Download Dentistry 2017- KJT- STUDENT part4

Exodontics
 Extraction of the tooth
 When?
Persistent deciduous teeth
 Prognosis of a tooth is grave
 Client prefers low cost method of treatment
 Anesthesia is contraindicated in patient

 Possible complications:
 Anesthetic factors
 Hemorrhage
 Iatrogenic trauma
Instruments: Periosteal Elevators and Luxators
 Goal is to weaken the PDL
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Instrument is placed in between tooth and bone
Tool is rotated slightly, held, and then rotated
in the opposite direction and held
Tooth is separated from its gingival attachments and is removed in
one piece
 Index finger is extended to working end
 Minimizes iatrogenic soft tissue trauma
Winged Elevators
Extraction Prep
 Pre and post radiographs
 Regional nerve block
 Delivered to specific nerves to block an entire region of mouth
 ___________ 0.5% and/or ___________ 2%
 Time of effect?
 Instruments needed:
 Dental luxator/elevators
 Extraction forceps
 Small suture and needle drivers
 Sx: High speed hand piece/burs, scissors, curettes, scalpel, and
root tip elevators if fx
Endodontics
 Performed when there is disease of the pulp
 Pulp is the vital part of the tooth, should not be exposed to
bacteria of the mouth

Can lead to ____________ and ______________
 Common indication is fracture
 More invasive and expensive route than extraction

Which teeth are commonly fractured?

Why is this painful?

What instrument is used to determine pulp exposure?
Endodontics
Endodontic disease requires treatment
1. Root canal therapy
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Removal of pulp with a dental bur, shape with H-files or Kfiles, disinfect with diluted bleach, dry with paper points, fill
canal with Gutta Percha, and place protective seal.
Requires pre and post radiographs
2. Vital pulp therapy
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When tooth is alive and can be saved
Immature teeth or recent trauma
Oronasal Fistulas (ONF)
 Holes formed between mouth and nasal cavity,
usually secondary to PDL destruction.
 Tooth becomes mobile and eventually falls out,
leaving a communication between oral and nasal
cavities.

Which teeth commonly affected?
 CS: sneezing, and persistent, usually single sided,
nasal discharge with or without bleeding.
 Treatment includes surgery to close fistula.
Oronasal Fistula
Tooth Resorption
 Destruction of tooth structures
 Lesions usually found clinically in
the __________ region
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Easily hidden by gingiva
Which instruments help find these lesions sooner?
 Actually begin break down in the root structures…
 How can we find this earlier?
 Idiopathic disease
 Vitamin D levels?
 Extraction required
“Cervical neck lesions”
Gingival Hyperplasia
 Thickening or over growth of gingival tissue
 Not a malignant condition.
 How do we confirm this?
 May be caused by periodontal disease
 Overgrowth of gingiva can increase sulcus depths,
forming pseudopockets
 Treatment:
 Remove tissue if needed
 More prophylactic cleanings
Trauma
 Jaw Fractures
 Most common type is _____________ separation
 Left and right mandibles separate from each other at
the symphysis
 Require rigid fixation for ~3-4 weeks
 Ex. Cerclage wire, tape (puppies)
Tape muzzles- stabilize fracture until Sx
Adhesive side up!
 Loose enough to allow tongue to move
between incisors  allows eating of slurry

Client Education
 Start young!
 Inform client of periodontal disease during vaccination process
 Distribute pamphlets or brochures
 Explain home care oral hygiene techniques
 Brushing with dentrifices or gels
 Rinses/wipes
 Water additives
 Dental treats
 Mention acceptable bones and chews
Home Care Instructions
 BRUSH, BRUSH,BRUSH!
 Start with water, work towards ____________
 Begin caudal and buccal, work towards incisors
Brushing Techniques
Stillman Technique:
Sweep in a coronal direction
*When is this used?
Bass Technique:
Bristles go into the
sulcus
Client Education
Once routine dental cleanings begin: (2-3 years of age)
 Discuss the procedures actually performed and:
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Any complications
Medications given or needed

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Ex. Local anesthetics, antibiotic, etc
Diet changes (temp. or long term)

Prescription needed?
 Any follow-up procedures needed
 Prepare estimates
 Give date of return
 Helpful websites: https://www.aaha.org/
http://vohc.org/index.htm
Prescription Diets Available