In the picture lower jaw on the right (6 below), at the site of the removed tooth, the boundaries of the removed roots are clearly visible. But in reality everything soft fabrics there were removed when cleaning the hole in the gum. I’m not attaching the photo, it’s on the card at the hospital. Can the image clearly show the roots of the tooth if all the soft tissue near the extracted tooth and roots are removed?
Yes, after removal, before formation bone tissue The x-ray shows a darkening - this is an empty socket. After 6-12 months, the picture in the picture will change.
What can you say about this tooth?
From this x-ray we can say that in the area of the apex of the medial root of the 6th tooth and in the area of bifurcation of the roots there is inflammatory process. The filling material is not visible throughout the entire length of the root canal and not up to the apical foramen; it has most likely dissolved. Consequently, the canals are not tightly sealed, which led to the occurrence of apical periodontitis. There are no guarantees for successful retreatment, so the tooth must be removed. Consult in person with a dental therapist.
3 weeks ago I had an orthopantomogram and there was periodontitis on the 1st tooth on the left. Now, as I understand it, periodontitis is already on 2 teeth on the left. What could cause this? What's happening on the right? What kind of education?
In the fifth tooth of the lower jaw, material has been removed beyond the apex of the root; this tooth needs to be monitored. In the area of the sixth tooth of the lower jaw on the left there is destruction of bone tissue. This is due to the fact that the root canals are not completely sealed. It is necessary to re-treat this tooth.
The pain in the joint is characteristic of a bruise, only when pressed. On the left side right next to the ear. I took a panoramic photo. Is there a problem with teeth, and can it manifest itself this way?
According to the picture, there is a problem in the 27th tooth. It is depulped, but the root canals are processed and sealed poorly and there is an inflammatory process in the area of the apex of the tooth root. Aim should be made x-ray of this tooth and consult in person with a dentist-therapist.
“You look gorgeous today,” says your friend and treats you to toffee. Breaking into a smile, you put the candy in your mouth, bite it and - oh God! - click, crunch, paleness on the face: is the tooth broken? "What to do?" - we asked the director of the dental clinic, Dmitry Gershevich Lancet.
Ugly empty spaces in the mouth are a sad sight. Not only do they not decorate a woman in any way, they are also a sign of not very good taste. And no one is immune from tooth loss. And at any age. It is clear that in this case you cannot do without a visit to the dentist, although he can solve the problem in different ways.
Trying to restore a tooth with a pin and filling materials is not always acceptable: it will quickly break again, causing you new grief. And when the coronal, visible part of the tooth is completely lost, it is better to refuse such offers.
If you do not have a doctor whose services you regularly use, and the doctor whom you contacted in this emergency situation offers to remove the root of the lost tooth, do not rush to agree. Consult with other specialists. It happens that there is indeed a need to remove the root. But you shouldn't do this often.
Because there is a method of dental microprosthetics, when the preserved root serves as the basis for all further manipulations. A stump inlay is modeled from wax or plastic and later cast in a metal laboratory. This is fixed into the root, after which you can begin to restore the outer part of the tooth, covering the inlay with a crown selected by color, shade, and shape. This restoration is also suitable for supporting a bridge.
As a rule, everyone is concerned with the question: which metal to prefer? For example, I work with silver; others choose gold or base metals. I think this is not important. The main thing is not from what, but how. After all, if a brooch of the highest standard is clumsily made, it will not bring you joy. Is it true? So it is here.
Many patients, when they hear the word “metal ceramics,” frown and sigh: oh, is it so heavy? In my opinion, this is an unfair opinion. Modern metal-ceramic prostheses have much more advantages than disadvantages, if any, with the exception of individual intolerance allergic in nature, which is extremely rare.
When one of your friends complains that they put in a ceramic crown and it was so unsuccessful, I assure you: in 99 cases out of 100 the reason discomfort not in the material, but in a poorly made prosthesis.
As a result of prosthetics, the gums should not experience pressure or stress. If any are present, then it is not the material that is to blame, but the hands into which it fell. There are no absolute technologies and magical materials, but there are masters of their craft. Therefore, do not be afraid of metal ceramics, but avoid illiterate specialists. Moreover, ceramic materials latest generation have great strength and reliability. Their glazed surface is similar in appearance to enamel, is easy to clean and looks natural.
Usually people do not have much love for the dentist and enter our office reluctantly. I am for a trusting relationship with the patient, and therefore I always tell everyone what, how and why I intend to do. The principle of my work, as strange as it sounds from the mouth of a dentist, is mutual pleasure from communication. Teeth require the same careful treatment as any other organ. We remember them most often only when they begin to signal about themselves. Don't forget that a well-groomed mouth is your calling card and in many ways an indicator of your overall condition.
By the term “internal caries,” the average patient at a dental clinic usually understands a disease that affects the tissue deep under the tooth enamel. At the same time, doctors know that, by and large, any caries affects the internal tissues of the tooth, which are softer and more easily damaged than enamel. Therefore, the phrase “internal caries” can be applied to almost any case of the disease and, by and large, is a tautology.
In some cases, they talk about internal caries when they mean a pathological process under a crown or a poorly installed filling. Here, caries inside the tooth develops completely unnoticed by both the doctor and the patient, and reveals itself only when the pathological process covers the enamel around the filling (crown) or when pain. But again, this is still the same ordinary caries, just with a non-standard localization.
In most cases, at the first examination of teeth, their walls (surfaces) affected by caries are striking. These are often not carious cavities at all, but simply gray, tarnished enamel that has lost its healthy appearance due to demineralization.
Often the dentist sees a certain “tunnel” in the space between the teeth, but the probe may, due to the density of the interdental space, not pass into the hidden internal carious cavity. Usually, the doctor shows the patient in the mirror the grayish shades of the enamel against the background of developed internal caries and, after anesthesia, begins treatment of the tooth.
When a bur touches gray enamel, in almost 90% of cases it breaks off within a couple of seconds and the bur falls into the internal cavity with an abundance of carious, pigmented, infected and softened dentin. If the anesthesia is administered correctly by the doctor, there is absolutely no pain.
The doctor cleans and seals the tooth strictly according to the caries treatment protocol. If the tooth already has a connection with the pulp chamber (the cavity where the nerve is located), then the doctor performs depulpation and filling of the canals, followed by a permanent filling in one or two visits.
The photo below shows a tooth in which deep internal carious cavities are visible under bright light:
The following photo shows, that is, localized in the area of the natural relief of the teeth. Such darkening inside also often hides significantly destroyed tissues that are not immediately detectable during a normal examination:
At home, such “internal caries” is almost impossible to detect. It will reveal itself only if there is extensive damage to the dentin and pain appears in the tooth when the pulp is included in the pathological process. That is why preventive visits to the dentist are so important, who, using special methods, will be able to detect caries in any location and treat the tooth before it requires pulp removal (nerve removal).
Reasons for the development of deep caries
The causes of caries in deep tooth tissues are similar to those for caries with any other types of its localization. The disease develops due to the following factors:
- Permanent presence in oral cavity acids, both those that got here with food (fruits, vegetables), and those produced by bacteria that consume the remains of almost any carbohydrate food - flour, sweets, cereals.
- Reduced secretion of saliva or its low bactericidal activity. This may be caused by other diseases or metabolic disorders.
- Mechanical and thermal damage to tooth enamel.
- Hereditary factors.
Typically, caries develops under the influence of a complex of several such factors.
In any case, it is in the deep parts of the tooth, located under the enamel, that caries develops most quickly due to the greater susceptibility of the tissues here to the action of acids. Therefore, there are often situations when, under a barely noticeable (or even completely invisible to the naked eye) hole, there is a large cavity destroyed by the carious process.
Note:
This is why the enamel almost always breaks off (comes off in pieces) when a large carious cavity has already formed, affecting the layers of softened, infected dentin. That is, the enamel can hold the load for a long time, hanging over a hidden carious cavity, often without giving it away.
Features of diagnosing caries inside a tooth
Caries inside a tooth is much more difficult to diagnose than regular caries, which has manifestations on the surface of the enamel. It can definitely be noticed when using the following diagnostic methods:
In addition, advanced internal caries causes pain in the patient, which is mild at first and occurs mainly when chewing hard food and getting very cold foods on the tooth, and intensifying as the disease progresses. If the tooth is without visible damage starts to get sick regularly, you should definitely go to the dentist for an examination.
The following methods can be used as auxiliary methods for diagnosing and confirming caries inside the tooth:
Rules for treating the disease
In all cases of caries development inside a tooth, its treatment requires opening the enamel, removing the affected dentin and filling the cleaned cavities. In its advanced form, internal caries leads to the need to remove the nerve and fill the canals.
Even more severe are situations when a very significant amount of tissue is damaged by caries from inside the tooth, and it either after their removal or simply due to softening, splits. In this situation, it is often necessary to remove a tooth according to indications, followed by installation of an implant at the request of the patient, or bypass modern techniques prosthetics.
Note
There is a difference between a split and a split, so tooth-preserving techniques may involve, for example, restoration of a tooth on a titanium (anchor, fiberglass) pin after thorough intracanal treatment + installation of a crown (metal-ceramic, stamped, solid-cast, etc.), may involve tooth preparation under the tab, installing the tab + crown. There can be many options.
Sometimes the damage is quite extensive, but it is possible to save the roots of the tooth by removing the pulp from them. In such cases, it is possible to get by with installing a crown.
In any case, after detecting a carious cavity, the doctor cleans it out with a bur. If such tissues come close to the pulp, their removal can be painful and is most often done using local anesthesia.
From dental practice
There are ambiguous situations when the pulp area has not yet been opened when cleaning the carious cavity, but the patient already begins to experience pain during the doctor’s work. It is impossible to say for sure whether it is worth carrying out depulpation here or not. Without depulpation after installing the filling, when chewing, it may begin to disturb the nerve endings and cause pain. Some doctors are inclined to depulpate such a tooth so that they do not have to carry out repeated work if, after installing the filling, the patient begins to experience pain. Other dentists explain the situation to the patient in detail and make a decision together with him. It should be borne in mind that many patients are very sensitive to the preservation of their teeth in a “living” form and are willing to take risks in order to walk around with a tooth with preserved pulp for several more years, if after a simple filling there is no pain.
In general, even with deep caries, the nerve has to be removed, according to statistics, in less than a third of cases, and the removal of the tooth itself due to deep caries is generally a rather rare situation.
Prevention of deep caries
You can avoid the development of caries deep inside the tooth if you regularly undergo preventive examinations at the dentist and detect the appearance of the disease at the stain stage. With this approach, it is highly likely that depulpation will be avoided, and in the absence of hidden caries, it will even be possible to do without opening the tooth and filling it.
To prevent the appearance of even the earliest signs of caries, the following preventive measures must be observed:
- brush your teeth thoroughly at least twice a day - after breakfast and before bed;
- after eating, rinse your mouth;
- do not get carried away with sweets and candies;
- remove food debris stuck between teeth;
- Avoid contact of too hot or too cold foods and drinks with your teeth.
If you are predisposed to dental caries, you should consult your doctor and, on his recommendation, take calcium and fluoride supplements in the form of tablets or special solutions.
An additional preventative measure may be chewing gum containing xylitol instead of sugar. They should be chewed for 10-15 minutes after eating to increase saliva production and clean the spaces between the teeth.
Taken together and systematically applied, such preventive measures will provide reliable protection against tooth damage, and even when the first signs of caries appear, the doctor will be able to eliminate the pathology before it spreads into the deep tissues under the enamel.
Interesting video: tooth preparation and restoration with deep caries
An example of a two-stage method for treating deep caries