RESUMO
Alveolar ridge preservation (ARP) is a method of decreasing bone resorption following tooth extraction and facilitating prosthetically-driven implant placement. An understanding of the physiological responses occurring after extraction and the effects of ARP are important in order to implement clinical procedures. ARP is a predictable way to reduce undesirable horizontal and vertical ridge reduction following extraction when dental implant treatment is to be delayed. Guided bone regeneration, socket fillers, socket sealers and growth factors have been used satisfactorily. However, there is currently no consensus on case selection, best clinical technique and material choice. Management of tooth extraction sockets is presented, with a focus on decision-making.
Assuntos
Perda do Osso Alveolar , Aumento do Rebordo Alveolar , Implantes Dentários , Processo Alveolar , Extração Dentária , Alvéolo DentalRESUMO
UNLABELLED: As part of treatment planning, options are presented to patients by dentists. An informal discussion takes place involving a cost-benefit analysis and a treatment plan is agreed. Evidence-based dentistry takes into account the best available literature, clinical experience and patient factors to guide the dentist. Dentists exert considerable influence on which treatment modality is selected. This paper focuses on the importance of patient factors which lead to less than ideal, clinically acceptable, treatment plans that nevertheless give patient satisfaction over the long term. Though no universally accepted healthcare model exists for restorative dentistry, patients' decisions are most influenced by their relationship with their dentist over factors such as time, access and cost. Letters should be sent to patients clarifying the nature of all proposed options, including advantages and disadvantages, complications, success rates, biological and financial costs and what happens if no treatment is carried out. CLINICAL RELEVANCE: Many psychological and social determinants influence patients'values and decision-making when planning for restorative dentistry. These lead to a treatment plan agreed between the patient and the dentist. Often an element of compromise is considered acceptable to both parties when the evidence would suggest an alternative treatment to be preferable.
Assuntos
Dentística Operatória , Planejamento de Assistência ao Paciente , Participação do Paciente , Adulto , Anodontia/reabilitação , Atitude Frente a Saúde , Periodontite Crônica/terapia , Comunicação , Análise Custo-Benefício , Coroas , Tomada de Decisões , Implantes Dentários , Prótese Dentária Fixada por Implante , Restauração Dentária Permanente , Relações Dentista-Paciente , Dentística Operatória/economia , Odontologia Baseada em Evidências , Feminino , Humanos , Incisivo/anormalidades , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Técnica para Retentor Intrarradicular , Determinantes Sociais da Saúde , Fatores de Tempo , Fraturas dos Dentes/terapia , Dente não Vital/terapia , Resultado do Tratamento , Adulto JovemRESUMO
Alpha-mannosidosis is a rare genetic lysosomal storage disorder that is inherited in an autosomal recessive pattern. Severe periodontal breakdown in alpha-mannosidosis patients has not previously been reported in the literature. The purposes of this paper are to: present the cases of 2 siblings diagnosed with alpha-mannosidosis, each of whom had varying severity of periodontal destruction; and provide an overview of alpha-mannosidosis, the possible reasons for the periodontal destruction, and the periodontal management in the 2 affected siblings. Both had preventive and nonsurgical periodontal therapy followed by a 5-year period of supportive therapy. Their pattern of bone loss was consistent with those with periodontitis as a manifestation of systemic diseases, with the extent of periodontal destruction being related to the severity of the alpha-mannosidosis. Alpha-mannosidosis patients present with social disfigurements and, to prevent tooth loss that can add to this, early periodontal diagnosis is important to optimize management and intervention.
Assuntos
Perda do Osso Alveolar/etiologia , Periodontite/etiologia , alfa-Manosidose/complicações , Adolescente , Aggregatibacter actinomycetemcomitans/isolamento & purificação , Perda do Osso Alveolar/patologia , Perda do Osso Alveolar/terapia , Criança , Placa Dentária/microbiologia , Feminino , Crescimento Excessivo da Gengiva/etiologia , Humanos , Masculino , Periodontite/microbiologia , Periodontite/patologia , Periodontite/terapia , IrmãosRESUMO
A lady with extrinsic acid erosion was referred to the restorative department at Bristol Dental Hospital by her General Dental Practitioner (GDP) for restoration of worn maxillary first molar teeth. These teeth were both causing symptoms of dentinal sensitivity and two attempts had been made to restore them with composite by her GDP. The restorations failed because there was insufficient space to bond the composite in place, which was due to dento-alveolar compensation of the first molars into the space created by the wear. Following relevant preventive advice, the maxillary first molar teeth were restored with 'high' direct composite resin, which allowed for adequate strength in bulk for retention while acting as fixed intrusion devices. These cured the patient's sensitivity and within four months her occlusion compensated for the composites and had re-established.
