DENT3060 Lecture Notes - Lecture 4: Pulp Necrosis, Dental Extraction, Bleeding Diathesis
Document Summary
Hard unyielding box en(cid:272)losing highly sensitive vas(cid:272)ular pulp (cid:894)(cid:858)nerve(cid:859)(cid:895) Cause of toothache: consider structures tooth composed of & surrounding tissues in close relation. Painless removal of whole tooth/root with min. trauma to investing tissues, so wound heals uneventfully & no postoperative prosthetic problem is created reality: mutilating surgical procedure with soft tissue & bone injury. Dental extraction can only take place after: detailed medical history, dental history: mc/hmc, clinical examination (extra/intraoral, special investigations, diagnosis & treatment planning, consent. Severe caries, pulpal necrosis, severe periodontal disease, orthodontics, malposed teeth, cracks/fractures, preprosthetic, impacted teeth, supernumeraries, teeth associated with pathologic lesions, aesthetics, teeth involved in jaw fractures, financial, non restoreable sepsis, social circumstance. Systemic contraindications: end stage renal disease, uncontrolled diabetes & hypertension, haemopoetic diseases e. g. leukemia, uncontrolled cardiac disease e. g. recent myocardial infarction, stroke, bleeding diathesis e. g. haemophilia, thrombocytopenia. Relative systemic contraindications: pregnancy, drugs e. g. anticoagulants, immunosupressants (corticosterioids), bisphosphonates, acute contagious diseases.
