Calcium hydroxide uses in dentistry.
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Sports events, particularly those in which mouth protectors are not commonly used, can be associated with injuries to the oral structures. While the incidence of sports-related orofacial injuries is not as high as for other traumatic events, the incidence could be reduced further by increased use of mouth and face protection. When injuries occur, quick action by primary health care providers can significantly improve the final outcome of the definitive treatment. Also important is appropriate follow-up evaluation and care since the effect of trauma on teeth is not always immediately apparent. Destructive resorption, unnecessary tooth loss, and possible alveolar infections may be prevented by referral to appropriate health care providers for evaluation following the initial urgent care of trauma patients.
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There are considered the principles to be noticed in the expert opinion on teeth injuries resulting from accidents. The corresponding table of physical damage is shown and 3 clinical cases are presented.
The use of calcium hydroxide in the treatment of traumatic injuries are reviewed in this paper and demonstrated by some clinical cases. The necessity of a proper crown reconstruction is also emphasized as it is impossible to use posts in these treatments.
Calcium hydroxide is used in the treatment of different traumatized teeth. New concepts about the effects of calcium hydroxide on vital pulps and immature non vital teeth are developed. Some clinical techniques and their results are described.
As figures stand now, dental trauma will in the forseeable future probably surpass dental caries and periodontal disease as the most significant threat to dental health among youth, affecting approximately 50% of schoolchildren before they reach school leaving age. This threat will also be accompanied by just as significant economic consequences. Despite the frequency and severity of dental trauma, little has been done in the dental academic world to examine the cause and effect relationship between, e.g. trauma and later healing complications or acute treatment and the same. Moreover, knowledge about long-term prognosis after trauma is fragmentary. 1989 has been declared by the European Community as children's safety year. Perhaps this year will bring the traumatized child into focus and trigger the research needed to understand the etiology of trauma, its treatment and its consequences.
As it is shown in Tables 1 and 2, there exist large gaps in the experimental basis for the treatment of dental trauma in both the primary and secondary dentitions. It can be seen that approximately 12% of presently accepted therapy are based on experimentally supported treatment principles. This has resulted in a myriad of varying and often conflicting treatment procedures. A systematic investigation of the effect of an acute dental trauma and various treatment procedures on the individual cellular systems would require tremendous scientific manpower. In contrast to this need, the extremely limited research activity in the area of dental trauma is cause for worry. Unless this research area is upgraded nationally and internationally, there is little hope that the random and empirical basis accepted in the treatment of traumatic dental injuries will ever be replaced by a scientifically based set of treatment principles which respect and enhance wound healing in the pulp and periodontium. Only by the fulfillment of this goal will the long-term prospects of traumatized dentitions be improved.
It is virtually impossible to compare the results of the many studies of traumatic dental injuries, primarily because information is lacking or inaccurate. Another reason, however, is that the basic materials differ substantially. Most studies are based on special groups comprising trauma patients exclusively, and furthermore these are often selected patients, although this fact is not always made clear. In recent years a number of Danish studies have attempted to examine the trauma problem on a population basis. The results of these studies are discussed, a few new results are added and attention is pointed out to problems needing further investigation.
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In the world stomatological literature many more or less extensive clinical classification of posttraumatic damage to teeth are available. In the Polish stomatological school Ellis classification is used most frequently. However, this classification comprising nine classes of traumatic teeth damage is not sufficiently precise in the descriptions qualifying various classes. Moreover, the successive classes are not always logically arranged depending on the degree of damage. In view of this, the author has evolved another clinical classification of traumatic dental damage based on own clinical material and other classifications. The new classification is used in the Department of Developmental Age Stomatology in Zabrze. The base of the classification is the degree of damage to the dental tissues and the used therapeutic methods. Two-year experience with the classification showed that it is simple, sufficiently precise and easy for application by students and stomatologists.
For modern medical care, social background may be an essential factor, and medical care through out the individual's life time appears to have significant meaning. From this point of view, total dental care throughout childhood is being carried out in the field of pediatric dentistry. It can be stated that we pedodontists have a degree of farsight in the treatment of traumatic injuries to the teeth regarding children (the theme of the lecture), since the injured teeth are treated not only as items to be restored but also as a part of the growing body with careful consideration on the effects with regard to orlo-facial growth. It is obvious that epidemiological surveilance is necessary to understand the cause of dental injuries, and also careful attention ought to be paid to the activity of the children to grasp the potential background of dental trauma. Here, I would like to explain the consequences of the serial work on the traumatic injuries to teeth which were carried out in our department. 1) The prevalence of dental injuries in children appeares to be on the increase according to a judgement based on the surveilances form in and out of the country. Also as the parental recognition for dental injuries became higher, more patients visited dental clinic or hospital looking for improved treatment techniques. 2) Careful consideration must be paid to the succedaneus permanent tooth germ, when a deciduous tooth suffered from traumatic injury. The effect of the direction applied and the area of the traumatic force on the root of the deciduous tooth, the successor and the surrounding tissue was investigated by means of kinetic analysis.(ABSTRACT TRUNCATED AT 250 WORDS)
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A clinical case of exarticulation and replantation served to discuss recent insights regarding the treatment of total avulsions of permanent teeth. A flow chart representing all treatment options is given. The tooth has been replanted in near ideal conditions; within one hour after the avulsion, the young patient attended the dental school with his avulsed tooth stored in milk. After replantation, a very simple splint was applied for only a fortnight and a provisory endodontic therapy with calcium hydroxide was performed. Adequate oral hygiene measures supported with chlorhexidine gel were instructed. These promote the healing process and ultimately also contribute to a long-term survival of the replanted tooth. After healing, a permanent root canal filling was applied and the crown was restored by means of composite material. The one-year- follow up check did not show any sign of resorption and/or ankylosis.