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Abstract: This is a case of a 40-year-old female patient who came to our hospital with severe tooth pain and a serious impact on sleep quality. Through specialist examination and intraoral films, she was diagnosed with pulpitis and communicated with the patient to improve it by means of root canal treatment. The patient was very satisfied with the treatment result.
Basic information】Female, 40 years old
Disease Type】Pulpitis
Hospital】The Second Affiliated Hospital of Nanchang University
Date of Consultation】January 2022
Treatment plan] Endodontic treatment (pulp drainage + sealer + root canal preparation + root canal sealer + root canal filling + crown restoration)
[Treatment Period] About 1 month for root canal treatment, follow up after 6 months
Treatment effect] The tooth pain disappeared and the pulpitis was cured.
I. Initial consultation
In January 2022, a 40-year-old female patient came to the hospital with severe pain in her left upper posterior tooth, which was so severe at night that she could not sleep. The patient reported that the tooth had been treated with a filling in another hospital 2 years ago and the filling was completely lost. 3 days ago, she developed pain from hot and cold irritation, which was spontaneous and caused ipsilateral head and facial radiating pain and affected her sleep. The physical and dental examination found that: 26 adjacent cavities, caries cavities or defects that invade to the pulp cavity can be seen with the naked eye (caries to the pulp cavity tissue exposing the pulp and causing bacterial attack causing pulpitis, severe pain under hot and cold stimulation, and the pain has a tendency to increase), the pain is obvious when probing into the cavity, cold water reaction is also obvious discomfort, no obvious discomfort on percussion, no loosening of the tooth, a small amount of soft tartar around the gingival margin of the tooth. A small amount of soft tartar around the gingival margin. The intraoral small tooth film showed that 26 distal and middle adjacent jaw caries had reached the pulp cavity, and the image of translucent area with reduced density was seen at the edge, and the bone in the apical area was not abnormal. After the complete examination, the patient’s condition was evaluated, and the patient was diagnosed as pulpitis according to the clinical manifestations and auxiliary examinations, and the patient had no special contraindications. The patient agreed to the treatment plan after communicating with the patient and explaining the situation of the affected tooth, treatment plan and related costs.
II. Treatment process
After the patient agreed to the treatment modality and signed the informed consent form, preoperative intraoral photographs were taken of the patient. The patient was then anesthetized and the affected tooth was opened and drained, and the patient was instructed to drain the tooth for 3 days and to seal the inactivator after 3 days. After 7-10 days, the patient was seen again to remove the inactivator, root canal preparation was performed, the affected tooth was flushed and disinfected, and the root canal diameter was subsequently enlarged and sealed by the root canal, and a tight root canal filling was performed after 1 week of sealing. After filling, the morphology and occlusal function of the closed tooth were restored to the natural state of the tooth itself, and a crown restoration was performed 1-2 weeks after the root canal filling treatment.
III. Treatment results
The patient recovered from the pulpitis and healed through aggressive root canal treatment as prescribed by the doctor. The root canal treatment resolved the painful sensitivity of the tooth and preserved the tooth from the risk of extraction. At the follow-up visit after six months, the patient said that the tooth pain disappeared completely, and the hot and cold sensitivity also disappeared, and there was no recurrence of tooth pain, and the quality of sleep at night was effectively improved, so he was very satisfied with the treatment and restoration effect.
IV. Notes
We are glad that the patient was able to repair the pulpitis and eliminate the tooth pain through active and regular treatment. However, the following matters still need to be noted.
1. Regular maintenance to prevent recurrence. Due to the insidious and destructive nature of the disease, it often leads to chronic progressive irreversible destruction of the teeth, so regular review and maintenance should be strengthened.
2. Pay attention to oral hygiene and cleanliness in general, develop good brushing habits and correct brushing methods, and maintain good dietary habits to avoid causing recurrence of pulpitis or leading to other dental infections.
V. Personal insight
Pulpitis is usually triggered by inflammatory infection, and the disease is insidious and destructive, often leading to chronic progressive irreversible destruction of teeth, to achieve early prevention, early diagnosis, early treatment, to avoid continued aggravation of symptoms. If there is tooth pain and discomfort, it is important to seek timely medical attention, as in the case of this patient, so that pulpitis can be treated actively and effectively through regular treatment. Even if pulpitis is in remission, it is important to pay attention to dental care in daily life, avoid excessive hot and cold stimulation, and maintain good and correct brushing habits to prevent recurrence.