
