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8/6/2019 Single Visit tics (Sve)
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SINGLE VISIT
ENDODONTICS (SVE)
presented by
Dr Binu P
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y 1 .Introduction
y 2.Indications
y 3.Contra indicationsy 4.Advantages
y 5.Dis advantages
y 6.Conclusion
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INTRODUCTIONy Cleaning, shaping ,disinfection followed by obturation
at same appointment.
y Concept of SVE started at least 100 years back.y studies shown that SVE show
-no difference in quality of the treatment
-success rate
-incidence of postoperative complications.
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Factors for not performing SVE
y Doubt of postoperative pain.
y Fear of failure of the endodontic therapy.
y Discomfort to patient-mouth open for a long period.y Lack of time.
y Lack of experience and equipment.
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y 5.Teeth with limited access
y 6.Nonsurgical retreatment cases
y 7.Medically compromised requiring antibioticprophylaxis
y 8.Physically compromised who cannot come
frequently
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Contraindicationsy 1.Non vital teeth with apical periodontitis
y 2.Acute abscess requiring I n D
y 3.Severe pain when tooth is lightly touchedy 4.Weeping canals
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y 5.Re treatment cases
y 6.Cellulitis
y 7.In sufficient timey 8.Incompetence of dentist
y 9.Stress on TMJ musculature
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Advantages of SVE
y 1.Convenience: no repetitive LA, treatment procedureand postoperative recovery
y 2.Efficiency:no need to refamiliarize with anatomy orlandmarks.
y 3.Patient comfort: reduced number of visits andinjections
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y 4.Reduced intra-appointment pain: no mid treatmentflare-ups due to leakage of the temporary cements.
y5.Economics:
- no extra cost of multiple visits
-use of fewer materials
-comparatively less chair side time.
y 6.Minimizes the fear and anxiety
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y 7. Reduces incomplete treatment: Some patients dontreturn to complete RCT.
y 8.Lesser errors in working length
y 9.Restorative consideration: immediate placement of
restoration - effective coronal seal and esthetics.
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y Mechanical instrumentation alone causes 100-1000fold reduction in bacteria (Bystrom,Sundqvist 1981)
yIf some bacteria are left after adequate obturation theyare
-entombed
-subjected to reduced nutritional conditions
-incapable of reaching vital tissues-rendered non-viable by canal medications
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yAll vital cases should be done SVE for less post-op pain
-all temporary filling materials leak-any reduction of bacteria in I st visit repopulates in
2 nd visit
-toughest cases to achieve success are fungally
infected
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Disadvantages
y 1.Patients keep their mouth open for long durations
y 2.If mid treatment flare-ups occur- difficult to remove
filling material.y 3.Clinician may lack proficiency to perform SVE.
y 4.Very fine, curved, calcified, multiple canals,hemorrhage or exudation-SVE not done
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y 5.Clinician fatigue
y 6.No opportunity to place an intra canal medicament
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Criteria ofCase Selection
y 1.Competence of the clinician: Clinician - liability toperform all steps in SVE.
y 2.Positive patient acceptance: Patient should becooperative for SVE
- TMJ problems, limited mouth opening- avoided.
y 3.Absence of anatomical interferences: fine, curved orcalcified canals require more time.
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y 4.Accessibility: sufficient accessibility and visibility
eg:- anterior teeth are more accessible.
y 5.Availability of sufficient time to complete the case:
-for both clinician as well as patients
y 6. Pulp status: Vital teeth are better candidate for SVE- less flare-ups
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y 7.Clinical symptoms: Teeth with acute alveolar abscessshould not be treated by SVE
teeth with sinus tract are good candidate for SVE.
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Criteria of case selection -Oliety 1.Positive patient acceptance
y 2.Absence of acute symptoms
y 3.Absence of continuous hemorrhage or exudationy 4.Absence of anatomical interferences like
fine, curved or calcified canals.
y 5.Availability of sufficient time to complete the case
y 6.Absence of procedural difficulties like canal
blockage, ledge formation or perforations.
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Conditions where SVE cannot be
Performedy 1.Teeth with anatomic anomalies such as calcified and
curved canals.
y
2.Asymptomatic non vital teeth with periapicalpathology and no sinus tract
y 3.Acute alveolar abscess with frank pus discharge
y 4.Patients with acute apical perodontitis
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y 5.Symptomatic non vital teeth and no sinus tract.
y 6.Retreatment cases
y 7.Patients with allergies or previous flare-upsy 8.Teeth with limited access
y 9.Patients unable to keep mouth open for long time-TMJ disorders.
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conclusiony SVE- effective treatment modality, when compared to
multiple-visit therapy
y
Beneficial to patients and dentists in many waysprovided there is careful cases selection and adherenceto standard endodontic principles
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