Emergencies in endodontics

Hitna stanja u endodonciji uključuju prije svega simptome boli i otekline, a uzrokovana su najčešće bolestima pulpe i periapikalnog područja, kao i traumatskim ozljedama zuba. Zadaća doktora dentalne medicine jest ukloniti bol, a to može jedino dijagnosticiranjem uzroka boli. Za postavljanje dijagnoze neophodno je uzimanje iscrpne anamneze, pažljiv klinički pregled, kao i primjena različitih dijagnostičkih metoda (testovi vitaliteta, rtg i dr.). Postavljanje dijagnoze nije uvijek jednostavno zbog varijacija kliničke slike, kao i zbog toga što bol odontogenog izvora može iradirati u udaljena područja, ali i obrnuto. Osnovni je princip terapije potpuno uklanjanje ili redukcija podražaja koji su doveli do nastanka bolesti. Potrebno je ukloniti patološki promijenjenu pulpu, instrumentirati korijenske kanale uz adekvatnu primjenu kemijskih sredstava, osigurati drenažu periapeksnog eksudata te pripremiti endodontski prostor za punjenje kanala. Također je potrebno pacijentu objasniti sve potencijalne komplikacije endodontske terapije i dati postoperativne upute te ordinirati odgovarajuću farmakoterapiju.Emergencies in endodontics include primarily the symptoms of pain and swelling and are mostly caused by the disease of pulp and the periapical area, as well as traumatic dental injuries. The responsibility of a Doctor of Dental Medicine is to remove the pain, which can be done only by identifying its cause. Proper diagnosis includes patient's detailed medical history, physical examination and various diagnostic tests (such as vitality testing, RTG test etc.). The diagnosis is not always straightforward due to variations in the clinical picture and the fact that the source of odontogenic pain can spread into other areas. The basic principle of the treatment is to completely eliminate or reduce the stimuli which led to the occurrence of the disease. It is necessary to remove the pathologically altered pulp, begin the instrumentation of the root canals with the appropriate application of chemical substances, ensure drainage of periapical exudation, and prepare the endodontic space for root canal filling. Also, the patient needs to be informed of all potential complications of the endodontic treatment, as well as be given post-operative instructions and administered appropriate medical therapy