LEARN TO DO INTRAORAL INCISION & DRAINAGE PT. 1 | OnlineExodontia.com
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- Опубліковано 2 жов 2024
- This video discusses the rationale for incision and drainage procedure to assist in the resolution of dental infections.
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This channel deserves a lot more views. These videos are excellent!
Thank you for your kind words!
Very informative doc, where is part 2?
Great explanation Doc. Thank you for sharing the information.
Where can i find part 2??
What if the buccal tissue has a fluctuant swelling but the vestibule does not? I had a case like that where I made an incision in the vestibule area near the suspected tooth and no puss came out?
Doc!
Say a patient has a necrotic tooth with a periapical abscess! In that case local anesthetic won't work or do the nerve block works!?
And also as u said, antibiotics are not gonna work due to less blood supply there! If that's the case then no point in giving a prophylactic antibiotic one day prior to extraction
So how to intervene?
How to combat the problem of anesthetising and draining the abscess? As periapical abscess is a confined one we can't do I and d
Can u give me a little insight
By the way ur vedios are my go to list for exodontia!!! Thank u so much for helping the budding new dentist out here!
Great to hear that you're enjoying the videos! Whenever possible in these situations, do a block, then just prior to extracting the tooth once the block has set in, go ahead and do PDL injections at the line angles of the tooth in question. Upper teeth typically respond well to palatal PDL injections to supplement the blocks and get the teeth out without issue. There are very few situations where you would not be able to get a tooth adequately numb for extraction using this approach. Also, if you have the luxury instruct the patient to take some NSAIDS prior to their appointment as this will help the anesthetic by decreasing inflammatory mediators. All the best!
@@OnlineExodontia omg!! Thank u sooo muchhh!!! I'll surely have these in my mind...
Really, it's your vedios which gave some confidence and insight when it comes to exodontia!
I'm too, so Gald that i found your channel! And my best wishes for u to reach greater heights.. Doc...
@@bhargavi368 Thanks and same to you!
First comment,
Liked and Subscribed :)
Thankyou
Amox 500 and metronidazole 250 combo usually wipes out everything
Did you not listen to the start of the video?
@@alexwong3940 I drain but that rx combo is solid. Lot of docs give amox or augmenten which is bs. I didnt mean to say rx is better
@@iddicted Apologies. In the UK our guidance says to give Pen-V as a first line antibiotic (because its narrower action is thought to be less likely to lead to antimicrobial resistance), but only if there are signs of spreading infection. Problem is it's more likely to give side effects than amox or metro
@@alexwong3940 I've personally never given that so I can't say but the hospitals prescribe that to dental patients. I use amox metro only in swellings or abscess. Cheers doc
what about draining a gingival abscess on lingual side of mandibular molars? how to do so without injuring the lingual nerve?
Dan - it’s important any time that you’re working on the lingual to stay under the periosteum. Don’t go incising straight through the tissue, but rather use an instrument to open a mini envelope flap starting at the gingival crest. Keep your periosteal or whatever you’re using in intimate contact with the bone as you go apically. The lingual nerve is often close to the height of the bony crest in the third molar region then it dives down as it moves forwards. All the best!
what if the swelling is indurated?
Ghaith - great question. In these situations you're sort of pre-abscess so to speak and moreso dealing with cellulitis. Once the immune response kicks in that should often become more fluctuant and isolated. When you have a firm swelling that appears to be of odontogenic origin and you feel that I & D is indicated based on the health of your patient and clinical presentation, I would by all means consider doing so. This will provide a pathway for drainage in the future so that you don't get a space filling up with pus. In these situations you'll see lots of bleeding, often minimal pus, but you're still doing the patient a favour. All the best!
But if there is a sinus tract and indurated swelling
It still needs I& D
Thanks for your comment Mohamed! Can you shed more light on the rationale for what you have proposed? All the best!
Once I and D was done , do we need to suture the incision that has been made? Thaaaanks!!
No, you do not need sutures intraorally as you are basically just making a puncture wound that will close on its own. You may add a suture if you are placing a drain however. All the best!
@@OnlineExodontia yes you are right! I already read some books while waiting for your reply haha thanks by the way. Merry Christmas!
Great approach! where can I get one of these exact skull? do you have a link?
I found it on eBay Mehrdad, however it was a while back and I can't seem to find the exact link. This would be something similar I believe:
www.ebay.com/sch/i.html?_from=R40&_nkw=human+skull+replica&_sacat=185285
Sorry I can't remember the exact one and it's too far back to see in my purchase history. Hopefully that is of some help. All the best and thanks for watching!