Minimally invasive procedures are the new paradigm in health care. Everything from heart bypasses to gall bladder, surgeries are being performed with these dynamic new techniques. Dentistry is joining this exciting revolution as well. Minimally invasive dentistry adopts a philosophy that integrates prevention, remineralisation and minimal intervention for the placement and replacement of restorations. Minimally invasive dentistry reaches the treatment objective using the least invasive surgical approach, with the removal of the minimal amount of healthy tissues. This paper reviews in brief the concept of minimal intervention in dentistry.
There is an increasing population of apparently well, but in fact medically compromised people in the community. Most will require dental treatment at some stage and will usually seek it away from a hospital environment. In a recent survey of a general dental practice in Australia it was found that up to 55 per cent of some age groups had concurrent medical problems. Thus there is a real risk that adverse interactions between medical conditions and dental treatment may occur on some occasions, even fatal ones. It is not possible for any individual to know the details of all medical conditions, their treatment and the possible interactions with dental treatment. However, by the application of some sound general principles the risks of any potential interactions can be evaluated. The essential steps for a clinician are: knowledge of the medical history of all patients, potential drug interactions and management of medical emergencies. These principles will be discussed and illustrated by examples of medically compromised patients who may experience common or potentially serious sequelae as a result of dental treatment.
Necrotizing soft-tissue infections (NSTI) are characterized by extensive and rapidly progressing soft tissue inflammation with necrosis. It typically involves a gas-forming bacterium such as group A b-hemolytic Streptococcus or a Clostridium species. This gas formation leads to the radiographic finding of subcutaneous emphysema. It is recognized as a surgical emergency. NSTI of the abdominal wall, flank, or thigh resulting from break-in bowel integrity is an atypical presentation that may cause delayed recognition and treatment, resulting in a mortality rate greater than that in Fournier gangrene. Early detection and aggressive surgical debridement are crucial to reduce patient mortality and morbidity. We present the case of a 30-year-old patient presenting with fasciitis of lower limb. Surgical exploration revealed the source of the emphysema to be an entero-cutaneous fistula. The patient had an unstable and prolonged hospitalization after debridement of the thigh and abdominal surgery and was discharged after one month. It suggested that clinical presentation can be highly variable and range from early sepsis with obvious skin involvement to minimal cutaneous manifestations of underlying disease.
Primary teeth should be preserved until their normal exfoliation time so as to maintain arch length and function in order to provide proper guidance for the eruption of permanent teeth , enhance esthetics and mastication, prevent aberrant tongue habits, aid in speech and prevent the psychological effects associated with tooth loss. Pulpectomy consists of removing the pulp tissue associated with micro-organisms and debris from the canal and obturating with resorbable filling material. Success rate of endodontic therapy depends on many factors like familiarity with the complexity of primary tooth canal systems, their formation and resorption pattern, obturating material as well as obturation technique used that is capable of densely filling the entire root canal system and providing a fluid tight seal from the apical segment of the canal to the cavosurface margin in order to prevent reinfection. This review article basically focuses on various obturating techniques used in deciduous teeth with their comparison, pros and cons.
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