The Teeth-Ing Troubles

Friday, 13 June 2014

Zimmer One Piece Implant

The Teeth-ing Troubles

Patient's Cosmetic Concerns In Dentistry

The Teeth-ing Troubles-Cosmetic needs and patient satisfaction

Ref: American Dental Association Newsletter

http://www.quintpub.com/journals/ejed/abstract.php?article_id=14383#.U4zpqPZOWcw

Achieving patient satisfaction, step-by-step

It’s not uncommon for cases that start out with low esthetics to be accompanied by high patient expectations. Researchers publishing in the summer 2014 issue of The International Journal of Esthetic Dentistry described how to manage such circumstances using the case of a 27-year-old woman with amelogenesis imperfecta.
Caused by protein mutations involved in enamel formation, the genetic developmental disorder causes light and dark discolorations and atypical crown shapes. The subject’s chief complaint was dark and white opaque staining. However, she was also bothered by teeth that overlapped and an asymmetrical gingival margin. Researchers hoped to sacrifice as little healthy enamel as possible, while still meeting high expectations for an improved appearance.
The initial clinical examination did not reveal the true depth of the staining, so in agreement with the patient, a step-by-step treatment plan was adopted.
The first treatment step consisted of a home bleaching process. The patient noticed a positive change and was motivated to seek further improvement.
Step two was a microabrasion technique. Only the most superficial enamel layer was etched and removed with an abrasive paste and a rubber cup. Again, in the follow-up visit, the patient noticed improvement and wanted to continue treatment. This time the goal was to correct the position and shape of her front teeth.
All conditions were ideal for step three, a plan to restore the maxillary incisors and canines with ceramic veneers. At the outset, corrections were performed digitally, and foreseen changes were transferred into a wax-up. The dentist used the resulting mock-up to serve as a communication tool and discuss the prospective outcome with the patient.
Both were satisfied with the result during a try-in session, when veneers were inserted with glycerin gel in order to improve color assessment. All involved with the treatment plan were “very satisfied with the final treatment outcome,” authors reported.
“The patient was heavily involved in the process of decision-making and, therefore, her esthetic expectations could be integrated into the final treatment,” authors commented about the success. “For the predictability of the treatment, a meticulous prediagnostics and a stepwise treatment protocol is crucial; otherwise the outcome may be compromised.”

American Dental Association Family Nutrition: Message to the children and parents

The Teeth-ing Troubles

Monday, 7 April 2014

Antiplatelet drugs, anticoagulants and elective dental surgery

What Are the Risks of Having a Stent?

Why do you need to be cautious before a dental extraction??

There is an increased risk of bleeding when patients taking anticoagulant or antiplatelet drugs require surgery.This risk must be balanced against the risk of harm if treatment is stopped. For many minor procedures aspirin or warfarin can be continued. Patients having non-cardiac surgery may be able to continue aspirin, but clopidogrel should be stopped unless there is a high risk of thrombosis. Patients taking warfarin may require bridging anticoagulation around the time of major surgery.This involves replacing the warfarin with unfractionated or low molecular weight heparin. Consultation with a cardiologist is particularly recommended if a patient with a coronary stent requires surgery.

Figure A shows the coronary arteries located on the surface of the heart.

Figure B shows a stent-widened artery with normal blood flow. The inset image shows a cross-section of the stent-widened artery.

In figure C, tissue grows through and around the stent over time. This causes a partial blockage of the artery and abnormal blood flow. The inset image shows a cross-section of the tissue growth around the stent.

Risks Related to Percutaneous Coronary Intervention

Percutaneous coronary intervention (PCI), the procedure used to place stents, is a common medical procedure that is sometimes referred to as coronary angioplasty. PCI carries a small risk of serious complications, such as:

Bleeding from the site where the catheter was inserted into the skin
Damage to the blood vessel from the catheter
Arrhythmias (irregular heartbeats)
Damage to the kidneys caused by the dye used during the procedure
An allergic reaction to the dye used during the procedure
Infection

Another problem that can occur after PCI is too much tissue growth within the treated portion of the artery. This can cause the artery to become narrow or blocked again. When this happens, it's called restenosis (RE-sten-no-sis).

Using drug-eluting stents can help prevent this problem. These stents are coated with medicine to stop excess tissue growth.

Treating the tissue around the stent with radiation also can delay tissue growth. For this procedure, the doctor threads a wire through a catheter to the stent. The wire releases radiation and stops cells around the stent from growing and blocking the artery.

During any dental procedure which might involve bleeding, a consultaton with the cardiologist is mandatory and bridging treatment with Low molecular weight Heparin and close monitoring is mandatory.

For more information
Kindly contact
Dr.Sreenita Chowdhury
sreenita28@gmail.com