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Endo Complex Case Treatment Planning

patient evaluation and diagnosis

• patient history
  • chief complaint and pain history
  • med hist
  • dental hist
• clinical exam
  • extra oral
    • swelling, asymmetry, tenderness
  • intraoral
    • cavity fracture, larg resto
    • gingiva, mucosa, colour erythema oedema, sinus tract, PPD
  • percussion
  • palpation
  • fracture assessment
  • check for mobility
• pulp testing
  • cold
  • hot
  • ept
  • selective anaesthetic
• radio
  • intra oral
  • CBCT
• diagnosis
  • typical diagnosis
  • other
    • TMD, sinusitis, referred pain from ear or jaw,
    • head and neck trauma, trigeminal neuralgia
• treatment plan

Evaluation and Diagnosis

British Endo Soc guide to good endo practice

Dental trauma

Mejare et al 2012

• due to the crude nature of pulp testing and lack of available quality evidence for their precision
• results from pulp tests must always be viewed with a degree of scepticism and put into context with other information gathered about the condition

Oral Medicine Pathology, Oral Cancer

Oral Cancer Update

Global and Regional Overview

• Oral cancer ranks 13th globally in incidence, with 377,713 new cases and 177,757 deaths in 2020.
• In Southeast Asia and the Western Pacific, high incidence is linked to smokeless tobacco and areca nut (betel quid) use.
• HPV16 accounts for about 2% of global oral cancer cases.
• In Victoria, Australia, oral cancer causes 16 new diagnoses and 3 deaths per week.
• Incidence is projected to increase by 12.8% by 2025.

Risk Factors

• Tobacco (smoked and smokeless), heavy alcohol consumption, and betel quid chewing are major contributors.
• Quitting these habits significantly reduces risk over time.

Prevention Strategies

Primary Prevention

• Behavioural and pharmacologic interventions to stop tobacco, alcohol, and betel quid use.

Secondary Prevention

• Clinical Oral Examination (COE) is the main screening method.
  • Sensitivity: 50–99%
  • Specificity: 75–99%
• Biomarkers in breath, blood, and saliva are being researched but not yet reliable.