DOCSLIB.ORG

The Secrets of Predictably Successful Endodontics Part II Dr

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Secrets of Predictably Successful Endodontics Part II Dr 4/2021 The Secrets of Predictably Successful Endodontics Part II Dr. Andre K. Mickel 1 4/2021 Andre’ K. Mickel DDS, MSD, MDiv 2 4/2021 LET EVERYTHING THAT HAS BREATH…Praise the Lord! 3 4/2021 God, Family…then Endodontics 4 4/2021 My Favorite Rotary System • Fast • Effective • Only need one file!! • Inexpensive • BUT… A BIT FRIGHTENING! 5 4/2021 YOU WANT TO KNOW ABOUT ROTARIES ?? OPEN UP, I CAN SHOW YOU BETTER THAN I CAN TELL YOU! The Secret to Success… • Seeing your work primarily as a service to others and not as a means of personal gain (video)? 6 4/2021 DO NO HARM 7 4/2021 Case Scenario ● 25 y.o. caucasian female ● Chief complaint: “Burning pain in my top front area; it burns to touch it” ● Medical history: noncontributory ● Dental history: 6 RCTs performed 6 months ago by general dentist ○ No pain prior - but constant pain ever since ○ Patient’s understanding of why tx was performed: “deep decay” ● Pain meds: NSAIDS - no relief Case Scenario ● Clinical and Radiographic Exam ○ Pertinent Findings: ■ Severe pain to touch teeth and soft tissues in the anterior area ■ Constant pain 10/10. Felt swollen, but not clinically detectable Case Scenario ● No treatment was done. Patient referred to Oral Medicine and Orofacial Pain clinic ● Diagnostic bilateral injections relieved the pain. Presumptive Diagnosis of Trigeminal neuropathic pain. Gabapentin 300mg t.i.d. ● Came back 3 weeks later with photophobia and nausea consistent with Migraine. Topiramate 25mg-100mg b.i.d. ● Came back for an emergency visit with severe pain and autonomic symptoms. Patient was placed on 10 liter/min oxygen for 20 minutes and immediate relief was noted. 8 4/2021 Case Scenario ● Final Diagnosis: Cluster Headache ● Brain MRI was made to rule out any CNS neoplasms ● Pain was completely relieved by 60mg Prednisone for 5 days ● Daily therapy of Verapamil t.i.d. Showed adequate symptom control DO NO HARM 9 4/2021 This Photo by Unknown Author is licensed under CC BY-NC-ND 10 4/2021 11 4/2021 12 4/2021 Holmes and Rahe Life Change Index Scale Holmes and Rahe Life Change Index Scale As clinicians, effective communication provides a baseline in the establishment of patient-provider trust when treating an anxious or fearful patient. Considering the apprehensiveness exhibited by patients recommended for Endodontic procedures, recognizing dental anxiety allows for a more timely and accurate diagnosis. Learning simple techniques to desensitize a patient’s unpleasant expectations will pave the way for more time efficient encounters. 13 4/2021 Other Nonpharmacological options for the management of dental anxiety pleasing scents Rapport building giving patients a sense of control Distraction- visual and/or aural Increased information on the experience cognitive behavioral therapy Systematic desensitization Computer-assisted relaxation learning Behavioral changes Hypnosis Relaxation therapy 14 4/2021 15 4/2021 16 4/2021 A root canal is just like: Baking cookies at grandma’s ! 17 4/2021 18 4/2021 Soft and Relaxing Music OR… …Frank Sinatra and RCT’s 19 4/2021 20 4/2021 21 4/2021 Yummmm…Can you smell them?? 22 4/2021 23 4/2021 24 4/2021 Patient Management CAUSES OF FAILURE 2. Lack of AMBITION to move past mediocrity COMMUNICATION: MUST “SOLERize” Patients 25 4/2021 Square on Open Posture Lean In Eye Contact Relax What is SOLER? SOLER is mainly focusing on your attending skills in a counseling session. Gerard Egan created this theory and acronym to assist new counselors in a therapeutic setting, understand how to put their clients at ease through their body language. What is S.O.L.E.R ? The Gerard Egan Soler Theory describes techniques for active listening . It can be valuable when helping another person as it will make them feel cared for, involved, respected and understood. S.O.L.E.R S= Square On O=Open L=Lean In E=Eye Contact R= Relaxed 26 4/2021 Solar theory 1: Square on The first important part is how you posture yourself in relationship to your client. Your face facing the clients face shows that you are engaging, interested and actively listening. You can have your shoulders turned a little away to dispel any feelings of intimidation, but your face should be square onto the clients face. Square on… Soler theory 2: Open This openness refers again to posture. Ensuring that arms and legs are not crossed will convey a sense of ease to your client. As mentioned above, this openness in body posture will stop feelings of intimidation from occurring. 27 4/2021 Open posture while listening Solar Theory 3: Lean in By leaning towards your client, a sense of care and genuine interest will be conveyed to the other party. Simply leaning forward will automatically make them feel that their concerns are being heard and understood and this will instill further ease and facilitate openness. 28 4/2021 No No No!! Lean in while listening… Soler theory 4: Eye contact This interest is further enhanced by eye contact. Maintaining eye contact shows interest and concern. However, it is important to vary the eye contact so that the other party does not feel threatened or intimidated. 29 4/2021 When they look you in the eyes…look back…and don’t blink! Solar theory 5: relax This is an obvious, but sometimes forgotten aspect. One must relax before your client. If you are fidgeting or showing any anxiety, this will be conveyed. They will either think you are not interested in them, or they will take on your tension, or possibly both! NO NO NO… 30 4/2021 COMMUNICATION: RELAXED!! “SOLERize” Patients Psychological aspects of endodontic pain Within the scope of Endodontics, pain management is a critical entity in securing patient trust. Emphasizing the importance of pain management, special care should be taken to enhance patient experience and reduce procedural chair time. S.O.L.E.R is used to connect psychologically with patients to aid in reducing anxiety and fear in regards to treatment plan acceptance, patient compliance and post-operative pain. Psychological aspects of endodontic pain . It’s been determined that the best predictors of post operative pain are pre-operative pain/swelling- Walton & Fouad. Best predictors: Level of pre-operative pain and anxiety- Torabinejad . Concluded that apprehension causes reduced pain threshold- Hargreaves & Keiser 31 4/2021 Psychological aspects of endodontic pain Patients who never received Endodontic treatment experienced high levels of dental anxiety and considered it to be more unpleasant than oral surgery (Wong 1991) 67% of patients reported moderate anxiety associated with endodontic treatment, while 17% experienced intense anxiety (Dou 2018) For patients with moderate levels of dental anxiety, providing more information about endodontic treatment and what they will experience can reduce dental anxiety and fear of pain (Newton 2012; van Himel2006) Anxiety Assessment and treatment Flowchart The triangle in the middle represents CBT's tenet that all humans' core beliefs can be summed up in three categories: self, others, future. 32 4/2021 Cognitive behavioral therapy Cognitive behavioral therapy is a psycho-social intervention that aims to improve mental health. CBT focuses on challenging and changing cognitive distortions and behaviors, improving emotional regulation, and the development of personal coping strategies that target solving current problems. Originally, it was designed to treat depression, but its uses have been expanded to include treatment of a number of mental health conditions, including anxiety. CBT includes a number of cognitive or behavior psychotherapies that treat defined psychopathologies using evidence-based techniques and strategies……………………………Blah Blah Blah… General Anesthesia IV Sedation Inhalation Sedation Psychological Techniques Good Pain Control Communication 33 4/2021 34 4/2021 …Frank Sinatra and RCT’s 35 4/2021 36 4/2021 Yummmm…Can you smell them?? 37 4/2021 38 4/2021 Ethics • Informed consent • Discussion of risks, benefits and alternatives • Best interest of the patient • Best evidence 39 4/2021 • Informed consent • Discussion of risks, benefits and alternatives • Best interest of the patient • Best evidence 40 4/2021 CAUSES OF FAILURE 2. Lack of AMBITION to move past mediocrity “C.I.B.” Endo Mother Litmus Test Nothing like Mommy! 41 4/2021 NOTHING LIKE MOMMY! Don’t talk about my Mama! Treat every patient like your Mommy! 42 4/2021 A root canal is just like: Baking cookies at grandma’s ! Yummmm…Can you smell them?? A root canal is just like: Baking cookies at grandma’s ! 43 4/2021 But…stuff does happen… Mishaps: Bleach Injury 44 4/2021 Irrigant NaOCL ERRORS AND TX • MAKE SURE CHAMBER NOT “LEAKING” • GOOD RUBBER DAM ISOLATION • DO NOT WEDGE NEEDLE • USE SIDE RELEASING NEEDLES • MOVE NEEDLE UP AND DOWN WHEN IRRIGATING TX OF NaOCL ERRORS • DILUTE- REANESTHETIZE • NSAIDS • TOPICAL CORTICOSTEROID OR CONSIDER MEDROL DOSE PACK • CALL OFTEN, CLOSE FOLLOW • WARN OF SEQUELA • SWELLING, SLOUGHING, DISCOLORATION, LONG TERM DISCOMFORT •TLC 45 4/2021 This Photo by Unknown Author is licensed under CC BY-SA This Photo by Unknown Author is licensed under CC BY-SA This Photo by Unknown Author is licensed under CC BY-ND 46 4/2021 Things go wrong!! • Too small • Missed canals • Visibility • Instrument access • Fatigue • Breakage of instrument • Inadequate Cleaning and shaping Things go wrong!! • Off center • Perforations • Restorability • Missed canals • Reduced prognosis • Inadequate cleaning Access in special conditions 47 4/2021 Things go wrong!! • Too shallow or too deep Law Regarding Perforation • Let patient know an accident occurred and was promptly repaired. (MTA, RRM Putty, matrix/geristore) • Prognosis better if repaired ASAP • Smaller is better • No communication with sulcus • Above bone better • SOM …Magnification + Illumination Mommy LOVE 48 4/2021 CAUSES OF FAILURE 3. A NEGATIVE mental attitude This Photo by Unknown Author is licensed under CC BY-SA This Photo by Unknown Author is licensed under CC BY-SA 49 4/2021 This Photo by Unknown Author is licensed under CC BY-SA This Photo by Unknown Author is licensed under CC BY-SA-NC This Photo by Unknown Author is licensed under CC BY-SA 50 4/2021 Don’t POUT! DON’T BE A GRUMPY OLD MAN! 51 4/2021 THERE IS ALWAYS SOMEONE WORSE OFF ! CAUSES OF FAILURE 3.
Load more

Recommended publications
  • Management of Acute Periodontal Abscess Mimicking Acute Apical Abscess in the Anterior Lingual Region: a Case Report
    Open Access Case Report DOI: 10.7759/cureus.5592 Management of Acute Periodontal Abscess Mimicking Acute Apical Abscess in the Anterior Lingual Region: A Case Report Omar A. Alharbi 1 , Muhammad Zubair Ahmad 1 , Atif S. Agwan 1 , Durre Sadaf 1 1. Conservative Dentistry, Qassim University, College of Dentistry, Buraydha, SAU Corresponding author: Muhammad Zubair Ahmad, [email protected] Abstract Purulent infections of periodontal tissues are known as periodontal abscesses localized to the region of the involved tooth. Due to the high prevalence rate and aggressive symptoms, it is considered a dental emergency; urgent care is mandatory to maintain the overall health and well being of the patient. This case report describes the management of a patient who presented with an acute periodontal abscess secondary to poor oral hygiene. Clinically and radiographically, the lesion was mimicking an acute apical abscess secondary to pulpal necrosis. Periodontal treatment was started after completion of antibiotic therapy. The clinical presentation of the condition and results of the recovery, along with a brief review of relevant literature are discussed. Categories: Pain Management, Miscellaneous, Dentistry Keywords: periodontal abscess, antimicrobial agents, dental pulp test, dental pulp necrosis, apical suppurative periodontitis Introduction Periodontium, as a general term, describes the tissues surrounding and supporting the tooth structure. A localized purulent infection of the periodontal tissues adjacent to a periodontal pocket, also known as a periodontal abscess, is a frequently encountered periodontal condition that may be characterized by the rapid destruction of periodontal tissues [1-2]. The symptoms generally involve severe pain, swelling of the alveolar mucosa or gingiva, a reddish blue or red appearance of the affected tissues, and difficulty in chewing [1-3].
    [Show full text]
  • Prevention and Treatment of Periodontal Diseases in Primary Care Guidance in Brief
    Scottish Dental SD Clinical Effectiveness Programme cep Prevention and Treatment of Periodontal Diseases in Primary Care Guidance in Brief June 2014 Scottish Dental SD Clinical Effectiveness Programme cep The Scottish Dental Clinical Effectiveness Programme (SDCEP) is an initiative of the National Dental Advisory Committee (NDAC) in partnership with NHS Education for Scotland. The Programme provides user-friendly, evidence-based guidance on topics identified as priorities for oral health care. SDCEP guidance aims to support improvements in patient care by bringing together, in a structured manner, the best available information that is relevant to the topic and presenting this information in a form that can be interpreted easily and implemented. Supporting the provision of safe, effective, person-centred care Scottish Dental SD Clinical Effectiveness Programme cep Prevention and Treatment of Periodontal Diseases in Primary Care Guidance in Brief June 2014 Prevention and Treatment of Periodontal Diseases in Primary Care Cover image: Colour-enhanced photomicrograph of oral bacterial colonies growing on an agar plate. Derren Ready, Wellcome Images. © Scottish Dental Clinical Effectiveness Programme SDCEP operates within NHS Education for Scotland. You may copy or reproduce the information in this document for use within NHS Scotland and for non-commercial educational purposes. Use of this document for commercial purposes is permitted only with written permission. ISBN 978 1 905829 18 7 Published June 2014 Scottish Dental Clinical Effectiveness Programme Dundee Dental Education Centre, Frankland Building, Small’s Wynd, Dundee DD1 4HN Email [email protected] Tel 01382 425751 / 425771 Website www.sdcep.org.uk Prevention and Treatment of Periodontal Diseases in Primary Care Introduction Prevention and Treatment of Periodontal Diseases in Primary Care is designed to assist and support primary care dental teams in providing appropriate care for patients both at risk of and with periodontal diseases.
    [Show full text]
  • Acute Periodontal Abscess in an Adolescent Patient: Case Report
    ISSN: 2639-0434 Madridge Journal of Dentistry and Oral Surgery Case Report Open Access Acute Periodontal Abscess in an Adolescent Patient: Case Report Alparslan Dilsiz* Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey Article Info Abstract *Corresponding author: Periodontal abscess has been defined as a suppurative lesion that is associated with Alparslan Dilsiz periodontal breakdown and pus collection in the gingival wall of the periodontal pocket. Professor Department of Periodontology The prevalence of periodontal abscess is relatively high and it affects the prognosis of Faculty of Dentistry, Atatürk University the tooth. In this article, a patient with acute periodontal abscess due to poor oral Turkey hygiene was treated periodontically 10 days after the start of antibiotic therapy. The Fax: +90 442 2361375 clinical features and likely healing results of the lesion were discussed and related Tel: +90 442 2360940 E-mail: [email protected] literatures were reviewed. Keywords: Periodontal Abscess; Periodontal Pocket; Alveolar Bone Resorption; Received: August 16, 2017 Accepted: September 3, 2017 Suppuration; Anti-Bacterial Agents; Periodontal Atrophy and Periodontal Debridement. Published: September 8, 2017 Introduction Citation: Dilsiz A. Acute Periodontal Abscess in an Adolescent Patient: Case Periodontal abscess, which is a localized purulent infection of the periodontal Report. Madridge J Dent Oral Surg. 2017; tissues adjacent to a periodontal pocket, is a frequent periodontal condition in which 2(2): 77-79. periodontal tissues may be rapidly destroyed [1,2]. Major symptoms of a periodontal doi: 10.18689/mjdl-1000118 abscess are known as the spontaneous or evoked pain, gingival or mucosal swelling, Red or reddish blue discoloration of affected tissue [1-4].
    [Show full text]
  • Volving Periodontal Attachment, the Apposition of Fire Or Severe Trauma, Physical Features Are Often Cementum at the Root Apex, the Amount of Apical Destroyed
    ISSN 0976-2256 E-ISSN: 2249-6653 The journal is indexed with ‘Indian Science Abstract’ (ISA) (Published by National Science Library), www.ebscohost.com, www.indianjournals.com JADCH is available (full text) online: Website- www.adc.org.in/html/viewJournal.php This journal is an official publication of Ahmedabad Dental College and Hospital, published bi-annually in the month of March and September. The journal is printed on ACID FREE paper. Editor - in - Chief Dr. Darshana Shah Co - Editor Dr. Rupal Vaidya DENTISTRY TODAY... Assistant Editor: We are living in an era in which community experience for Dr. Harsh Shah students is becoming a more essential component to the mission of dental education. Dental Public Health aims to improve the oral health of the population through preventive and curative services. The Editorial Board: introduction of mobile clinics into dentistry dates back to 1924. They have Dr. Mihir Shah been successfully used to provide dental treatment to schools, disabled patients, rural communities, industries and armed forces of various Dr. Vijay Bhaskar countries. Outreach programs using Mobile Dental Vans (MDV) are desirable model of clinical practice in a non-conventional setting, and help Dr. Monali Chalishazar the student to disassociate the image that best dentistry can only be Dr. A. R. Chaudhary practiced in conventional clinical settings. Confrontation with limited resources and economic barriers to Dr. Neha Vyas dental care for patients requiring more extensive procedures also serve as an additional learning experience in community-based programs. Unlike Dr. Sonali Mahadevia stationary dental clinics, mobile clinics provide greater physical access to dental care for medically underserved populations in poor urban and Dr.
    [Show full text]
  • Seltzer and Benders Dental Pulp 2012 4.Pdf
    Effects of Thermal and Mechanical Challenges burs).19 Collectively, these results indicate that pulpal 8 HS air reactions to various restorative procedures17-19 are not necessarily caused by excessive heat production. However, it is difficult to precisely position tempera­ ture sensors to detect heat generated during cut­ ting. In addition, the poor thermal conductivity of dentin can result in thermal burns to surface dentin without much change in pulpal temperature.20 HS air-water Pulpal reactions to restorative procedures may / - - - ...... in part be caused indirectly. It is possible that a high LS air-water surface temperature can thermally expand the den­ tinal fluid in the tubules immediately beneath poorly -5 0 5 10 15 20 25 30 35 irrigated burs. If the rate of expansion of dentinal Time(s) fluid is high, the fluid flow across odontoblast pro­ cesses, especially where the odontoblast cell body fills the tubules in predentin, may create shear forces Fig 15-2 Changes in pulpal temperature during low-speed (LS) and high­ sufficiently large to tear the cell membrane21 and speed (HS) cavity preparation with and without air-water cooling. (Modified from Zach and Cohen10 with permission.) induce calcium entry into the ce//,22 possibly leading to cell death.23 This hypothesis suggests that ther­ mally induced fluid shifts across tubules serve as the transduction mechanism for pulp cell injury without causing much change in pulpal temperature. An additional factor that can cause pulpal irrita­ that produced in pulp tissues. However, the out­ tion is evaporative fluid flow.24 Blowing air on dentin come may be influenced by the fact that the blood causes rapid outward fluid flow that can induce the flow per milligram of tissue is higher in the periodon­ same cell injury as the inward fluid flow caused by tal ligament (PDL) than in the pulp.9 heat.
    [Show full text]
  • Odontogenic Cysts II [PDF]
    Odontogenic cysts II Prof. Shaleen Chandra 1 • Classification • Historical aspects • Odontogenic keratocyst • Gingival cyst of infants & mid palatal cysts • Gingival cyst of adults • Lateral periodontal cyst • Botroyoid odontogenic cyst • Galandular odontogenic cyst Prof. Shaleen Chandra 2 • Dentigerous cyst • Eruption cyst • COC • Radicular cyst • Paradental cyst • Mandibular infected buccal cyst • Cystic fluid and its role in diagnosis Prof. Shaleen Chandra 3 Gingival cyst and midpalatal cyst of infants Prof. Shaleen Chandra 4 Clinical features • Frequently seen in new born infants • Rare after 3 months of age • Undergo involution and disappear • Rupture through the surface epithelium and exfoliate • Along the mid palatine raphe Epstein’s pearls • Buccal or lingual aspect of dental ridges Bohn’s nodules Prof. Shaleen Chandra 5 • 2-3 mm in diameter • White or cream coloured • Single or multiple (usually 5 or 6) Prof. Shaleen Chandra 6 Pathogenesis Gingival cyst of infants • Arise from epithelial remnants of dental lamina (cell rests of Serre) • These rests have the capacity to proliferate, keratinize and form small cysts Prof. Shaleen Chandra 7 Midpalatal raphe cyst • Arise from epithelial inclusions along the line of fusion of palatal folds and the nasal process • Usually atrophy and get resorbed after birth • May persist to form keratin filled cysts Prof. Shaleen Chandra 8 Histopathology • Round or ovoid • Smooth or undulating outline • Thin lining of stratified squamous epithelium with parakeratotic surface • Cyst cavity filled with keratin (concentric laminations with flat nuclei) • Flat basal cells • Epithelium lined clefts between cyst and oral epithelium • Oral epithelium may be atrpohic Prof. Shaleen Chandra 9 Gingival cyst of adults Prof. Shaleen Chandra 10 Clinical features • Frequency • 0.5% • May be higher as all cases may not be submitted to histopathological examination • Age • 5th and 6th decade • Sex • No predilection • Site • Much more frequent in mandible • Premolar-canine region Prof.
    [Show full text]
  • Clinical Implications of Calcifying Nanoparticles in Dental Diseases: a Critical Review
    International Journal of Nanomedicine Dovepress open access to scientific and medical research Open Access Full Text Article REVIEW Clinical implications of calcifying nanoparticles in dental diseases: a critical review Mohammed S Alenazy1 Background: Unknown cell-culture contaminants were described by Kajander and Ciftçioğlu Hezekiah A Mosadomi2,3 in 1998. These contaminants were called nanobacteria initially and later calcifying nanoparticles (CNPs). Their exact nature is unclear and controversial. CNPs have unique and unusual charac- 1Restorative Dentistry Department, 2Oral and Maxillofacial Pathology teristics, which preclude placing them into any established evolutionary branch of life. 3 Department, Research Center, Riyadh Aim: The aim of this systematic review was to assess published data concerning CNPs since Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia 1998 in general and in relation to dental diseases in particular. Materials and methods: The National Library of Medicine (PubMed) and Society of Pho- tographic Instrumentation Engineers (SPIE) electronic and manual searches were conducted. Nanobacteria and calcifying nanoparticles were used as keywords. The search yielded 135 full-length papers. Further screening of the titles and abstracts that followed the review criteria resulted in 43 papers that met the study aim. Conclusion: The review showed that the existence of nanobacteria is still controversial. Some inves- tigators have described a possible involvement of CNPs in pulpal and salivary gland calcifications, as well as the possible therapeutic use of CNPs in the treatment of cracked and/or eroded teeth. Keywords: calcifying nanoparticles, nanobacteria, sialolith, pulp stone, enamel repair Introduction Unknown cell-culture contaminants were first described by Kajander and Ciftçiog˘lu in 1998.
    [Show full text]
  • Gingival Cyst of Adults- Two Case Reports and Literature Review
    https://doi.org/10.5272/jimab.2018242.2065 Journal of IMAB Journal of IMAB - Annual Proceeding (Scientific Papers). 2018 Apr-Jun;24(2) ISSN: 1312-773X https://www.journal-imab-bg.org Case reports GINGIVAL CYST OF ADULTS- TWO CASE REPORTS AND LITERATURE REVIEW Elitsa Deliverska1, Aleksandar Stamatoski2 1) Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Medical University – Sofia, Bulgaria. 2) Department of maxillofacial surgery, Faculty of Dental Medicine, Ss. Cyril and Methodius University- Skopje, Macedonia. ABSTRACT usually found in the incisor, canine, and premolar areas. Background: Gingival cyst of adult is an [1, 3, 4] uncommon, small, non inflammatory, extra-osseous, Clinically, the gingival cysts may certainly occur developmental cyst of gingiva arising from the rests of without bone involvement and may appear as painless, dental lamina. small sessile soft tissue swellings, usually involving the Purpose: The aim of our paper is to present two rare interdental area of the attached gingiva. clinical cases of gingival cyst of adult. These lesions measure about 0.5 to 1 cm in diameter. Material and methods: In the present cases, the They are often bluish or blue-gray due to thinning of the combined anatomic characteristics of the soft tissue overlying mucosa. In some instances, the cyst may cause presentation and the osseous defect suggest that the lesion slight erosion of the surface of the bone, which is usually is a gingival cyst of adult. Two cases of gingival cyst were not detected on a radiograph but is apparent during surgical diagnosed and treated with exicisional biopsy followed by exploration.
    [Show full text]
  • Denticles. a Literature Review
    Prog Health Sci 2015, Vol 5, No2 Denticles – literature review Denticles. A literature review Kisiel M, Laszewicz J, Frątczak P, Dąbrowska B, Pietruska M, Dąbrowska E. Department of Social and Preventive Dentistry Medical University of Bialystok, Poland Social and Preventive Dentistry Research Club under the supervision of Ewa Dąbrowska ABSTRACT __________________________________________________________________________________________ Denticles are pulp degenerations in the form of obtain proper access to the pulp chamber bottom and calcified deposits of mineral salts, usually found in the canal orifices. There is also the increased risk of molars and lower incisors, as well as in impacted bending or breaking the endodontic instruments. teeth and deciduous molars. Denticles may come in Sometimes, denticles fill the entire space of the tooth various sizes, from microscopic particles to larger chamber and pushing the pulp to the edges of the mass that almost obliterate the pulp chamber and are chamber. Denticles can cause pain due to the visible only on X-ray images. Denticles form as a pressure on the nerves and blood vessels supplying result of chronic inflammatory lesions, but may also the internal tissue of the tooth. The presence of large be caused by injuries and conservative treatment. denticles might eventually lead to necrosis of the They are most frequently found in necrotic foci. pulp. Denticles accompany certain diseases, such as Denticles may cause problems for root canal dentin dysplasia, odontodysplasia or Albright treatment, as their presence might make it difficult to hereditary dystrophy. Key wards: teeth, denticles, _________________________________________________________________________________________ *Corresponding author: Ewa Dąbrowska Department of Social and Preventive Dentistry Medical University of Bialystok ul.
    [Show full text]
  • Denture Technology Curriculum Objectives
    Health Licensing Agency 700 Summer St. NE, Suite 320 Salem, Oregon 97301-1287 Telephone (503) 378-8667 FAX (503) 585-9114 E-Mail: [email protected] Web Site: www.Oregon.gov/OHLA As of July 1, 2013 the Board of Denture Technology in collaboration with Oregon Students Assistance Commission and Department of Education has determined that 103 quarter hours or the equivalent semester or trimester hours is equivalent to an Associate’s Degree. A minimum number of credits must be obtained in the following course of study or educational areas: • Orofacial Anatomy a minimum of 2 credits; • Dental Histology and Embryology a minimum of 2 credits; • Pharmacology a minimum of 3 credits; • Emergency Care or Medical Emergencies a minimum of 1 credit; • Oral Pathology a minimum of 3 credits; • Pathology emphasizing in Periodontology a minimum of 2 credits; • Dental Materials a minimum of 5 credits; • Professional Ethics and Jurisprudence a minimum of 1 credit; • Geriatrics a minimum of 2 credits; • Microbiology and Infection Control a minimum of 4 credits; • Clinical Denture Technology a minimum of 16 credits which may be counted towards 1,000 hours supervised clinical practice in denture technology defined under OAR 331-405-0020(9); • Laboratory Denture Technology a minimum of 37 credits which may be counted towards 1,000 hours supervised clinical practice in denture technology defined under OAR 331-405-0020(9); • Nutrition a minimum of 4 credits; • General Anatomy and Physiology minimum of 8 credits; and • General education and electives a minimum of 13 credits. Curriculum objectives which correspond with the required course of study are listed below.
    [Show full text]
  • DENTAL PULP the Pulp Proper but Are in Small Amounts and Not Well
    DENTAL PULP 9 Diffuse collagen fibers Collagen bundles Collagen bundles Fig. 9.17 Collagen bundles in an older pulp organ. Trauma may also have contributed to collagen in this pulp. the pulp proper but are in small amounts and not well areas of the body, and the blood pressure is quite high. The characterized. diameter of the arteries varies from 50 to 100 ␮m, which equals the size of arterioles in other areas of the body. These Vascularity vessels have three layers: the inner lining, or intima, which The pulp organ is highly vascularized, with vessels arising consists of oval or squamous-shaped endothelial cells sur- from the external carotid arteries to the superior and inferior rounded by a closely associated fibrillar basal lamina; a alveolar arteries. It drains by the same veins. Although the middle layer or media, which consists of muscle cells from periodontal and pulpal vessels both originate from these one to three cell layers thick (Fig. 9-20 ); and an outer layer, vessels, their walls are different. The walls of the periodontal or adventitia, which consists of a sparse layer of collagen and pulpal vessels become quite thin as they enter the pulp, fibers forming a loose network around the larger arteries. because the pulp is protected within a hard, unyielding con- Smaller arterioles with a single layer of muscle cells range tainer of dentin. These thin-walled arteries and arterioles from 20 to 30 ␮m, and terminal arterioles of 10 to 15 ␮m enter the apical canal and pursue a direct route up the root are also present.
    [Show full text]
  • NEW CLASSIFICATION of PERIODONTAL and PERI-IMPLANT DISEASES Guest Editors: Mariano Sanz and Panos N
    Scientific journal of the Period I, Year V, n.º 15 Sociedad Española de Periodoncia Editor: Ion Zabalegui 2019 / 15 International Edition periodonciaclínica NEW CLASSIFICATION OF PERIODONTAL AND PERI-IMPLANT DISEASES Guest editors: Mariano Sanz and Panos N. Papapanou ADVERTISING Presentation ANTONIO BUJALDÓN, PRESIDENT OF SEPA 2019-2022 THIS IS THE FIRST EDITORIAL of Periodoncia Clínica of the Before ending this editorial, it is essential to dedicate some SEPA presidential mandate for 2019-2022. It is a huge honour lines of recognition and thanks to the active and committed SEPA to start with a monographic issue on the New Classification members involved with Periodoncia Clínica over the four years that of Periodontal and Peri-implant Diseases, fruit of the work of have passed since the creation of this informative publication, which the World Workshop held in 2017 by the American Academy has consolidated a style and friendly way of strengthening and of Periodontology (AAP) and the European Federation of facilitating professional access to knowledge, under the values of Periodontology (EFP), to which SEPA is proud to belong as one of its rigour, innovation, and excellence that are the hallmarks of SEPA. most dynamic members. Ion Zabalegui, editor of Periodoncia Clínica, together with The rejoicing increases by having the brilliant collaboration as associate editors Laurence Adriaens, Andrés Pascual, and Jorge guest editors of Panos N. Papapanou and Mariano Sanz, the latter Serrano, deserve a display of immense gratitude from all SEPA
    [Show full text]