Patients typically associate dental care with pain. Pain has both physiological and psychological components. Endodontic post-treatment pain continues to be a significant problem facing the dental profession. For patients presenting with preoperative pain, most will continue to experience pain after root canal treatment, with pain levels ranging from mild to severe. The purpose of this paper was to review the symptoms and classification of irreversible pulpitis, including acute and chronic pulpitis, incidence of postoperative pain following treating teeth with irreversible pulpitis, factors influencing postoperative pain, persistent pain after root canal treatment, preventing postoperative pain and pharmacological management of postoperative pain.
The mechanical debridement of the root canal system fails to completely remove debris from the root canal walls. So, one or more irrigants must be used for complete disinfection of the root canal system (RCS). One possible way to improve the bactericidal efficacy of the disinfecting solutions is to incorporate different detergents as surface active agents to help reduce the surface tension and increase the wettability of the solutions. Surfactants have been added to various root canal irrigation solutions. The purpose of this paper is to review the effects of adding surfactants to established root canal irrigants and new surfactant-containing root canal irrigants.
The acidity of wine can cause dental erosion. Furthermore, its constituents may lead to excessive staining of teeth. The authors report the case of apatient whose amount, manner and timing of wine consumption caused these dental problems.
Minimally invasive indirect veneers (MIIV) are ultrathin porcelain veneers that can be cemented onto labial surfaces after no or minimal tooth preparation. The benefits of no or minimal veneer preparation are conservation of tooth structure, absence of postoperative sensitivity, bonding to enamel, minimal flexural stresses, no need for provisionals and improved patient acceptance. However, no or minimal preparation veneers should be considered only after thorough functional and aesthetic evaluation. The article presented here illustrates a case of diastema closure using MIIV, to highlight the importance of treatment planning for achieving good results.
Managing dental caries remains a challenge to clinicians—more so when treating caries in remote, underserved areas of the world. The purpose of this article is to report preliminary results of an effort to reduce to practice the best features of silver nitrate (SN) anti-caries effect and atraumatic restorative treatment (ART) for lesion preparation and restoration. The modifications made to two approaches have practical applications to school-based outreach programs hoping to respond to the dire need for preventive and conservative restorative methods in parts of the world where access to the dental office is unobtainable.
This is the report of a case of arteriovenous malformation (AVM) of the tongue in a 13-year-old female patient. The clinical course is outlined; anintraoperative dilemma is discussed; and a review of the literature is presented. Vascular lesions demand heightened attention by all practitioners throughout the planning and diagnostic phase, during surgical treatment, as well as postoperatively. Careful attention to detail can help avoid poor patient outcomes and, even, fatal consequences.
The purpose of this article is to present a new computerized technique for evaluating tooth color before and after internal bleaching. Internal bleaching is a common and relatively safe procedure, from which results can be easily evaluated by both the dentist and the patient. Clinically, evaluation of the tooth color before, during and after internal bleaching is usually completed by using a color scale and comparing the shade to that of the tooth. However, since in some cases the bleaching results are not obvious, this method has limited value for complicated cases and especially for dental research. The case presented here demonstrates the digital color evaluation process of a tooth going through all phases of internal bleaching. The detected color is presented as the color scale numbers and can easily be saved for follow-up. Those results are presented on the device screen for the all-labial surface and also separately for the incisal, middle and cervical areas. This digital method for color detection can easily be used at every dental clinic as a validated dental record for the bleaching process. This method can also be used for dental research that evaluates the efficacy of bleaching techniques. The esthetic results can be verified easily and precisely.
To determine the use of fluoride varnish (FV) to prevent dental caries and explore related factors, a survey was mailed to all 540 licensed general and pediatric dentists in eight Western New York counties. Of 193 surveys analyzed, 47.5% of dentists used FV in children. Only 44% accurately assessed high-risk cases for caries. Dentists serving children under age 2 and those correctly assessing high-risk children for caries were more likely to use FV in children under 7. Only 28% correctly recommended the first visit at 6/12 months; 38.7% recommended age 3. The authorsconcluded that FV was underutilized, suggesting a need for guide-line based strategies.
Salivary gland tumors account for a small fraction of head and neck tumors. Pleomorphic adenoma, the most common salivary gland neoplasm, frequently arises in major salivary glands; its localization to minor salivary glands is uncommon and typically involves the palate. We describe a patient with an asymptomatic, long-standing mass of the upper lip, which was found to be a pleomorphic adenoma.
Management of missing lateral incisors presents a challenge to attaining optimum esthetics and must be preceded by careful examination of areas of missing teeth and the relationship to adjacent soft and hard tissues. This case series describes various approaches and techniques for managing missing lateral incisors. These techniques were chosen depending mainly on the amount of space in mesiodistal and insiocervical dimensions. The amount of underlying bone played an important role in selecting the treatment modalities.
Anatomical characteristics, periodontal diseases and toothbrushing trauma make the management of multiple, adjacent, recession-type defects (MARTDs) particularly challenging. Even though connective tissue grafting is considered the gold standard in management, it has limitations, such as a second surgical site and limited amount of donor graft. Porcine pericardium membrane (PPM) is a reliable soft-tissue substitute with a three-dimensional collagen network that exhibits better stability, slow degradation, high-tear resistance, good handling properties and enhancedvascularization. This article describes the use of PPM, along with modified coronally advanced flap (Zucchelli’s technique), in treating Millers Class I and II gingival recession in a 38-year-old male patient. Satisfactory outcomes were observed in gingival recession depth and clinical attachment loss from the baseline to six months postoperative. Two-thirds of the sites showed 100% root coverage. The mean root coverage achieved was 88.8%. A significant increase in the width of keratinized tissue was observed after six months of followup. The PPM was safe and healed uneventfully.
