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Endo Questions for the RWE Faculty:

In this area, users are encouraged to ask questions from the RWE Faculty regarding Endodontics in General and the EndoSequence Technique.

Endo Questions for the RWE Faculty:: Ensodontic abcess

Missing

Joined: November 2017

Rank: Rookie

Posts: 3

#1
Excuse me dr allen its my first post here and i want to know how to deal with endodontic abcess ??
Allen_ali_nasseh

Joined: August 2013

Rank: Faculty General

Posts: 221

#2
In reply to ahmed lotfy You need to be more clear. Abscess after a root canal? Or a non-endo treated tooth with an abscess?
Missing

Joined: November 2017

Rank: Rookie

Posts: 3

#3
Non endo treated tooth with abcess and pus formtion ?? Is it true that we cant use sodium hypoclorite in first appointement as sodium hypoclorite will react with pus and and block apical third
Allen_ali_nasseh

Joined: August 2013

Rank: Faculty General

Posts: 221

#4
In reply to ahmed lotfy It’s not true. I’ve been using NaCLO in 100% of cases in decades and have never experienced this. 
This is just an academic bad advice. Most blockage is due to poor instrumentation technique and debris management, not instruments themselves and most definitely not the standard irrigants.  
Cheers!
Missing

Joined: November 2017

Rank: Rookie

Posts: 3

#5
Thank you dr allen. Im waiting pan arab endodontic conference to gain more knowledge from you doctor (right way of endodontic treatment )
Img_20171129_234623

Joined: December 2017

Rank: Rookie

Posts: 2

#6
In reply to ahmed lotfy Sir ask u.. The what is the best.. Sequence... Of irrigation.solution.. In rct during bmp ... In abscess case... How many duration... Caoh need... Close dressing.... ..some tell me.... Use between triple antibiotic paste in caoh... Dressing. What is the best way.... We do pt have no pain ..... Hw we can manag abscess case.... Can we use both sodium hypochloride &chlorohexidine.. Irrigation....together... In bmp If yes than how...
Allen_ali_nasseh

Joined: August 2013

Rank: Faculty General

Posts: 221

#7
In reply to Dr.Gaurav Shastri Avpiding post op pain is not a function of irrigation solutions or sequence. It’s a function of instrumentation protocol that both allows adequate drainage (decompression) and reduces debris extrusion! The latter is very important. Post op pain is often a function of old, hand and instrument motions that cause a piston effect in the canal and push debris out. The extruded debris causes post op pain. 
Therefore, crown down protocols and minimizing engagement time while frequently flushing out debris is a criticial part if instrumentation. Irrigation solutions are important for disinfection but more important to post op pain control is instrument motions. 
I use water, EDTA and lots of ultrasonics in the first phase and then full strength NaClO during the second phase. In severely infected cases Ca(OH)2 is recommened. Triple AB paste is not nec ssary in most cases when proper instrumentation is acheived. 
Cheers!
Img_20171129_234623

Joined: December 2017

Rank: Rookie

Posts: 2

#8
In reply to Allen Ali Nasseh Oh... Thanks allen Some use chlorohexidine 2% last irrigation solution.. But I ask u ca(OH)2 use... Duration of change Dressing.. Some doctor stop the dressing in one week some 1month some after compelet heal periapical lesion What is correct time to obdurate the canal What is best way..
Allen_ali_nasseh

Joined: August 2013

Rank: Faculty General

Posts: 221

#9
In reply to Dr.Gaurav Shastri I personally use it for a one week duration and then fill from there, unless there's an issue. At the point of fill, I'm certain I've found all the canals and have achieved length and adequate apical width in all situations. Otherwise I won't fill. So, the Ca(OH)2 is helping disinfect some more while I'm still doing the traditional work of cleaning the canals adequately with instrumentation and irrigation. 
Cheers!