ASEPSIS : By rubber dam placement or isolation or by sterilization of instruments.
- APPLICATION OF RUBBER DAM :
- To maintain a safe and aseptic operating field .
- Only safeguard against the bacterial contamination from saliva and swallowing of root canal instruments.
2. STERILIZATION :
- Cold sterilization
- Hot salt sterilization
- Glass bead sterilization
- Direct flaming
- Autoclaving
- Dry heat oven
a) DEBRIDEMENT OF ROOT CANAL :
- Infected root canal must be cleaned of debris .
- All the necrotic tissue should be removed from the root canal as it encourages bacterial growth.
- Instrumentation and irrigation is required for complete debridement .
- Sodium hypochlorite or any other irrigant should be used for irrigation.
b)DRAINAGE :
- Drainage should be done when gross infection or swelling is present.
- In case of acute alveolar abscess drainage should be done either through root canal or by incision or both .
- Drainage is established by preparing a cavity lingually on anterior teeth and occlusally on posterior teeth.
c) IMMOBILIZATION :
- Done to allay pain and promote healing .
- It reduces the potential for spreading of microorganisms.
- Also reduces trauma to PDL.
d)ATRAUMATIC PROCEDURES :
- All traumas should be avoided.
- Soft tissues should be handled carefully and gently.
- Instrument should not be passed beyond apical foramen.
- Radiograph should be carefully studied.
e)TERPHINATION:
- Means relieving pain.
- Biterphination means creating of a surgical passage in the region of the root apex for escape of pus or blood to relieve the pressure of accumulated pus or gas in jaw bone.
- Done in case of acute alveolar abscess .
f)CHEMO PROPHYLAXIS:
- If the patient has history of rheumatic fever or valvular heart disease , an antibiotic such as phenoxy -methyl penicillin 2 g 1 hour before and 1 g 6 hour after the operation should be given.
References: GROSSMANS TEXBOOK
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