EMC - Dentisterie最新文献

The bacterial etiology of periodontal diseases has now been perfectly proved ; therefore using antiseptics to treat such diseases is an absolutely imperative therapy. When and now do they have to be used ? For what kinds of specialties or pathologies ? What are their indications and contra-indications ? What are their positive and negative effects ? In this article, the main antiseptic molecules are listed, as well as the instructions to use them.

Dental caries is the most shared pathology in the world. A good clinical diagnosis allows adapted care and the settlement of prophylactic measures. Now, there are two principal classifications: classification from Black, concerning only coronal caries, and SISTA concept concerning coronal and root caries. Secondary caries are clinically and radiologically similar to a primary lesion.  They appear in dental plaque stagnation zones. There are various diagnosis methods (visual examination, probe, radiography).These différent tools are more efficient when using together.

Haemostasis is a physiological process triggered by a breach in a blood vessel. Haemostasis plugs the breach and stops the loss of blood via two distinct but intertwined and interdependent mechanisms: primary haemostasis and plasma coagulation. Primary haemostasis is an emergency mechanism in which circulating blood platelets adhere to the injured endothelium to produce a white thrombus or platelet plug. Then, the platelet plug is strengthened by the development of a fibrin network that entraps the aggregated platelets. Insoluble fibrin is produced when the soluble plasma protein fibrinogen is exposed to thrombin, the final product of a cascade of enzymatically activated reactions among clotting factors. The fibrin-platelet thrombus is eventually dissolved by the proteolytic enzyme plasmin, which is the main protein of the fibrinolytic system. The various phases of haemostasis are tightly regulated by a system of plasma activators and inhibitors that locally control the development of the clot and avoid activation of coagulation at a distance from the vascular injury.

Success of a treatment with removable partial denture (RPD) essentially depends on the occlusal integration of the different prosthetic constructions realised according to the treatment planning intially defined. An articulator’s set-up of the plaster models is necessary as far for the case’s study as for the prosthetic realisation and information’s transmission to the technician. Considering the gaptoothed situation, a different reference is to be chosen : dental reference : the maximal intercuspidian occlusion (MOI) or articular : the centric relation. Different materials can be used. Choice of impression’s techniques is important, particularly for the realisation of mixed prosthesis. Tooth choice and tooth placement are important stages for the future esthetic integration of the RPD. Patients wishes must be considered and also remaining teeth and dentogenics, described by Frush and Fisher. It is also possible to make up the resin and porcelaine teeth. Techniques are described in this article. Tooth placement will be facilitated by the pre and pro-prosthetic preparations intra and inter arch, which will restore satisfaying compensation curves. Polymerisation and finition are finally important laboratory’s stages which must not be neglected. Resin properties are briefly reminded. The final purpose is to obtain RPD that combines esthetic in visible parts and prophylaxis in posterior areas.