1. Treatment Planning &
Seminars
Case Presentation
By Mohsen Mazhari
[200811361]
Nadim Ahmad
[200810082]

2. «29 year old lady presented with massive acute
onset swelling on right hand side cheek. The
swelling was diffuse, hot and tender and followed
Root Canal Treatment visit of Upper Right Second
Premolar.
Primary Medical History: no chronic illnesses, no
known allergies, the only medical intervention she
had was cheek augmentation with polyalcylamide
gel filler 3 years ago.»

4. Differential Diagnosis
Inadequate Root Canal Treatment?

5. Differential Diagnosis
Sodium Hypochlorite Accident?

6. Sodium Hypochlorite Accident
• Severe pain for two to five minutes
• Immediate swelling (ballooning) of the area, with spread of the tissue
reaction to the surrounding areas through the loose connective tissue
• Profuse hemorrhage, either interstitially or manifesting intraorally
through the tooth

7. Differential Diagnosis
Periapical Pathologies?
Hematoma?

8. Periapical Pathologies
• Acute Apical Periodontitis
BUT
s/s
• Acute Periapical Abscess
• Chronic Periapical Abscess

9. Differential Diagnosis
Inflammatory Facial Swelling due to reaction to
polyalcylamide Gel Used for Cheek
Augmentation?

10. What is Polyacrylamide gel filter and what
is it used for?

12. Article

13. Article

14. Complications related to disruption of
Polyacrylamide Gel Biofilm
1. Foreign Body Reaction:
a) Nodule
b) Granuloma
2. Disruption and Detachment
a) Abscess
b) Cellulitis

15. Treatment

16. even if microbial culture is -ve
Penicillin
amoxicillin
The exact antibiotic used depends on the preferences of the doctor and any compounds to which
the patient is allergic. Approximately 30 percent of all patients who are treated for facial
cellulitis will have the infection come back, also known as recurrent facial cellulitis. For
these patients, a l o n g e r c o u r s e o f a n t i b i o t i c s may be needed to ensure that all of
the bacteria are eradicated.
For allergic patient we can prescribe
Cephalosporin
Erythromycin

17. After Returning from Eid Adha holidays, lets ask
God…
Thank You for Your Attention
Ukraine, Crimea [2012]