EMC - Dentisterie最新文献

Even if implications are different in children or adults, injuries of the teeth and alveolar bone represent reasons to consult in emergencies department, stomatology or maxillo-facial surgery unit, dentistry unit. Diagnosis must be immediately determined and treatment quickly achieved to obtain success, but difficulty consists in particular situations : children, vital prognosis, poor dental condition… However, lack of foresight is constant, even if success seems to be occurred, and must be explained to the patient or his family. Primary medical attestation is an important thing to give with prescription. Follow-up is essential : weekly in the beginning, up to several years.

The properties of ceramic materials including biocompatibility, stability, durability and optical qualities have resulted in new clinical applications. With more and more materials being introduced it is important that dentists understand the variety available and the factors which will contribute to the success or failure of the restoration. When faced with the task of evaluating a new or alternative ceramic system you should have a number of question in mind : the flexural strenght, tooth reduction needed, aesthetic, marginal fit, abrasivity, clinical studies support and cost. For the last ten years, the application of high-technology process to dental ceramics allowed for the development of new materials such as heat-pressed, injection-molded and slip-cast ceramics . This paper review advances in new materials and process available for ceramic restoration. The most recent ceramic materials are review including leucite, alumina, spinel and zirconia. An overview of mechanical propertes is included. The automatic production methods for dental restorations, the high quality of the materials used have opened up new possibilities in therapy, the current state of analog and CAD/CAM systems is described and analysed to make an informed decision and maximize clinical success. Research is continuing to develop materials which are strong, aestheticand suitable for multiple applications, including crowns, bridges, inlays and onlays.

Accident occasionned by wisdom teeth are frequent in our practice, and mostly due to infection. Achievement of third molar growth needs several factors : a normal tooth bud which evolution will be tutored by the second molar in order to be situated on the right place in the posterior aspect of mandibular arch. Lack of growth of the mandible in an anteroposterior direction, lack of space in the arch, developmental abnormality in the positioning of the tooth germ or an aberrant path of eruption, cause an impaction or a partial eruption. The crown appears to be partially covered by a gum flap, which inflammation causes the most common complication : an acute péricoronaritis, which main symptoms are : pain, limitation of jaw movements, and fever. If it is mis-treated, an abcess can spread in the oropharyngeal area ant threatens the airways. Subacute complications are sinusitis, osteitis are caused by a long-term evolution and favorised by a treatment which neglected the cause of infection. Mecanical complications are also frequent : third molars may be responsible for the destruction of the crown of the second molar, to create an area of weackness in angular fractures. Multiplication of X rays permit to discover quiescent impacted teeth wich are surrounded by important dentigerous cysts, which histologic analysis is mandatory in order to eliminate an ameloblastoma. Treatment of these complications include the treatment of the acute pathology without forget the treatment of the responsible tooth.

As an alternative to reconstructive surgery, maxillo-facial prosthesis allows the rehabilitation of maxillo-facial abnormalities. Whatever the origin of the abnormality, undertaking restoration of the facial mutilation induces dealing with the patient’s psychological suffering. The success of the prosthetic procedure depends on the therapeutic management which should include a close support of the patient. A psychological management of the patient and of his family is necessary throughout the patient’s medical history, and necessitates the involvement of a multidisciplinary team. Various techniques for supporting patients exist, such as sophrology, and are of utmost importance in terms of stress coping and in mobilizing patient’s personal resources.