Tài liệu Clinical Problem Solving in Dentistry pdf

- SECOND EDITION Clinical Problem Solving in Dentistry EDITED8Y Edward W Odell • A high canes rate Summary A 17-ycar-old sixth-form college student presents ,11 your general dental surgery with several carious lesions, one of which is very large How should you stabilize his condition? EXAMINATION Extraoral examination I Ie is a fit ,ltld heillthy-looking ildolcsccnt No sublllen\Od~ of toolh.lche in the pdst 11(' is kl.'('f1 to all thilt C,ln be dune to Sol\"(' all tt't'th and a d«islon i~ made to try to f('Stor~ the lower molar ::=:::lJ A HIGH CARIES RATE Table 1.3 Dletary adw:e Aims Methods RcWcc tile all1Ol.t1t of sugar Check manufacturl!ls'labels and iMlOd foods Wlth sugars such as sOC/ose, glucose and fructose ~sted early III the Ingredients, Natural sugars (e.g, hooey, blown sugar) are as carlOgeJJic as purified Of added sugars 'M1eo SWi!'I!t foods are required, choose those containing sweelcring agents such as sacchafin acesu~ame-K arid aSpaflame, Diet formulatlons contain less sugar than their standard counterparts, Reduce the sweetness 01 drinks and foods Become accustomed 10 a less sweet diet overal Reslrtelled, $Ialograms are performed by pasSlllg radiopaque contrast media Into the duct Tlle commonly used materialS contallllOd'rte and are coniralll(hcated on lhose wtlh IOdine hypersensrtr'llly Ultrasound is a oon'O\Iasive, harmless IRlieshgatlOn useful to show the gland parenchyma and stones over mm diameter II is relalrvely QUICk and sometimes useful to d,sbng",sh stO/lCS and s.'> Wlrat yorl sel'? of the ultrasound lransducer (lransmltler/deteclorl to provide views at differenl angles Ultrasound scans are conven\lonally ollentated WIth the surface of the pallent Interpreling a single ullrasound picture IS difficult, the (ultrasound transducer) atl11e top Objects that renect Investigation IS dynamre and the ultrasound operator may ultrasound such as stones, appear wtule and cast a dark obsel'le the screen for several minutes altering the angle acoustiC shadow below them, Dilated docts prOXJmal to the 55 l ~l'N IN TNt IUCM Lltrr.;cn:; waves are cirecled '" the stone ItrcJui1'Ilhe sott ttssues of the ned 10 shatter the stone The poecei shooJId then pass oown the 00ct and be eJi,PeIed II " SIM.Tble 101 stones up 10 11lV11 II l:Umeler May reqo.ore one long 01 sever" sh;wt 'o'ISIIS 10 red\o:e the oMlole slone 10 traemerl\s Nt can be passed II sakva, Successf~ Radlologocaty glilded mervenl.oDnalleclnques loUCII as OOfllwa basket utr«tlOn of stones E_ _ n I ~ teclnques nd:JdIn& nI1XOIJIOl'eal ItholrlPsy 11 one-third of slJllabie cases, (Sell Fig 55,5) A OorrTllOU1U.' of infection If this W uf th infôtTon (Sft> C, ' I), ã nrl' I",ril'l'kol rtidiosrnpllS al'l" slrown i,1 56J U'trat yo~ StOr? r;g~rt' see Table 561 DIAGNOSIS see Table 56.2 TREATMENT • Hmv wou/II you ma.mgl' tlll'St' failed ",Morutions? The posts and crowns need to be leml1lIed from ail tkee teeth to aIow further IfI'o'eslIgabon lor root fracllKe and to assess the posslblhty of re-root filling the teeth by an orthograde approach • How will yOIl rcmov/' till' /1Osls m,,1 ('rm,ms? IVlml On' till' flll"rllltngcs (I/1{lllis(ld,'outas/,s of tlrl' met/rods? f' 56.3 p~ radooerJl)hs Iaken on pre5elltatoon That on the Il!fl_ tal 01 trep/wles of OfIerent aameters that are used 10 CUI ar-ound the POst Car-e must be used to select the smalest Itep!wle that l!ts ewer the post The treptwle cuts a cylIldncai hole and IS thus I'lOt conservalnle of rool