Going around and viewing other colleague experience during dental congress and conference an idea has been focused in my mind, the profession of dentists is going in two different ways : The Invasive way, and the minimal invasive way.
As most of the things in this world i think that the truth is just in the middleand that simply is not possible to approach every single situation every time in the same way, this is just an utopia!
I hope this protocol will help colleagues getting through this evenience ,protocol is the key to success!
” Something rare to be seen”
This is what it has flashed in our mind few days ago at Dr. Fabrizio Antenucci’s office, reason way we decided document the case to shoot some pictures,and here we are,talking about External Resorption, in this specific case…
– bilateral resorption,affecting 4 elements in a single (unlucky) patient –
But what does the scientific bibliography says about Internal and *External Resorption?
Resorption is both cases if it is *external or *Internal is a physiological and pathological process which results in loss of hard tissues of the tooth , cement and dentine and the surrounding bone are tricked by this degenerating process.
As you will see in the following case pictures, the patient tooth seems health and in a good general state, before going on reading, take your time and think about it…and try to answer!
what it can cause a tooth degeneration without any visible damage? (1)
If the patient during smile exhibits a portion of the gum greater or equal to three millimeters, there is an indication for the surgical treatment of gummy smile.
This is my first full protocol case published on Universal Dentists, hope you will enjoy, if you have any questions, please write me down the article. Hope you will enjoy !!
♦ What is periodontitis ?
Periodontitis is the irreversible loss of attachment to the connective tissue supporting the alveolar bone. It is an inflammatory desease characterized by the distruction of alveolar bone, root cement, periodontal ligament as a response to elicited by microbial accumulance on tooth surface. (1)
♦ Periodontal desease
Periodontitis is the main cause of tooth losing .The aim of periodontal therapy , is to eliminate the inflammatory process, to stop the progression of periodontal desease and to regenerate the lost periodontal tissues. (2) Earlier attemps to archive regeneration , included denator of the interdental bone to treat intrabony defect and the use of autografts to fill the surgical site. Good results have been taken in treatment of periodontitis using a combination of graft material and collagen membrane (3).
But recently , the focus is in the use of ‘growth factors’.The periodontal wound healing , needs the colaburation of epithelial cells , gingival fibroblasts , periodontal ligament cells and osteoblasts. There is evidence that the presence of growth factors , cytokinins in platelets , play an important role in the wound healing.Platelets also secrete fibrin , fibronectin and vitronectin which are a matrix for the connective tissue .These leads to the use of platelets in periodontal desease (4)
♦ Role of platelets in periodontal wound healing
Platelets play a key role in wound healing and hence wound healing after periodontal treatment can be accelerated by the use of platelet concentrates.The wound healing process
RISKS – APPROACH – GUIDELINES
The somministration of bisphosphonate drugs,in the last years is becoming every day more common.
This therapy has numerous benefits in case of osteoporosis and carcinomas metastasizing bones, but it exposes patients to a series of important side effects that concern our profession.
To our knowledge, numerous studies widely reported osteonecrosis by bisphosphonates (ONJ)*, It is well known as surgical procedures such as surgical extractions or fracture reduction, dramatically increase the development of osteonecrosis in patients under bisphosphonate treatment.