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Post Operative Pain

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30 views28 pages

Post Operative Pain

Uploaded by

m.mohammed5701
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Post operative pain

Pain is described as an unpleasant


sensation and emotional experience
associated with actual or potential
tissue damage.

Pain mostly warns that there


is a degree of tissue damage
taking place and the
correction is necessary
Pain is usually felt whenever a stimulus just
exceeds the pain perception threshold of the
stimulated part under given condition
Diagnosis of post operative pain
The character of the pain:-
dentinal pain &
hypersensitivity have
normal radiographical
archeticture

Sweet and
sour
Intensified by Mild to
thermal moderate
changes pain
Causes of post operative pain

local the operative the restorative


Preoperative
anaesthesia phase phase

Post operative causes


A) Preoperative causes:-

1- Improper diagnosis (History, visual, tactile)


2- Instruments contamination
B) Causes related to local anaesthetic problems:-

Postoperative complications :-
1- soreness
The reaction may vary from slight
discomfort after an infiltration to pain
on opening the mouth after an
inferior alveolar injection.
2- pain may persist for several days.

 The degree of trauma produced depends on


the application technique, and how carefully
the operator delivers the anaesthetic solution.
3- discoloration and tenderness at the area of
injection which is usually tender.

4- Haematoma is a result of trauma and a


subsequent extravasation of the blood into
surrounding tissues
c) Operative causes
1- Actual cutting in dentin

Exposes 30000 to 45000 dentinal tubules

fluid movement in these DT stimulating nerve


damage
2- Using of dull instruments
( increases pressure, heat generation, dentin dehydration)

 Proper cooling is mandatory for elimination of


excessive heat generated with the rotary
instruments.
3- Excessive pressure:

This might cause actual aspiration of nuclei into the


tubule
4- Dentin desiccation:
Caused by :-
1- Overheating of dentin during cutting,
2- Use of chemicals to sterile the cavity and/or
use of excessive air as a coolant for final cavity
toilet.

These factors cause water imbalance in


dentin
5- improper isolation.

Contamination, affect properties of materials


d) Causes related to restorative phase
Resin Composite
1- Polymerization shrinkage of the resin
composite:
Techniques to overcome polymerization shrinkage:

1- Composite insertion techniques


2- Use of stress absorbing intermediate layer.
3- Modification in composite resin formulation.
Low shrinkage composite ( Ring opening
polymerization).

Use high molecular Wt monomers (Dimer –


acid dimethacrylates.)

prepolymerized additives as nanogels.


2- Under-cured resin:
Causes :-
1- The light source is not significantly close to the
surface of the material being polymerized.

2- The light source is of insufficient intensity.

3- The light is attenuated by passage through


restoration or structure.
Consequences of under cured resin :-

1-Bending of the outer layer, inward


displacement, marginal fracture or open margin.

2- Chemical toxicity most often results from the


monomer or the bonding agent which leaches
out from the incompletely cured composite.
3- Faulty bonding procedures :-

Failure to stick to the recommended etching


time, etchant concentration, priming and
bonding technique cited by the manufacturer

Post operative pain & improper bonding


Amalgam Restoration
(Lining due to thermal conductivity, Galvanism)

E) Post operative causes:-

1- Restoration finishing and polishing


2- Fractured restoration:
During mastication

The fracture line usually opens up allowing oral


fluids and oral microbes which cause movement
of dentinal fluids and hypersensitivity.
3- Cuspal strain:
When the continuity of enamel layer is broken,
tooth rigidity is significantly reduced.

Deformation in response to loading increases.


Cuspal strain may result in adhesive failure (fatigue
failure of the resin bond) or cohesive failure (fracture
of restoration and/or tooth structure).
Management

1- large class II MOD cavities are ideally restored with


restorations that include cuspal coverage.
4- Faulty occlusal and proximal contact relationships
 High occlusal contact:
- high spot is on the marginal ridge of an amalgam
causing fracture.
- If the traumatic occlusion persists, some mobility may
develop.

 A light or open proximal contact:-


- may result in food impaction with gingival
inflammation & Interproximal bone lose.
- Correct by replacing the restoration.

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