Endodontic Treatment Of A Tooth With Change Of Diagnosis From Pulp Necrosis To Irreversible Pulpitis
DOI:
https://doi.org/10.46862/interdental.v20i3.8260Keywords:
vitality pulp test, pulp necrosis, irreversible pulpitisAbstract
Introduction: Dental caries is the primary cause of pulp disease. As caries progresses, the pulp undergoes morphological and histological changes. To detect pulp conditions, pulp vitality tests can be performed to stimulate myelin nerve fibers in the pulp tissue.
Case: A 31-year-old female patient came to RSGM Universitas Padjadjaran with a complaint of a large cavity in the upper right front jaw tooth since a year ago. A few months later, she fell from a motorcycle which caused the cavity to become even larger. The patient had a history of spontaneous throbbing pain, but it is now completely gone.
Case Treatment: A root canal treatment was performed over six visits. The first visit involved initial examination and status recording. The second visit included caries removal, access opening, and pulp extirpation. The third visit encompassed re-walling, working length measurement, and root canal preparation. The fourth visit involved sterilization control and trial obturation. The fifth visit included obturation or filling of the root canal of tooth 11. The sixth visit consisted of obturation verification.
Discussion: Accurate pulp diagnosis based on neurovascular changes within the pulp is crucial for the success of endodontic treatment. Pulp vitality tests such as cold pulp test (CPT), hot pulp test (HPT), and electric pulp test (EPT) are common methods for assessing pulp condition.
Conclusion and Suggestions: To obtain a more comprehensive understanding of pulp vitality, it is necessary to use a combination of various vitality tests.
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References
James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, Briggs AM. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet 2018; 392(10159): 1789-1858. doi: 10.1016/S0140-6736(18)32279-7.
Rajendran, R. Shafer's textbook of oral pathology. India: Elsevier; 2009.
Zero DT, Zandona AF, Vail MM, Spolnik KJ. Dental caries and pulpal disease. Dental Clinics 2001; 55(1): 29-46. doi: 10.1016/j.cden.2010.08.010.
Mainkar A, Kim SG. Diagnostic accuracy of 5 dental pulp tests: a systematic review and meta-analysis. Journal of endodontics 2018; 44(5): 694-702. doi: 10.1016/j.joen.2018.01.021
Putri AR. Crown Down preparation technique with large taper endodontic hand instrument. Interdental: Jurnal Kedokteran Gigi 2021; 17(1): 41-48. doi: https://doi.org/10.46862/interdental.v17i1.2424
Glickman GN. AAE consensus conference recommended diagnostic terminology. J Endod 2009; 35(12): 1634.
Matos FS, Cunha TC, Ribeiro MAG, Araujo CS, Bernardino ÍM, Moura CCG, Paranhos LR. Accuracy of the dental pulp sensibility test using cold spray for the diagnosis of pulp diseases: an observational clinical study. Bioscience Journal 2021; 37(e37040): 1981-3163. doi: https://doi.org/10.14393/BJ-v37n0a2021-60365
Jafarzadeh H, Abbott PV. Review of pulp sensibility tests. Part I: general information and thermal tests. International endodontic journal 2010; 43(9): 738-762. doi: 10.1111/j.1365-2591.2010.01754.x.
Cheng L, Zhang L, Yue L, Ling J, Fan M, Yang D, Zhou X. Expert consensus on dental caries management. International journal of oral science 2022; 14(1): 17. doi: 10.1038/s41368-022-00167-3.
Almutairi W, Aminoshariae A, Williams K, Mickel A. The validity of pulp tests on crowned teeth: a clinical study. Eur Endod J 2021; 6(2): 151-4. doi: 10.14744/eej.2020.94840
Dastmalchi N, Jafarzadeh H, Moradi S. Comparison of the efficacy of a custom-made pulse oximeter probe with digital electric pulp tester, cold spray, and rubber cup for assessing pulp vitality. Journal of endodontics 2012; 38(9): 1182-1186. doi: 10.1016/j.joen.2012.06.012.
Chávez CEV, Marín PN, Rodríguez LJP, Alonso ZNV, Castañón MGA, Solís MCE. Predictive values of thermal and electrical dental pulp tests:a clinical study. J Endod 2013; 39(8): 965–9. doi: 10.1016/j.joen.2013.04.019
Elmeguid AA, Yu DC. Dental pulp neurophysiology:part 2. Current diagnostic tests to assess pulp vitality. J Can Dent Assoc 2009; 75(2): 139–43.
Jespersen JJ, Hellstein J, Williamson A, Johnson WT, Qian F. Evaluation of dental pulp sensibility tests in a clinical setting. J Endod 2014; 40(3): 351–4. doi: 10.1016/j.joen.2013.11.009.
Farid H, Khan FR, Pasha L, Shinwari MS. Are pulp sensibility tests still sensible? J Ayub Med Coll Abbottabad 2015; 27(4): 874–7.
Weisleder R, Yamauchi S, Caplan DJ, Trope M, Teixeira FB. The validity of pulp testing:a clinical study. J Am Dent Assoc 2009; 140(8): 1013–7. doi: 10.14219/jada.archive.2009.0312.
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