سلسلة مهمة لكل طالب و طبيب أسنان عن
New Guidelines for the Management of Traumatic Dental Injuries
في هذه السلسلة تجدون آخر تحديث ٢٠٢٠ لتوصيات المنظمة العالمية لاصابات الأسنان IADT
آخر تحديث كان في عام ٢٠١٢
#endo_edu
#ahjabali_endo
#endogate
New Guidelines for the Management of Traumatic Dental Injuries
في هذه السلسلة تجدون آخر تحديث ٢٠٢٠ لتوصيات المنظمة العالمية لاصابات الأسنان IADT
آخر تحديث كان في عام ٢٠١٢
#endo_edu
#ahjabali_endo
#endogate
1️⃣Use of water has been removed, therefore water should not be used for rinsing and or as a storage solution
2️⃣ 2- The Best option for avulsed tooth is to replant the tooth regardless of how long the toot has been outside and whether kept in a storage medium or not
2️⃣ 2- The Best option for avulsed tooth is to replant the tooth regardless of how long the toot has been outside and whether kept in a storage medium or not
3️⃣ External Root Resorption older and newer terms have been kept
A- Infection related (inflammatory root Resorption)
B- Ankylosis related (Replacement Resorption)
4️⃣ If the tooth was replanted in a wrong socket then it can be repositioned in the correct socket within 48 hours
A- Infection related (inflammatory root Resorption)
B- Ankylosis related (Replacement Resorption)
4️⃣ If the tooth was replanted in a wrong socket then it can be repositioned in the correct socket within 48 hours
5️⃣ If there is visible contamination on the tooth then the tooth can be agitated gently in the storage medium. Or a stream of saline can be used to briefly rinse the tooth surface.
rigorous manipulation of the root surface should not be applied
rigorous manipulation of the root surface should not be applied
6️⃣ The tooth to be stored in a storage medium while taking the history
7️⃣ Anesthesia without vasoconstrictor to be used, but the evidences supporting this recommendation are few.
7️⃣ Anesthesia without vasoconstrictor to be used, but the evidences supporting this recommendation are few.
8️⃣ RCT to Be started within 2 weeks. Some authors stated that RCT can be initiated immediately if the patient won't be able to make it within 2 week-period and also to avoid any chance of root Resorption
9️⃣Others recommend to initiate RCT later (but within 2 weeks)to minmize any further trauma to the tooth during RCT and to maximize the healing chances because some animal studies has shown that medicament and irrigants may reach root surface and may interfer with the healing
1️⃣0️⃣ If the tooth was left longer than 60 minutes then the recommendation is: to start RCT within 2 weeks not before Replantation.
Old guidelines state: RCT to be initiated before Replantation if the tooth was left out longer than 60 minutes
Old guidelines state: RCT to be initiated before Replantation if the tooth was left out longer than 60 minutes
1️⃣1️⃣No recommendation to treat root surface with fluoride or any other materials even for immature teeth because there is no strong support from the literature
1️⃣2️⃣For immature teeth, no further treatment should be done unless sign of pulp necrosis has been noticed
1️⃣2️⃣For immature teeth, no further treatment should be done unless sign of pulp necrosis has been noticed
1️⃣3️⃣ if ankylosis is expected and decoronation is anticipated then proper intra canal material (That can be easily retrieved or resorbed ) is indicated
1️⃣4️⃣ Splitting of avulsed teeth now is standardized to be for 2 weeks using passive flexible splint and To be placed on the labial away from gingival tissues, to avoid any harm to the tissues and to be able to do RCT from lingual side
1️⃣5️⃣ Word passive has been added in addition to flexible splint indicating no force should be applied
1️⃣6️⃣if the avulsion is associated with bone fracture then rigid splint for 4 weeks to be placed
1️⃣6️⃣if the avulsion is associated with bone fracture then rigid splint for 4 weeks to be placed
1️⃣7️⃣ Follow up for avulsed teeth should be as follow: 2 and 4 weeks, 3 and 6 months then annually for 5 years
1️⃣8️⃣ Photographic documentation is highly encouraged and CBCT is also encouraged when needed and if possible
1️⃣8️⃣ Photographic documentation is highly encouraged and CBCT is also encouraged when needed and if possible
1️⃣9️⃣ Antibiotics to be used (amoxicillin/penicillin) and if the patient is allergic to these medications then doxycycline if the patient is older than 12 years. If younger then clindamycin or Azithromycin can be prescribed
2️⃣0️⃣ Pulp is not vital if the pulp is not responding to tests for several months not only 3 months and the RCT should not be done only based on the pulp test results. Another sign or symptom should be there to initiate RCT
2️⃣1️⃣ If there is evidence of infection related Resorption, RCT should be initiated immediately and calcium hydroxide should be placed for several months until the sign of active inflammatory Resorption stops
2️⃣2️⃣ Follow ups for luxation injury should be at least for 5 years not as before for 5 years only
لازال هناك اضافات نخصص لها وقت لاحق إن شاء الله.
وهنا المصدر 👇🏻لمن أراد الاطلاع و الاستزادة
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وهنا المصدر 👇🏻لمن أراد الاطلاع و الاستزادة
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