PIT & FISSURE SEALANTS

 WHAT ARE PIT & FISSURE SEALANTS?

                                                                        These are defined as thin plastic coating which are placed on the occlusal surfaces of the posterior teeth to form a mechanical barrier between the tooth structure & the oral environment. They are to be used for teeth which are susceptible to caries.

TYPES OF SEALANTS:

                                         There are 4 different types of fissures namely I,K,U,V.

 TYPE I: They are extremely narrow slits. They are deep, narrow,& quite constricted, resembling a bottle neck. Susceptible to caries.

TYPE K: They are seen as narrow slit associated with larger shape at the bottom. Very susceptible to caries.

TYPE U: They are also shallow & wide. These are self cleansing and somewhat caries resistant.

TYPE V : They are shallow & wide and tend to be self cleansing. They are caries resistant.

HOW IT WORKS: 

Physical obstruction of pits & fissures which prevents colonization of pits & fissure with new bacterium & prevention of fermentable carbohydrates to gain access into pits& fissure so that any remaining bacterium cannot produce acid in carciogenic concentration.

ADVANTAGES OF SEALANTS :

1. Placement of sealants is a non invasive procedure.

2. Sealants will prevent occurence of fissure caries.

3. Sealants can be used at community level for prevention of caries.

4. Easy to apply.

TYPES OF SEALANTS:

1. BASED ON TYPE OF ACTIVATION - A). Self activation, B). External energy activation

2.BASED ON APPEARANCE - A). Transparent, B). Opaque

3.BASED ON FILLER -A). Filled, B). Unfilled.

QUALITIES TO BE CHECKED IN SEALANTS BEFORE APPLICATION:

1. Adequate working time.

2. Rapid cure.

3. Good& prolonged adhesion to enamel.

4. Resistant to wear.

5. Minimum irritation to tissues.

6. Cariostatic action.

PROCEDURE FOR PLACEMENT OF PIT & FISSURE SEALANTS:

1. Cleaning the tooth surface .

2. Centric stops should be registered

3. Isolate the tooth which is to be sealed with sealants.

4. Etching the tooth surface with 37% ortho- phosphoric acid for 15 secs after which it is washed away with a jet of water for 30 secs.Enamel should appear chalky white after washing & drying. After which bonding agent to be applied & light cured. Finally a thin layer of sealant is applied , such that it does not flow into the centric stops and light cured.

5. Occlusal adjustments to be made if needed.

FOR FURTHER DETAILS CONTACT US AT:

Rootz Dental Care and Implant Center has specialists with proven expertise in Implantology. For more information regarding treatments contact us today.

                                             

                                                No:2/2, First Floor, Sakthi Nagar,

                                                Rajiv Gandhi Salai, Thuraipakkam,

                                                Chennai - 600 097,

                                                Phone :- 9786688755,044-49504825

DRY SOCKET

 Definition:  

Dry socket is a post-operative complication that occurs after a dental extraction. It has been called as post-operative pain in and around the dental alveolus. The severity of pain increases between the first and third day after a dental extraction.It is followed by partial or total disintegration of the intra-alveolar clot, causing foul smell. 

Etiology:  

1. Difficult or traumatic extraction. 

2. Use of oral contraceptives. 

3. Normal changes. 

4.Tobacco.

5.Inadequate intra-operatory irrigation. 

6.Advanced age.

                              
                                                                  

Clinical Feature:      

          

 1. Pain typically appears on the second or third day after the extraction and it usually lasts either with or without treatment for 10 to 15 day.      

2. Pain is localised to the extraction socket which will be sensitive to even gentle probing. 

3. Bad breath is present. 

4. It is common for the pain to spread to   the ear and one side of the head. 

5. Clot in the socket which may be empty.

6. Radiological studies do not show important alternatives. 

Management: 

1. Patient should be radiographed to the possibility of retained fragments of tooth or foreign body. 

2. The affected socket should be gently irrigated with 0.12 % warmed chlorexidine and all debris dislodged and aspirated.

3. Intra-alveolar pastes consisting of zinc oxide eugenol paste, anesthetic drug (drug for pain) and an antibiotic (Metronidazole) can be placed. They act principally by increasing the drug concentration locally, reducing their secondary effects, avoiding the entrance remains of food to the alveolus and protecting the exposed bone from local irritation in addition to the use of eugenol as abundant. 

4. The complications secondary to the placement of dressings in the treatment of dry socket are ignored. 

5. The topical application of an emulsion of oxytetracycline and hydrocortisone & use of parahydroxybenzoic acid (PHBA) in extraction site decreased the incidence of mandibular third molar dry socket. Appropriate analgesics as the NSAIDs drugs are useful in managing pain. 

6. When it is considered that socket dressings are no longer needed the patient can be instructed in home socket irrigation techniques using 0.12% chlorehexidine. Patient should be kept under review until they are pain free and socket healing in ensured. 

 

HERPES SIMPLEX VIRUS

HERPES SIMPLEX VIRUS:

Also know as HSV, is an infection that causes herpes. It can occur in various parts of the body, most commonly on the genitals/mouth.The term herpes means to "creep"- which means easily spreading nature.

TYPES 

HSV 1: It causes oral herpes. This type can cause cold sores & fever blisters around the mouth & on the face. This spreads by contact with infected saliva.

HSV 2: It causes genital herpes. Said to be transmitted by sexual contact.

PATHOGENESIS:

Man is the only natural host to HSV, the virus is spread by contact, the usual site for the implantation is skin /mucous membrane.

Incubation period is around 3 to 7 days.

Local symptoms incluse- pain, itching, vaginal & uretheral dischrage & lymphadenopathy

HSV 1( Gingivostomatitis):

Oropharynx is the most commonly affected site. Usually it starts with a tingling

Tiny blisters show up & quickly break open, causing a painful sore which eventually scabs over time.

It is most common to haveout breaks 2 to 3 times a year.

Herpes is contagious, but its possible for one person in a family to have it , while the others dont.

Herpes is spread through direct skin to skin contact.

HSV 2 (GENITAL HERPES) :

Genital herpes is a common sexually transmitted infection caused by HSV. This occurs in the absence of symptoms.

There is no cure  for genital herpes, but medications can ease symptoms& reduce the risk of infecting others.

Symptoms begin about 2 to 12 days after exposure to the virus

Babies born to infected mothers can be exposed to the virus during the birthing process. This may result in brain damage , blindness or death of the newborn.

CLINICAL FEATURES:

1. High temperature.

2.Malaise.

3.Cold sores around the mouth.

4. Red bisters on skin.

5.In most cases , ulcers will heal & the individual will not have any lasting scars.

 

TREATMENT:

1. There is no cure for herpes.

2. Medicines such as acyclovir & valaciclovir fights the herpes virus.

3. Avoid touching an active outbreak site, washing hands frequently.

4.If the medicines are being used to treat a repeat outbreak, they should be started as soon as you feel any tingling, burning or itching.

GINGIVAL RECESSION

 WHAT IS GINGIVAL RECESSION ?

It is defined as the exposure of the root surface by a shift in the position of the gingiva.

ETIOLOGY:

1. Plaque induced gingivitis

2. Plaque induced periodontitis

3. Age

4.Faulty tooth brushing

5.Tooth malposition

6. Gingival inflammation

7.Trauma from occlusion

TYPES OF RECESSION:

1. Visible.

2. Hidden.

3. Localised.

4. Generalised.

5. Narrow.

6. Shallow.

 
    

MILLERS CLASSIFICATION OF RECESSION:

CLASS 1: Marginal tissue recession not extending to the mucogingival junction. 

                   No loss of interdental bone/ soft tissue.

CLASS 2: Marginal tissue recession extends to or beyond the mucogingival junction. 

                  No loss of interdental bone / soft tissue.

CLASS 3: Marginal tissue recession extends to or beyond the mucogingival junction

                  Loss of interdental bone /soft tissue is apical to the CEJ, but coronal to the apical extent of                       marginal tissue recession.

CLASS 4: Marginal tissue recession extends beyond the mucogingival junction .

                  Loss of interdental bone extends to a level apical to the extent of the marginal tissue                                recession.

 

     

WHAT CAN GINGIVAL RECESSION LEAD TO ?

 

1.The exposed root surface are susceptible to caries. 

2.Abrasion /erosion of the cementum leading to sensitivity.

3.Interproximal recession creates oral hygiene problems & results in plaque accumulation.

4. Finally resulting in aesthetically unacceptable teeth.

FOR FURTHER DETAILS CONTACT US AT:

Rootz Dental Care and Implant Center has specialists with proven expertise in Implantology. For more information regarding treatments contact us today.

                                             

                                                No:2/2, First Floor, Sakthi Nagar,

                                                Rajiv Gandhi Salai, Thuraipakkam,

                                                Chennai - 600 097,

                                                Phone :- 9786688755,044-49504825

EARLY CHILDHOOD CARIES(ECC)

 WHAT IS EARLYCHILDHOOD CARIES:

It is a form of dental caries seen soon after tooth eruption,which progresses rapidly leaving detrimental impact on the dentition. It is also known as "nursing bottle caries "due to its frequent association with inappropriate feeding habits.

ETIOLOGY/ CAUSE:

1. CARIOGENIC MICRO-ORGANISM: Commonly involved micro-organisms are Streptococcus mutans, & Streptococcus sobrinus, the reservoi r of which is the oral cavity. The number of organisms increases with the number of erupted teeth & with age. Lactobacilli is also said to play a role in the progression of caries.

2.CARIOGENIC SUBSTRATE( dietary factors): Diet plays an important role in ECC.  Feeding high carbohydrate diet ,bottle feeding during bedtime or sleeping increases the risk of initiation of caries                                   

3 SUSCEPTIBLE TOOTH( host factors): Proper oral hygiene to be maintained. Saliva has a  protective role against caries. Feeding of high sugary food at night increases the initiation of caries because of the decreased salivary flow.

CLINICAL FEATURES:

1. Cavities maybe visible as early as 10 months of age

2. Initially seen as white lines/spots on maxillary incisors .These white areas will rapidly breakdown into yellow brown cavities ,if left untreated.

3.These cavities are discolored to brown /black from stains in foods & drink

STAGES OF ECC:

1. VERY MILD: clinical appearance shows slight demineralization usually at gingival crest without any cavitation.

2.MILD: Clinical appearance shows demineralization in gingival third of the tooth & moderate cavitation.

3. MODERATE: Clinical appearance shows frank cavitation on multiple tooth surface.

4.SEVERE: Clinically apearance consists of widespread destruction of tooth & partial to complete loss of crown structure.

 FOR FURTHER DETAILS CONTACT US AT:

Rootz Dental Care and Implant Center has specialists with proven expertise in Implantology. For more information regarding treatments contact us today.

                                             

                                                No:2/2, First Floor, Sakthi Nagar,

                                                Rajiv Gandhi Salai, Thuraipakkam,

                                                Chennai - 600 097,

                                                Phone :- 9786688755,044-49504825

PERICORONITIS

 WHAT IS PERICORONITIS:

                                               It refers to swelling & infection of gum tissues around the wisdom teeth, the third & final set of molars.Most commonly noticed around the lower third molars.

 

CAUSES OF PERICORONITIS:  

This occurs around a wisdom tooth that has failed to erupt or has only partially erupted. 

A partially erupted wisdom tooth can leave a flap of gum tissue that collects food particles & other debris , which acts as a ideal breading ground for bacteria.

Trauma caused to the soft tissue flap in mandibular 3rd molars by the cusps of the opposing maxillary 3rd molar.

SYMPTOMS:

1.The overlying soft tissue shows 4 signs of inflammation namely, pain,redness, swelling & warmth.

2. Trismus.

3. Chills, fever, malaise & halitosis are present.

4. Painful, swollen gum tissue near the affected tooth with/ without pus discharge will be seen.

5. In certain cases swelling in that part of face, swollen lymph nodes & jaw spasms are also noted.

TREATMENT:

1. CONSERVATIVE METHOD:  Management of pain & resolving the pericoronal inflammation or infection .

2. SURGICAL REMOVAL OF OVERLYING FLAP: Minor surgery to remove the overlapping gingival tissue (OPERCULECTOMY).This is to be done when the molars can be useful for chewing & there is a desire to keep the tooth, minor oral surgery can be performed to remove the operculum. This will allow better access to properly clean the area & prevent the accumulation of bacteria & food debris.

3.SURGICAL REMOVAL OF TOOTH

FRENECTOMY

WHAT IS A FRENUM:

                                             Frenum is a fold of tissue/muscle connecting the lip, cheek, or tongue to jaw bone.The primary function of frenum is to provide stability to upper & lower lip & tongue.

 

WHAT IS FRENECTOMY:

                                                It is the complete removal of frenum, including its attachments to underlying bone. It maybe a genetic condition or can be the result of recession of the gingival margins, reaching the area of the frenum.

TYPES OF FRENAL ATTACHMENT:

1. MUCOSAL: The frenal fibres are attached up to the mucogingival junction  .

2. GINGIVAL : The fibres are inserted within the attached gingiva.

3. PAPILLARY: The fibres extends into the interdental papilla.

4. PAPILLA PENETRATING: The frenal fibres cross the alveolar process& extends up to palatine papilla

WHEN TO DO FRENECTOMY:

1. LIP TIE.

2. TONGUE TIE.

3. DIASTEMA.

4. GUM RECESSION.

5. PAIN.

HOW TO DETECT FRENECTOMY:

By applying tension on the frenal attachment & observing the movement of papillary tip or blanching around the alveolar attachment of the frenum due to ischemia.

MANAGEMENT: 

1.Simple excision technique: For the simple excision technique , a narrow elliptical incisions around                                                         the frenal area down to the periosteum is completed.

2.Z-plasty technique :small elliptical excision of mucosa & underlying loose connective tissues.                                                  closure is done with interrupted sutures.

3.Localised vestibuloplasty with secondary epitheliazation : wide v- type of incision made at most                                                                                                          inferior portion of frenal attachments 

4.Laser frenectomy : supraperiosteal ablation of mucosal & dense fibrous frenal attachment.                                                       Healing occurs by secondary epithelization.

 FOR FURTHER DETAILS CONTACT US AT:

Rootz Dental Care and Implant Center has specialists with proven expertise in Implantology. For more information regarding treatments contact us today.

                                             

                                                No:2/2, First Floor, Sakthi Nagar,

                                                Rajiv Gandhi Salai, Thuraipakkam,

                                                Chennai - 600 097,

                                                Phone :- 9786688755,044-49504825

                                                          Email :- rootzdentalcare@gmail.com

                                         CLEAR ALIGNERS

CLEAR ALIGNERS treatment is an orthodontic modality in which the patient wears a series of customized clear, removable aligners that gradually move the teeth to the desired position. Clear aligners are made up of either polyurethane, polyvinyl chloride(PVC) or polyethylene terephthalate glycol( PET-G).

 

INDICATIONS:

1. Mild crowding.

2. Deep overbite.

3. Spacing problems.

4. Absolute intrusion.

5. Tip molar distally.

CONTRAINDICATIONS:

1. Centric relation & centric occlusion discrepencies.

2. Severely rotated teeth( greater than 20 degree).

3.Teeth with short clinical crown.

4.Severe crowding ( greater than 5mm).

5.Severely tipped tooth ( more than 45 degree).

ADVANTAGES:

                                     

1. Trays are clear , aesthetic & comfortable.No metal brackets or wires to cause mouth irritation or laceratioms.

2. Clear aligners are often not visible, allowing patients to smile with greater confidence.

3. Better oral hygiene than fixed appliance

4.Healthier periodontal tissue & less risk of enamel de-calcification by avoiding brackets.

5. Treatment duration more precise than braces

6. In most cases extraction can be avoided by inter-proximal reduction to gain space.

DISADVANTAGES:

1.Since it is removable , it requires patient co-operation to achieve the desired results.

2. Should be worn for atleast 22 hours/day.

3.It should be removed during meals, while drinking hot drinks as it can lead to deformation,& during oral hygiene.

HOW DOES TOOTH MOVEMENT OCCUR:

It occurs through force driven system- which requires bio-mechanical principles to facilitate tooth movement. Aligners are designed to apply desired forces on the tooth.The shape of aligners to produce such a force is not necessarily the same as the shape of tooth.The shape of aligners is altered via pressure points or power ridges in order to apply desired forces & these do no produce certain movements soo "SMART FORCE ATTACHMENTS" are introduced.These attachments are small composite bulges designed to produce a force system favourable for the designed movement.

FOR FURTHER DETAILS CONTACT US AT:

Rootz Dental Care and Implant Center has specialists with proven expertise in Implantology. For more information regarding treatments contact us today.

                                             

                                                No:2/2, First Floor, Sakthi Nagar,

                                                Rajiv Gandhi Salai, Thuraipakkam,

                                                Chennai - 600 097,

                                                Phone :- 9786688755,044-49504825

                                                          Email :- rootzdentalcare@gmail.com

PULP POLYP

WHAT IS PULP POLYP:

Pulp is the soft tissue which is present inside the tooth & supplies blood to the teeth.Any sensation perceived by tooth is because of the pulp.

A pulp polyp is an abnormal growth of tissues from the lining  tissues as a result of  pulpal inflammation due to extensive caries exposure of young pulp. It is also known as hyperplastic pulpitis.

The inflammation is mainly because of the fact that the healthy pulp tissue is resisting the irritation caused by the causative factors. It is a tissue that is formed when inflammation cause the tissue(pulp)to increase in size & swell.

               

 CAUSES: It occurs as a result of both mechanical irritation & bacterial invasion into the pulp of tooth .

1.Slow & progressive carious exposure of pulp is the main cause

2.Carious tooth with significant loss of tooth structure.

3.Long standing decay.

4. Fractured tooth due to trauma with pulpal exposure.

5.Loss of dental restoration that results in pulpal exposure.

SYMPTOMS:

1. Mastication leads to tenderness, localized bleeding may occur.

2. Mild to moderate pain to be present especially on the back teeth as these teeth help in breaking down food, so when these forces act on pulp ,the inflammation aggrevates.

CLINICAL FEATURES:

It is seen as a spongy soft tissue nodule which extrudes from the cavitated or fractured surface of tooth. It enlarges to fill the entire cavitated area or pulp chamber of tooth. Appears as round red or pink mass that can be seen popping out of the open tooth structure.

TREATMENT:

Removal of the hyperplastic tissue followed by1. RCT( if sufficient tooth structure present).

                                                                            2. RCT &POST&CORE( if sufficient tooth structure                                                                                                                                          not there).

                                                                            3. Extraction.

FOR FURTHER DETAILS CONTACT US AT:

Rootz Dental Care and Implant Center has specialists with proven expertise in Implantology. For more information regarding treatments contact us today.

                                             

                                                No:2/2, First Floor, Sakthi Nagar,

                                                Rajiv Gandhi Salai, Thuraipakkam,

                                                Chennai - 600 097,

                                                Phone :- 9786688755,044-49504825

                                                          Email :- rootzdentalcare@gmail.com