Endodontics |
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+381 11 354 4481 | +381 63 322 641 | +381 62 322 446 Praška 28 | Banovo brdo | Čukarica | Beograd |
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Dentistry today is a science that requires team work. In the course of orthodontic treatment it is sometimes necessary to perform certain surgical procedures. Before any work can be done, a doctor ( an orthodontist) will devise a detailed treatment plan that is based on the inspection of a patient, patients X-rays and a model study and decide if any surgery needs to be done. The most common procedures are : tooth extraction in order to prevent or treat crowding of teeth (usually it is the wisdom tooth that needs to be extracted sometimes even before it starts erupting- procedure called germectomy), frenectomy in order to correct spaces between teeth (usually central maxillary incisors), cortycotomy- a procedure that removes soft and hard tissue in order to facilitate tooth eruption.
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In some cases, while extracting maxillary teeth (premolars and molars) there is a chance that the maxillary sinus gets opened due to the fact that root tips of the maxillary teeth are located extremely close to the floor of the sinus. It is a situation that needs to be resolved quickly (usually by means of surgery) in order to prevent later complications such as chronic sinusitis or oroantral fistula.
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Periodontitis is a set of inflammatory diseases affecting the periodontium (the tissues that surround and support the teeth) accompanied by red, swollen, bleeding gums, halitosis and a persistent metallic taste in the mouth in the early stages followed by the loosening and migration off tooth/teeth in later stages and it ends with tooth loss. One of the symptoms is gingival recession resulting in an apparent lengthening of the teeth (significant esthetic problem) that leaves the roots exposed and sensitive in contact with hot, cold or sweet. The primary cause of periodontitis is poor oral hygiene which leads to the accumulation of a mycotic and bacterial matrix at the gum line, called dental plaque (a.k.a. bio film). |
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Management of periodontitis has four stages. The goal of the first stage a.k.a. initial therapy is to eliminate all of the factors that can cause or contribute to the spreading of an already existing inflammation in the gums or other tissue surrounding the teeth and to establish excellent oral hygiene. This is done by removing all microbic plaque and calculus in a non-surgical procedure using the ultrasound called scaling and planning. In the second stage the following procedures are performed: debridement and pocket reduction, adjustment of the occlusion (bite) to prevent excessive force on teeth that have reduced bone support, replacement of rough, plaque retentive restorations, closure of open contacts between teeth…. All these procedures are done in local anesthesia. The third stage is a surgical stage that involves open debridement, soft tissue management (free gingival grafting, subepithelial connective tissue graft…), as well as guided tissue regeneration and bone grafting. The fourth and final stage is maintenance. This is the longest stage, and a stage that is almost completely up to the patient, which includes regular dental checkups and proper dental hygiene (this includes brushing two times a day with daily flossing). It is important to remember that there is no periodontitis in the clean, plaque and calculus free, mouth. |
