Nursing bottle and rampant caries Are two of the major types of caries that affect the children and toddlers as well as infants. A Thorough knowledge about the types of caries , their clinical features is needed to correctly diagnose treat them .
Clinical Features & Diagnosis of Dental Caries
Dental materials are the tools that a dentist uses daily basis and must have adequate knowledge to use them correctly.
The knowledge should be clinical as well as theoretical. Proper knowledge about the properties and the use of material can save time , stop wastage of excess materials & give a proper finishing to the procedure.
Most common dental materials that a dentist uses in the clinical set up
Agar and Alginate Impression Materials
In this post I am also embedding a slide presentation on dental materials that can be useful in refreshing your knowledge about dental material.
Dental management of medically compromised patient can be a challenge as well as a headache for a dentist . So a dentist ought to know the various types of medical emergencies and the ways to manage them at the correct time appropriately.
This particular slide gives a clear cut and concise idea regarding the management of medically compromised patients in dental clinic . Be Aware , Be Empowered.
How do Braces Work & Cause tooth movement ?
In any orthodontic dentistry the major components involved are :
* Brackets made of metal or ceramic. A bracket is attached to each tooth.
* Bands are metal rings that are usually placed only on back teeth.
* An Arch Wire, which is a thin metal wire that runs from bracket to bracket and puts pressure on the teeth.
* The Elastic Ligature Tie (also called an “o-ring“). This is a small colored elastic that holds the bracket onto the arch wire. The ligatures are usually changed at each adjustment visit.
* The brackets and bands are held on to the teeth byBonding material (glue).
* Accessories on the braces such as headgear tubs, hooks, loops and steel ties are also often used for maximum control and tooth movement.
Mechanism of Tooth Movement
The teeth move when the arch wire puts pressure on the brackets and teeth. Sometimes, springs or rubber bands are used exert more force in a specific direction. Braces exert constant pressure, which over time, move teeth into their proper positions.
Your teeth are surrounded on top by gum tissue (also called Gingiva). Under the gum tissue, the Periodontal Membrane (sometimes called the Periodontal Ligament or PDL) encases the bottom portion of the tooth. Next to that lies Alveolar Bone.
When braces put pressure on your teeth, the periodontal membrane stretches on one side and is compressed on the other. This loosens the tooth. The bone then grows in to support the tooth in its new position. Technically, this is called bone remodeling.
Teeth move through alveolar bone, whether through the normal process of tooth eruption or by strains generated by orthodontic appliances. Both eruption and orthodontics accomplish this feat through similar fundamental biological processes, osteoclastogenesis and osteogenesis, but there are differences that make their mechanisms unique. A better appreciation of the molecular and cellular events that regulate osteoclastogenesis and osteogenesis in eruption and orthodontics is not only central to our understanding of how these processes occur, but also is needed for ultimate development of the means to control them. Possible future studies in these areas are also discussed, with particular emphasis on translation of fundamental knowledge to improve dental treatment.
Bone Remodelling and Tooth Movemment
Bone remodeling is a biomechanical process responsible for making bones stronger in response to sustained load-bearing activity and weaker in the absence of carrying a load. Bones are made of cells called osteoclasts and osteoblasts.
Bone remodeling works like this: increase the load on a bone and osteoclasts are created which break it down in response to the load. Remove the load and osteoblasts are created which create new bony cells. Repeat the process through repetitive motion and eventually the bone density increases.
The clinical picture of orthodontic tooth movement consists of three phases: an initial and almost instantaneous tooth displacement; delay, where no visible movement occurs; and a period of linear tooth movement.
The applied forces create strains in the tooth-supporting tissues that manifest almost immediately and can be roughly categorized as compressive and tensile.
The initiating inflammatory event at compression sites is caused by constriction of the periodontal ligament microvasculature, resulting in a focal necrosis, known by its histological appearance as hyalinization, and compensatory hyperemia in the adjacent periodontal ligament.
The PDL as a sort of messenger between the teeth and surrounding bony sockets. Pressure between the PDL and bone causes the bone to create osteoclasts and breakdown the bone to restore the normal spacing between the teeth and bone. The corresponding tension on the PDL behind the movement causes the bone to create osteoblasts, effectively building new bone to fill in the difference and restore the normal spacing between teeth and bone. Not a whole lot of force is necessary, only “some” force which is not normally present.
This is where the bracket s and archwires come into the picture – they generate the artificial force needed to create and sustain the pressure.
Archwires are made of various materials and strengths, but the general principle remains the same: teeth that are not in alignment follow the curve of the archwire and adapt to that new, aligned position. Archwires want to retain their shape and this creates the force that causes the bone to remodel and the teeth then to move into the desired position.
The osteoclast (breakdown) process takes about 72 hours to get fully going, the osteoblast (rebuild) process about 90 days. Stabilizing the result takes about 10 months (which is why it is important to wear your retainer to avoid a relapse of the original or some intermediate positions).
There is abundant evidence suggesting that neurovascular mechanisms play important roles in tooth movement, through the development of an inflammatory reaction.
The release of pro-inflammatory cytokines and lysosomal enzymes that promote tissue resorption at compression sites is well-documented. Prostaglandins, IL-1, IL-6, TNFα, and receptor activator of nuclear factor kappa B ligand (RANKL) are all elevated in the periodontal ligament during tooth movement.
Increases in the lysosomal enzymes, acid phosphatase, tartrate-resistant acid phosphatase,and cathepsin B are also localized at compression sites, suggesting that they may play pivotal roles during orthodontic tooth movement in the process of hard- and soft-tissue degradation by increased numbers of macrophage and dendritic-like cells.
The reason wearing your rubber bands full time or 24 hours a day is so important is because of the bone remodeling. If it takes 72 hours for the movement to get going and the bands are removed for long periods of time, then this process never really begins! This also explains why it is so important to continue wearing the rubber bands as prescribed: since it takes 90 days to rebuild the bone in the position the tooth moved from, without rubber bands pulling the tooth in the desired position, the tooth will slip back into its old spot. Ah-ha! That is why we are always telling you to wear your rubber bands!
This particular slide below describes in detail about the “Biology Of Tooth Movement”
N.B >>> Please click on the embedded links within the post that links you to additional videos , references & pictures from internet.
Bone grafting is a surgical procedure that replaces missing bone with material from the patient’s own body, an artificial, synthetic, or natural substitute. Bone grafting is used to repair bone fractures that are extremely complex, pose a significant health risk to the patient, or fail to heal properly.
Biological Mechanisms Involved in Bone grafting >>>>
The Following is a set of presentation and video that gives a clear and concise idea related to the topic.
IF IMPACTED TOOTH NOT REMOVED TIMELY >>
Gum Infections , periodontal problems , cyst and tumour occurrence.
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R.C.T Or ROOT CANAL TREATMENT
WHAT IS R.C.T or ROOT CANAL TREATMENT ?
R.C.T. is the choice of treatment when the carries(cavity) has destroyed your tooth structure to such an extent that normal filling (like amalgam, cement e.t.c) is no longer possible.
The most common reason for RCT are:
1.Progression of carries to such an extent that pulp is exposed.
2 Non vital tooth, which can be the result of a carious process or can some time be a result of trauma or pathologies like granuloma, cyst e.t.c.
4.Reimplantation as in tooth loss.
When the pulp inside the tooth gets infected or dies due to some infection or injury, it starts to putrefy and acts as a source of infection, which if not treated can cause severe pain and can even lead to formation of peripical granuloma, cyst or abcess. If the disease progress to a stage where a cyst granuloma or abcess is formed, it can involve other healthy neighbouring tooth and can be a potential source of infection for others body parts leading to other diseases.
CARE TO BE TAKEN AFTER R.C.T
1 : Till the process of R.C.T is completed do not bite any thing
hard from the tooth being treated or else there is a chance of
the tooth getting fractured.
2: If the temporary filling comes off ,report to your doctor.
3: After fixation of crown you should make special efforts to clean
the crown as well as the inter dental areas(i.e the area between two tooth) by using proper brushing technique and proper flossing technique.
R.C.T. can be described in these simple steps :
Click on the Pics to Enlarge Them
Step 1:.A wide cavity is drilled to gain complete access to the pulp chambers
Step 2:. Entire pulp is removed with the help of a broach
Step 3:.The pulp chamber and canal are cleaned of any infected material and irrigated, the root canal is subsequently packed using intracanal medicaments and the patient is called back after 72hs to check the root canal for signs of infection.
Step 4: On opening the canal,if infection is found then step 3 is repeated or else the root canal is filled (packed) with an inert substance like guttapercha.
Pros and Cons of Dental Root Canals
Advantage: Pain is always associated with root canals, but should actually be little to no pain during the procedure. The procedure is not for cosmetics, but rather your health. The infect will only get worse with time if left untreated. The root canal procedure is successful over 92 percent of the time. The biggest advantage is that the tooth will not need to be extracted in the future.
Disadvantage: Not often, but sometimes infected tissue is pushed through the ends of the root, which will infect the gum. This is easily treated, but is also painful until the infection is cleared up. Canals are irregularly shaped, and if the canal is not accurately measured or branches of the canal were not discovered, it cannot be completely cleaned or filled requiring the procedure to be done again when this area becomes infected.
See this album Describing the entire process of RCT in Pictures
As Swine Flu is on a high tide these days, the requisite of the hour is to bag in as much information as possible. When epidemics spread, rumours and myths also travel along. This makes the situation worse. Thus, it is our prime concern to clear off the misconceptions and spread the word of true information as far as possible. This presentation gives an insight of the present pandemic scenario as well as the prevention and medication tips. Apart from these, the presentation includes slides on slide flu vaccination, slide flu symptoms, slide flu history and swine flu cause.