Acute dental pain II: pulpal and peripical pain

Peter Jonasson; Lise-Lotte Kirkevang; Annika Rosen; Lars Bjørndal

Acute dental pain II: pulpal and peripical pain

Peter Jonasson, Lise-Lotte Kirkevang, Annika Rosen, Lars Bjørndal

Sektion 02

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Abstract

Den specialiserede anatomi i pulpa-dentin-organet samt den rige pulpale innervation fra trigeminusnerven forklarer de forskellige typer af smertefølelser i en tand. En kort skarp smerte er typisk for en A-(nerve) fibermedieret smerte, imens en langvarig, bankende smerte indikerer C-(nerve) fiberaktivitet. A-fibre reagerer på termiske eller mekaniske stimuli, såsom kolde drikke eller tandbørstning, imens C-fibre hovedsagelig aktiveres ved inflammatoriske mediatorer. Således vil en dvælende smerte indikere en irreversibel pulpal inflammation. Ved pulpitis vil der opstå strukturelle ændringer i de pulpale nerver, der samtidig frigiver neuropeptider, som udløser et immunrespons: neurogen inflammation. Smertefornemmelser under pulpitis kan variere fra hypersensibilitet overfor termiske stimuli til svære dunkende og uudholdelige smerter. Smerterne kan være meddelte og ofte vanskelige at lokalisere, hvorfor diagnostik af inflammation i pulpa er en klinisk udfordring. En biofilm forstærker hypersensitivitet af eksponerede dentinoverflader, fordi de mikrobielle irritamenter kan nå pulpa gennem åbne dentintubuli, hvorved der fremkaldes inflammation. Fjernelse af biofilm reducerer isninger i tænderne, men supplerende behandling er ofte nødvendigt med det formål at opnå en reduktion af dentinens permeabilitet. Cariesekskavering samt fyldningsterapi er en tilstrækkelig behandling ved en klinisk bedømt reversibel pulpitis, hvorimod endodontisk behandling er nødvendigt, når pulpitis har nået et irreversibelt stadium.

Originalsprog	Engelsk
Artikelnummer	111
Tidsskrift	Tandlaegebladet
Vol/bind	120
Udgave nummer	2
Sider (fra-til)	120-127
Antal sider	8
ISSN	0039-9353
Status	Udgivet - 2016

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Acute dental pain II: pulpal and periapical painForlagets udgivne version, 274 KBLicens: Ikke-specificeret

http://www.tandlaegebladet.dk/sites/default/files/articles-pdf/TB22016-120.pdf

Citationsformater

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title = "Acute dental pain II: pulpal and peripical pain",

abstract = "Acute dental pain most often occurs in relation to inflammatory conditions in the dental pulp or in the periradicular tissues surrounding a tooth, but it is not always easy to reach a diagnose and determine what treatment to perform. Theanamnesis and the clinical examination provide valuable information, and a systematic approach is necessary. This paper will focus on diagnosis and treatment of pulpitis, pulp necrosis and apical periodontitis, periodontal abscess and endodontic-periodontal lesions, pericoronitis and post-operative problems.When the patient seeks the dentist suffering from acute dental pain, they expect that the dentist starts treatment at once and that the treatment should provide pain relief. In this situation many patients are fragile, anxious and nervous. If the dentist is able to manage emergency treatment of acute dental pain thiswill build confidence and trust between patient and dentist. However, often the dentist does not have sufficient time to carry out more timeconsumingprocedures. This paper provides a guide for rational emergency treatments. Itdescribes how or whether the entire treatment or a less time-consuming pain relieving procedure should be carried out. The administration of local anaesthesia, the role of antibiotics and analgesics is discussed.",

author = "Peter Jonasson and Lise-Lotte Kirkevang and Annika Rosen and Lars Bj{\o}rndal",

year = "2016",

language = "English",

volume = "120",

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issn = "0039-9353",

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T1 - Acute dental pain II

T2 - pulpal and peripical pain

AU - Jonasson, Peter

AU - Kirkevang, Lise-Lotte

AU - Rosen, Annika

AU - Bjørndal, Lars

PY - 2016

Y1 - 2016

N2 - Acute dental pain most often occurs in relation to inflammatory conditions in the dental pulp or in the periradicular tissues surrounding a tooth, but it is not always easy to reach a diagnose and determine what treatment to perform. Theanamnesis and the clinical examination provide valuable information, and a systematic approach is necessary. This paper will focus on diagnosis and treatment of pulpitis, pulp necrosis and apical periodontitis, periodontal abscess and endodontic-periodontal lesions, pericoronitis and post-operative problems.When the patient seeks the dentist suffering from acute dental pain, they expect that the dentist starts treatment at once and that the treatment should provide pain relief. In this situation many patients are fragile, anxious and nervous. If the dentist is able to manage emergency treatment of acute dental pain thiswill build confidence and trust between patient and dentist. However, often the dentist does not have sufficient time to carry out more timeconsumingprocedures. This paper provides a guide for rational emergency treatments. Itdescribes how or whether the entire treatment or a less time-consuming pain relieving procedure should be carried out. The administration of local anaesthesia, the role of antibiotics and analgesics is discussed.

AB - Acute dental pain most often occurs in relation to inflammatory conditions in the dental pulp or in the periradicular tissues surrounding a tooth, but it is not always easy to reach a diagnose and determine what treatment to perform. Theanamnesis and the clinical examination provide valuable information, and a systematic approach is necessary. This paper will focus on diagnosis and treatment of pulpitis, pulp necrosis and apical periodontitis, periodontal abscess and endodontic-periodontal lesions, pericoronitis and post-operative problems.When the patient seeks the dentist suffering from acute dental pain, they expect that the dentist starts treatment at once and that the treatment should provide pain relief. In this situation many patients are fragile, anxious and nervous. If the dentist is able to manage emergency treatment of acute dental pain thiswill build confidence and trust between patient and dentist. However, often the dentist does not have sufficient time to carry out more timeconsumingprocedures. This paper provides a guide for rational emergency treatments. Itdescribes how or whether the entire treatment or a less time-consuming pain relieving procedure should be carried out. The administration of local anaesthesia, the role of antibiotics and analgesics is discussed.

M3 - Review

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EP - 127

JO - Tandlaegebladet

JF - Tandlaegebladet

IS - 2

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ER -

Acute dental pain II: pulpal and peripical pain

Abstract

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