Revue d'odonto-stomatologie最新文献

After setting the essential rules of the emergency prescription in the dental office, the authors consider successively from a standpoint of properties, indications, contra-indications, danger of associating medications, presentation, use and posology. The medicines used in order to treat the different emergency situations that can arise in a dental practice.

The psychological and psychiatrical behaviour troubles and the psychosomatical manifestations are very frequent in dental and oral surgery practice. Their variable expression is sometimes confuse for the practitioner who should quickly find the differential diagnosis with the imperative medical emergency. His attitude must be quiet and kind, still watching over the vital functions and waiting for the more frequent spontaneous favourable evolution.

After vagal collapsus, hypoglycemia is the emergency most often seen in the dental office. It usually happens among the treated diabetic population; there are approximately one million diabetics in France. Its sudden appearance requires an emergency treatment with oral or IV intake of glucose, or the injection of glucagon. Hypoglycemia is defined by a drop of the blood glucose level below the normal values. Of sudden onset, the clinical signs of hypoglycemia can vary, specially the neurological and psychiatric manifestations, and they can lead to a coma. The objective diagnosis relies on the blood glucose level.

The emergency tracheotomy is indicated when there is a respiratory distress caused by the complete obstruction of the upper airway and when the etiological and symptomatic treatments have failed. However, it is not an easy procedure for a non specialist outside the hospital environment. The translaryngeal stem maintains a minimal ventilation while waiting for the emergency medical unit.

Cardiopulmonary arrest is an acute emergency characterized by the absence of central pulse and ventilatory movements. Only the fast intervention of a resuscitation unit allows in some cases to preserve the vital prognostic. However its action can be efficient only if resuscitation gestures have been undertaken as soon as the cardiopulmonary arrest is established by the practitioner. These gestures are chest compressions and artificial ventilation. Their efficiency can be increased by the use of a simple and inexpensive oxygen therapy equipment.

Angina pectoris results from an insufficient flow of oxygen to the myocardia cells. It is not an unusual complication in the dental office, the most frequent factors that trigger angina are: -stress, -pain, -exercise. The treatment consists in providing oxygen and vasodilators. Hypertension is characterized by an increase in the diastolic arterial blood pressure over 120 mmHg and by other clinical manifestations. Stress, pain, and exercise are the most frequent factors responsible for hypertensive disease. Hypertensive disease can lead to various complications ranging from a headache to myocardial infarct or hemiplegia. Treatment consists of different types of vasodilators.

After a short summary of the circumstances that can arise a call for help, this article describes the different organisms able to intervene in case of an emergency situation: medical emergency units, firemen, other organisms and the means to contact them. The modalities of this call and its minimal and indispensable content are then repeated. The modalities are on one side description of the emergency situation and on the other side the geographical informations. When the message received, the organism called can adapt the means that need to be send to the emergency situation and can manage to send them on location as soon as possible.

In the mixed dentition, when there is a discrepancy between the bony structures and the teeth, in certain cases, serial extractions are performed in order to guide the eruption of permanent teeth and obtain a correct occlusal function. The treatment consists in the extraction of primary teeth and then of first bicuspids. The choice of the first tooth to be extracted is based upon the position of the crowns of the permanent teeth and their degree of root maturation. Then the first bicuspid is extracted as soon as or prior to its eruption. This interceptive treatment has limited indications which need to be respected in order to preserve the child's future dental health. This treatment is indicated for Class I malocclusions with severe crowding or moderate crowding associated with bi-maxillary protrusion.

The tomodensitometric image given to Odontologist is previously a "worked" image by radiologist. Therefore, a same anatomical structure may present different even opposite aspects. Understanding the scanographic technic is indispensable before prescribing and interpretating these numerics images.

A new technical approach for immediate cleansing and decontamination was studied. Control of cleansing was observed using macroscopic and microscopic (S.E.M.) examinations on different instruments currently used in dentistry. Antiseptic solution was tested regarding four bacterial strains representative of the normal oral flora. The synergistic action of the combined solution plus pressure was effective for removal of debris before they dry. Antiseptic solution was bacteriostatic and at concentration level recommended by the manufacturer, viable colonies were not detected.