Caries of permanent teeth and consecutive illnesses. Dr. Katalin Déri
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1 Caries of permanent teeth and consecutive illnesses Dr. Katalin Déri
2 Relation between the caries of primary and permanent teeth Bad oral hygiene Improper nutrition Cariogenic milieu Contact caries Periapical inflammation of primary tooth Turner-tooth
3 Turner-tooth
4 caries of the first permanent molar Occlusal caries
5 Occlusal caries
6 First permanent molar caries Occlusal caries Contact caries
7 Contact caries
8 Contact caries
9 Caries of first permanent molar Occlusal caries Contact caries Approximal caries Secunder caries Buccal, lingual, palatinal caries
10 Buccal + Contact caries
11 46 radix
12 Caries of upper permanent incisors Approximal caries
13 Caries of upper permanent incisors
14 Caries of upper permanent incisors Approximal caries Foramen coecum caries
15 Approximal+ foramen coecum caries
16 Caries of upper permanent incisors Approximal caries Foramen coecum caries Buccal caries
17 Approximal+ buccal
18 Caries of upper permanent incisors Approximal caries Foramen coecum caries Buccal caries Secunder caries
19 Caries of second permanent molars Occlusal caries Approximal caries Buccal, lingual, palatinal caries Secunder caries
20 caries of permanent premolars Approximal caries
21 Approximal caries
22 caries of permanent premolars Approximal caries Contactcaries Occlusal caries Buccal, lingual, palatinal caries Secunder caries
23 Caries of lower permanent incisors Approximal caries
24 Caries of lower permanent incisors
25 Caries of lower permanent incisors Approximal caries Buccal caries Secunder caries
26 caries of permanent canines Approximal caries Buccal caries Secunder caries
27 Therapy - permanent molars and premolars Caries superficialis: Composite filling Compomer filling Amalgam filling Glas-Ionomer filling (long term temporary)
28 Therapy - permanent molars and premolars Caries media: Composite filling LINER (glas ionomer) Compomer filling LINER (glas ionomer) Amalgam filling LINER (glas ionomer) Glas-ionomer filling (long term temp) Cinkoxid-eugenol filling (temp.) Inlay- onlay
29 Caries profunda: LINER!!! Glas-ionomer filling (temp) Cinkoxid-eugenol filling (temp) Composite Compomer filling Amalgam filling Inlay- onlay
30 Therapy - permanent molars Extraction: If the second molars/wisdom teeth are not erupted yet If there are wisdom teeth Normal occlusion in vertical plane (no deep bite) Angle I.occlusion Ideal time for extraction in mandibule : age of (average) maxilla age of (average)
31 Extraction: -Contraindications: Deepbite Distalbite Absence of wisdom tooth
32 Therapy - incisors Caries superficialis: Composite filling Compomer filling
33 Therapy - incisors Caries media: Composite filling LINER Compomer filling LINER
34 Therapy - incisors Caries profunda: Composite filling LINER Compomer filling LINER Acrilic crown(till the age f 14) ((Extraction: crowding))
35 Consequences of caries in permanent dentition
36 Etiology Caries Secunder caries Deep fillings Traumatic injuries
37
38 Reversible pulpitis of permanent molars Sypmtoms: Tooth hypersensitiviy for external factors (cold) Moderate pain Factor removal --- pain stops Possible causes: High filling Deep caries Secunder caries
39 Reversible pulpitis of permanent molars Therapy: Filling correction Removal of cariotic tissues --direct/indirect pulp cappig (CaOH2) --long term temporary filling (GIC/zincoxide eugenol) --recall no symptoms definite filling
40 Reversible pulpitis of permanent molars Therapy: Vitalamputation, Pulpotomy? --if root is still developing/immature tooth Partial pulpotomy ( 2mm) Cervical pulpotomia (total coronal pulp) Aim: let the tooth finish its root development apexogenesis after: definite rct
41 Reversible pulpitis of permanent molars Pulpotomy: Diamond bur + water Stop bleeding Ca(OH 2 ) + GIC liner + filling
42 Reversible pulpitis of permanent molars Extraction: If the second molars/wisdom teeth are not erupted yet If there are wisdom teeth Normal occluson in vertical plane (no deep bite) Angle I.occlusion Ideal time for extraction in mandibule : age of (average) maxilla age of (average)
43 Irreversible pulpitis of permanent molars Symptoms: Massive / pulsing pain Cold can induce Pain lasts longer than the stimulus Pain at night
44 Irreversible pulpitis of permanent molars Therapy: Root canal treatment Extraction
45 Permanent molars -Periodontitis apicalis chronica Symptoms: No specific symptoms Mild discomfort No response for vitality test Sensitivity for percussion X-ray
46 Permanent molars -Periodontitis apicalis chronica Therapy: Root canal treatment Extraction
47 Permanent molars -Periodontitis apicalis acuta Symptoms: Strong pain for percussion No vitality Beginning:no typical symptons on x-ray Later: wide periodontal gap If acute phase of a chronic inflammation--- x ray symptoms
48 Permanent molars -Periodontitis apicalis acuta Therapy: Root canal treatment Extraction
49 Permanent molars- Abscessus periapicalis chronica Symptoms: Not typical Might be sensitive for percussion Fistula gingiva skin No vitality X ray
50 Permanent molars- Abscessus periapicalis chronica Therapy: Root canal treatment Extraction
51 Permanent molars - Abscessus periapicalis acuta Symptoms: Swelling vestibulum/palatum Swollen face Feels like the tooth is extruded Mobility Massive pain for percussion Fever, discomfort, lymph node swelling X ray not typical
52 Permanent molars - Abscessus periapicalis acuta Therapy: Root canal treatment Incision Extraction Diffuse swelling/ general symptoms-- antibiotics
53 Permanent molars - Periostitis Symptoms: Diffuse extraoral swelling Massive local pain Feels like tooth is extruded Mobility Sensitive for percussion X ray
54 Permanent molars - Periostitis Therapy: Root canal treatment Extraction
55 Permanent incisors Pulpitis - rare Periodontitis /periostitis more often
56 Permanent incisors-periodontitis Therapy: RCT Sever crowdingextraction resection as late as possible
57 Permanent incisors-periodontitis Therapy: RCT Sever crowdingextraction resection as late as possible
58 Permanent incisors-periodontitis Therapy: RCT Sever crowdingextraction resection as late as possible
59 Permanent incisors-abscessus periapicalis Therapy: RCT Sever crowdingextraction resection as late as possible
60 Permanent incisors-abscessus periapicalis Therapy: RCT Sever crowdingextraction resection as late as possible
61 Apexification If we need to root canal treat an immature tooth which is still developing Wide root canal, open apex Aim: artificial closure of the apex dentine live pulp tissue close to the apex bone pulp necrotized cement pulp necrotized
62 X ray Apexification - Steps (Anaesthesia) Removal of alive or necrotized pulp tissues Careful mechanical cleaning (preparation) 1-3% NaOCl-chemical cleaning Dry the canal Ca(OH 2 ) paste or MTA Temporary filling 2 days after changing CaOH2 Changing CaOH- 4-8 weeks- 3 months
63 Apexification - Steps Treatment may last for 5-30 months Control x-ray apex closed Definite root canal filling Definite restauration
64 Apexification - Steps
65 Apexification- 1.Ca(OH 2 ) paste
66 Apexification- 3 months later Ca(OH 2 )
67 Apexification- 10 months later
68 Apexification- 10 months later definite rcf
69 Thank you for your kind attention!!!
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