Forside Udskriv

Dr. Franco

Dr. Caroline Naval Franco D.M.D
Naval Dental Clinic
11 G Fernando Ave San Rogue
Marikina City 1801
Philippines

E-mail: carole@navaldental.com
Web: www.navaldental.com
 

CLINICAL CASE 1: Acute Apical Periodontitis with Soft Tissue Swelling

A 52 year old female patient consulted the clinic with a complaint of intense pain on tooth #32 radiating all the way to the posterior buccal area for more than 2 days.

Intra-oral examination revealed a soft tissue swelling at the buccal area of the left side of the alveolar bone. Tooth #32 was very painful to palpation & percussion. It also had a big composite restoration with discoloration. Periapical radiograph revealed a diffused radiolucency at the periapical region of tooth #32. Patient has been taking analgesics but with no relief.

Because the patient was afebrile with no extraoral swelling, endodontic therapy was the treatment of choice with FotoSan® therapy.

  
Access was initiated without local anesthesia. Routine endodontic therapy was done using Protaper hand files. 0.2ml of the FotoSan® low viscosity agent was introduced into the canal and illuminated for 3 cycles of 30 seconds. After 3 cycles of illumination, patient reported that the tooth was not that painful anymore except for the soft tissue swelling. The canal was cleaned, dried and sealed with no intracanal dressing. Patient was advised not to take any antibiotics but may take analgesics if needed only. Patient was seen every 3 days for irrigation of the root canal with FotoSan®. On the third visit, no soft tissue swelling was almost gone. On the 12th day, the root canal was dry and asymptomatic and so obturation was done using Soft-Core obturator system.

 
 

CLINICAL CASE 2: Localized Periodontitis

A 40 year old male patient visited the clinic with an uncomfortable feeling between tooth nos. 17 and 18. He also felt that the gums in between the two teeth were swollen.

  
Intraoral examination revealed a swollen buccal interdental gingival between the tooth nos. 18 & 17. The teeth was negative to percussion but was tender on palpation. Deep scaling was initiated followed by FotoSan®.

The patient was asked to come back after 4 days for follow up. However, patient did not return to the clinic but relayed the message that his gums were alright and there was no uncomfortable feeling after 24 hours
 
 

CLINICAL CASE 3: Deep-seated cavity with associated hypersensitivity

Intraoral examination revealed a prepared tooth no. 47 with caries on the distal proximal area and pit caries on the occlusal and buccal. Just by opening the mouth, the patient felt the sensitivity already but was negative on percussion.

  
Mandibular block anesthesia was administered to control sensitivity during cavity preparation. However, patient still complained of intensed sensitivity during drilling when deep portion of the cavity was reached. Manual excavation of leathery dentin was done only until the point when the patient can tolerate the sensitivity when the metal touched dentin. FotoSan® was used using medium viscosity photosensitizer and was illuminated for 2 cycles of 10 seconds. Glass ionomer was the restoration of choice. Patient was asked to report to the clinic the next day. On follow up, the patient said that no sensitivity was felt when the anesthesia wore off and that she was able to use the tooth for chewing.

 
 

CLINICAL CASE 4: Apthous Ulcer

A 29 year old female patient consulted the clinic regarding a very painful apthous ulcer located at the mucosa of the lowe lip area that has been bothering her for 3 days. Intraoral examination revealed a big apthous ulcer with a red, erythematous margin and an ulcerated center.

  

Patient reported that there was no more painful sensation right after FotoSan® therapy. After one day, patient reported to the clinic, still no pain and the apthous ulcer showed signs of tissue healing (no more ulcerated center).
 

CLINICAL CASE 5: Dry Socket

A 54 year old patient consulted the clinic regarding a painful post-tooth extraction wound and a heavy feeling radiating from the extraction wound all the way to the posterior area of the mandible. History revealed patient underwent tooth extraction 4 days earlier of tooth no.44 with no difficulty and was given mefenamic acid 500mg every 8 hours and cefalexin 500mg every 8 hours for 4 days post-op.
Introral examination revealed that the old blood clot was too dark, extraction site was still hollow and had a foul odor. When rinsing with water, patient felt discomfort at the wound site. Treatment of wound debridement and FotoSan® was explained to the patient and that she had to stop the antibiotic medication given to her. Analgesics may be taken only when needed.

  
The old blood clot was removed and new bleeding was initiated. Normal saline solution was used to irrigate the wound and after drying FotoSan® agent of medium viscosity was introduced into the extraction site. The wound was illuminated for 2 cycles of 10 seconds.



Patient was recalled after 4 days for follow up. On follow-up, patient reported that on the evening of the day after treatment, pain and the heavy feeling was gone. She felt a lot better especially the day after. Intraoral examination revealed the extraction site healed normally.
 

FotoSan®