DGZMK Expertenforum 2005: Emergency Endodontics

Topics of Roundtable Discussion

• Frequency and Types of Pain seen
• Primary Pain Control and Flare-Ups
• Reversible and Irreversible Pulpitis
• Infected Necrosis
• Scope of Emergency Diagnostics
• Organizational Problems encountered in Practice

Contents
The Frequencies and Types of Pain seen in Emergency Endodontic Practices and Clinics are the First Questions addressed in the Roundtable Session. It becomes apparent that the Pain Cases most frequently treated by Private Endodontic Specialists are Infected Necrosis and Revision Treatment, whereas the Emergency Services of Dental Clinics see more Cases of Acute Pulpitis.
Ways to differentiate between Reversible and Irreversible Pulpitis are discussed with Consideration of Determining Factors like Caries, Cracks and Periodontal Causes. A Basic Presentation Format consisting of the General and Specifi c Case History, Radiographic Findings and Procedures for Establishing a Caries-Free State was to be followed in spite of the Short Time available.
Participants stress that Emergency Treatment should not obstruct the further Treatment Plans. If immediate Action is required, Extensive Opening of the Dental Pulp and Subsequent Treatment with Ledermix/Eugenol or Total Removal of the Coronal Pulp can be recommended. However, if suffi cient time is available, Complete Vital Extirpation (Total Pulpectomy) is the Treatment with the best chances of restoring a Pain-Free State.
The Experts unanimously reject the Use of Devitalization Techniques in Endodontics.
Pain Control in Infected Necrosis is the last Topic of Discussion. Opinions are divided. Recommendations range from a Complete Treatment Approach (time-consuming) to an Expectative Approach (waiting for 1-2 days) in the Case of Trepanated Teeth.