Mid-treatment or post-treatment emergency
Painful condition may persist after emergency pulpectomy or you experience the following pulpectomy not initially painful tooth. The last condition is called endodontic exacerbation of the disease. The reason is likely to be bacterial origin, combined with the inadequate technical procedure. Pollution due to the use of rubber dam, unsatisfactory temporary recovery, move carious dentin and plaque in the channel, are key factors(1, 42, 69, 86). Combined with inappropriate intracanal drugs, incomplete instrumentation, non total channels and apical overinstrumentation, easy to understand, that the conditions for bacterial multiplication are created in the system of root canals. It should be emphasized that the complications of this nature should be rare and occur only at a low rate in the correct management of clinical practice (42, 82). Cracked tooth substance and traumatic occlusion and other factors should be considered when examining the patient the reasons for endodontic exacerbation of the disease.
In painful conditions after pulpectomy, the first step is to determine whether the request for re-entry procedures. This is especially true if the tooth are constantly filled. The condition is often self-healing, and can be operated easily over-the-counter painkillers and decline in the functional areas. If the re-entry will be considered necessary, endodontic procedures should follow the same strict routine, as described above, includes appropriate rubber dam application and disinfection. In case of necessity of opening of access should be adjusted to the optimal entrance of the root canal system. It is profitable to enter without anesthesia to control missed channels or incomplete removal of tissue of the tooth pulp. Of course, the control should be carried out with caution, under the gentle probing potential channel of holes and root canals.
Special attention should be paid to the high frequency of the maxillary molars with two mesial channels; one that is most often skip mesiolingual channel. In the distal lower molars root user can also harbor the two channels. Excess irrigation and reinstrumentation of channels should perform, if necessary, under local anesthesia. To conduct the procedure, ensure adequate working length and delay of the channel with a sauce of calcium hydroxide. In order to ensure the bacteria compressed temporary filling of sufficient strength, a mixture of zinc oxide-eugenol cement or similar compound must be applied for calcium hydroxide, dressing room, followed by the sealing surface of the hard establishment of cement.
Endodontic outbreaks may also be associated with a crowded root canal. As a rule, small extrusion root filling material does not cause easier tenderness, if at all, over several days, and falls within the next days. If severe pain condition developed together with the apical tenderness and some swelling, often bacterial cause where, along with the root of the filling material, micro-organisms have been pushed aside in periodontal tissues. Gross overwhelmed by themselves can cause severe tissue responses due to a strong toxic effect. ..