single visit tics (sve)

8/6/2019 Single Visit tics (Sve)

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SINGLE VISIT

ENDODONTICS (SVE)

presented by

Dr Binu P


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y 1 .Introduction

y 2.Indications

y 3.Contra indicationsy 4.Advantages

y 5.Dis advantages

y 6.Conclusion


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INTRODUCTIONy Cleaning, shaping ,disinfection followed by obturation

at same appointment.

y Concept of SVE started at least 100 years back.y studies shown that SVE show

-no difference in quality of the treatment

-success rate

-incidence of postoperative complications.


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Factors for not performing SVE

y Doubt of postoperative pain.

y Fear of failure of the endodontic therapy.

y Discomfort to patient-mouth open for a long period.y Lack of time.

y Lack of experience and equipment.


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y 5.Teeth with limited access

y 6.Nonsurgical retreatment cases

y 7.Medically compromised requiring antibioticprophylaxis

y 8.Physically compromised who cannot come

frequently


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Contraindicationsy 1.Non vital teeth with apical periodontitis

y 2.Acute abscess requiring I n D

y 3.Severe pain when tooth is lightly touchedy 4.Weeping canals


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y 5.Re treatment cases

y 6.Cellulitis

y 7.In sufficient timey 8.Incompetence of dentist

y 9.Stress on TMJ musculature


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Advantages of SVE

y 1.Convenience: no repetitive LA, treatment procedureand postoperative recovery

y 2.Efficiency:no need to refamiliarize with anatomy orlandmarks.

y 3.Patient comfort: reduced number of visits andinjections


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y 4.Reduced intra-appointment pain: no mid treatmentflare-ups due to leakage of the temporary cements.

y5.Economics:

- no extra cost of multiple visits

-use of fewer materials

-comparatively less chair side time.

y 6.Minimizes the fear and anxiety


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y 7. Reduces incomplete treatment: Some patients dontreturn to complete RCT.

y 8.Lesser errors in working length

y 9.Restorative consideration: immediate placement of

restoration - effective coronal seal and esthetics.


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y Mechanical instrumentation alone causes 100-1000fold reduction in bacteria (Bystrom,Sundqvist 1981)

yIf some bacteria are left after adequate obturation theyare

-entombed

-subjected to reduced nutritional conditions

-incapable of reaching vital tissues-rendered non-viable by canal medications


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yAll vital cases should be done SVE for less post-op pain

-all temporary filling materials leak-any reduction of bacteria in I st visit repopulates in

2 nd visit

-toughest cases to achieve success are fungally

infected


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Disadvantages

y 1.Patients keep their mouth open for long durations

y 2.If mid treatment flare-ups occur- difficult to remove

filling material.y 3.Clinician may lack proficiency to perform SVE.

y 4.Very fine, curved, calcified, multiple canals,hemorrhage or exudation-SVE not done


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y 5.Clinician fatigue

y 6.No opportunity to place an intra canal medicament


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Criteria ofCase Selection

y 1.Competence of the clinician: Clinician - liability toperform all steps in SVE.

y 2.Positive patient acceptance: Patient should becooperative for SVE

- TMJ problems, limited mouth opening- avoided.

y 3.Absence of anatomical interferences: fine, curved orcalcified canals require more time.


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y 4.Accessibility: sufficient accessibility and visibility

eg:- anterior teeth are more accessible.

y 5.Availability of sufficient time to complete the case:

-for both clinician as well as patients

y 6. Pulp status: Vital teeth are better candidate for SVE- less flare-ups


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y 7.Clinical symptoms: Teeth with acute alveolar abscessshould not be treated by SVE

teeth with sinus tract are good candidate for SVE.


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Criteria of case selection -Oliety 1.Positive patient acceptance

y 2.Absence of acute symptoms

y 3.Absence of continuous hemorrhage or exudationy 4.Absence of anatomical interferences like

fine, curved or calcified canals.

y 5.Availability of sufficient time to complete the case

y 6.Absence of procedural difficulties like canal

blockage, ledge formation or perforations.


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Conditions where SVE cannot be

Performedy 1.Teeth with anatomic anomalies such as calcified and

curved canals.

y

2.Asymptomatic non vital teeth with periapicalpathology and no sinus tract

y 3.Acute alveolar abscess with frank pus discharge

y 4.Patients with acute apical perodontitis


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y 5.Symptomatic non vital teeth and no sinus tract.

y 6.Retreatment cases

y 7.Patients with allergies or previous flare-upsy 8.Teeth with limited access

y 9.Patients unable to keep mouth open for long time-TMJ disorders.


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conclusiony SVE- effective treatment modality, when compared to

multiple-visit therapy

y

Beneficial to patients and dentists in many waysprovided there is careful cases selection and adherenceto standard endodontic principles


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single visit tics (sve)

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