Caries of permanent teeth and consecutive illnesses Dr. Katalin Déri
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
Turner-tooth
caries of the first permanent molar Occlusal caries
Occlusal caries
First permanent molar caries Occlusal caries Contact caries
Contact caries
Contact caries
Caries of first permanent molar Occlusal caries Contact caries Approximal caries Secunder caries Buccal, lingual, palatinal caries
Buccal + Contact caries
46 radix
Caries of upper permanent incisors Approximal caries
Caries of upper permanent incisors
Caries of upper permanent incisors Approximal caries Foramen coecum caries
Approximal+ foramen coecum caries
Caries of upper permanent incisors Approximal caries Foramen coecum caries Buccal caries
Approximal+ buccal
Caries of upper permanent incisors Approximal caries Foramen coecum caries Buccal caries Secunder caries
Caries of second permanent molars Occlusal caries Approximal caries Buccal, lingual, palatinal caries Secunder caries
caries of permanent premolars Approximal caries
Approximal caries
caries of permanent premolars Approximal caries Contactcaries Occlusal caries Buccal, lingual, palatinal caries Secunder caries
Caries of lower permanent incisors Approximal caries
Caries of lower permanent incisors
Caries of lower permanent incisors Approximal caries Buccal caries Secunder caries
caries of permanent canines Approximal caries Buccal caries Secunder caries
Therapy - permanent molars and premolars Caries superficialis: Composite filling Compomer filling Amalgam filling Glas-Ionomer filling (long term temporary)
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
Caries profunda: LINER!!! Glas-ionomer filling (temp) Cinkoxid-eugenol filling (temp) Composite Compomer filling Amalgam filling Inlay- onlay
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 10-12 (average) maxilla age of 10-14 (average)
Extraction: -Contraindications: Deepbite Distalbite Absence of wisdom tooth
Therapy - incisors Caries superficialis: Composite filling Compomer filling
Therapy - incisors Caries media: Composite filling LINER Compomer filling LINER
Therapy - incisors Caries profunda: Composite filling LINER Compomer filling LINER Acrilic crown(till the age f 14) ((Extraction: crowding))
Consequences of caries in permanent dentition
Etiology Caries Secunder caries Deep fillings Traumatic injuries
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
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
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
Reversible pulpitis of permanent molars Pulpotomy: Diamond bur + water Stop bleeding Ca(OH 2 ) + GIC liner + filling
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 10-12 (average) maxilla age of 10-14 (average)
Irreversible pulpitis of permanent molars Symptoms: Massive / pulsing pain Cold can induce Pain lasts longer than the stimulus Pain at night
Irreversible pulpitis of permanent molars Therapy: Root canal treatment Extraction
Permanent molars -Periodontitis apicalis chronica Symptoms: No specific symptoms Mild discomfort No response for vitality test Sensitivity for percussion X-ray
Permanent molars -Periodontitis apicalis chronica Therapy: Root canal treatment Extraction
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
Permanent molars -Periodontitis apicalis acuta Therapy: Root canal treatment Extraction
Permanent molars- Abscessus periapicalis chronica Symptoms: Not typical Might be sensitive for percussion Fistula gingiva skin No vitality X ray
Permanent molars- Abscessus periapicalis chronica Therapy: Root canal treatment Extraction
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
Permanent molars - Abscessus periapicalis acuta Therapy: Root canal treatment Incision Extraction Diffuse swelling/ general symptoms-- antibiotics
Permanent molars - Periostitis Symptoms: Diffuse extraoral swelling Massive local pain Feels like tooth is extruded Mobility Sensitive for percussion X ray
Permanent molars - Periostitis Therapy: Root canal treatment Extraction
Permanent incisors Pulpitis - rare Periodontitis /periostitis more often
Permanent incisors-periodontitis Therapy: RCT Sever crowdingextraction resection as late as possible
Permanent incisors-periodontitis Therapy: RCT Sever crowdingextraction resection as late as possible
Permanent incisors-periodontitis Therapy: RCT Sever crowdingextraction resection as late as possible
Permanent incisors-abscessus periapicalis Therapy: RCT Sever crowdingextraction resection as late as possible
Permanent incisors-abscessus periapicalis Therapy: RCT Sever crowdingextraction resection as late as possible
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
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
Apexification - Steps Treatment may last for 5-30 months Control x-ray apex closed Definite root canal filling Definite restauration
Apexification - Steps
Apexification- 1.Ca(OH 2 ) paste
Apexification- 3 months later Ca(OH 2 )
Apexification- 10 months later
Apexification- 10 months later definite rcf
Thank you for your kind attention!!!