Marcus Aurelius Mediation

The main goal of endodontic treatment is to prevent or heal apical periodontitis. The cleaning and shaping procedures are adversely affected by the highly variable root canal anatomy. The presence of additional canals needs to be detected in to avoid incomplete instrumentation and preservation of bacteria and their toxins, which can compromise the outcome of the root canal treatment. Therefore, the knowledge of the internal anatomy of teeth is a prerequisite for successful endodontic therapy(1).

With all these results, many variations among materials, operators, and patients can contribute to these clinical failures. Therefore, further clinical research and studies are necessary to evaluate the performance of the restorative materials and to determine the factors related to the failures as many conditions cannot be reproduced in the labatory. In previous studies, evaluations of the studies showed that in a period of 5-12 years, the success was 85 to 98 percent. In the longest follow-up mentioned by Dr.

Impregum was used for the second impression and was sent to the lab for a bruxZir crown. This material had also been used for years by Dr. Spencer due to its flexibility and pleasant taste. Dr. Spencer had tried different products in the past, however, he found these specific materials to be more effective. The bruxZir crown is a more esthetic choice and was selected for this specific patient based on grinding habits. The other procedure I observed was a porcelain-fused-to-metal (PFM) crown placement using Cavidry, Carboxylate cement, and Durelon. Cavidry is a cleaning agent used for rapid drying, degreasing, and cleaning the area before a crown placement. Carboxylate cement and Durelon are mixed together to create a cement that is the most effective for porcelain-fused-to-metal crowns or gold crowns. The Carboxylate cements and Durelon were selected by the dentist due to its desirable retention of restorations, easy to use, and is inexpensive. The dentist also selected the PFM crown because it is a noble metal that is least likely to break. The office manager explained that a specific crown is selected based on insurance, esthetic purposes, and according to patient’s oral habits.

My internship with Dr. Kharouf last summer was a paid position, in which I served as an assistant in his practice. The bulk of this job entailed aiding Dr. Kharouf as he conducted a variety of procedures, including brace and retainer adjustments, cleft palate pre-operation preparations, as well as tooth reshaping and repair. Often these procedures required x-rays, retainer formation, mold creation, and taking bite indicators, the responsibilities of which fell to me. Retainer formation and mold creation were the most common of these activities, as I conducted these on a daily basis. While pouring up molds was relatively straightforward, the retainers were more complex, especially when a permanent retainer was required. However, Dr. Kharouf helped develop my ability to synthesize synthetic retainers, a valuable skill he assured me I would be using regularly in both dental school and my future practice. Complementing these daily tasks, Dr. Kharouf’s office also frequently utilized an indirect bonding method of brace application, of which I was responsible for the creation of temporary brace settings, as well as the application of these braces onto new patients. The latter portion of this job I initially found to be quite difficult, not

While Visiting Cheshire Dental lab on March 31, I was astonished by how many steps and equipment it took to produce a final dental restoration. From the first step of disinfection to the final step of sand blasting the final product, the process of making a crown requires time and accurate procedures. During my observation, I was able to see the development of a crown and the process of creating a wax and metal coping. Our mentor, Joseph Feeley, was extremely informative and explained his techniques in an interesting way. The overall experience of my observation was fascinating, and will be a helpful tool when educating my future patients.

Dental sealants can be accomplished through the use of either glass ionomer sealant (GIS) or through the use of resin based sealants (RBS) as currently recommended by the American Dental Association. Resin based sealants form a micromechanical-bonded resin layer that acts as a physical barrier between enamel and surface and the oral environment and thus changes the occlusal morphology (3) Resin based sealants can be either filled or unfilled. Filler particles improve the dental sealants wear resistance. Unfilled sealants are beneficial when “high spots” in the occlusion cannot be adjusted with dental hand pieces. These type of sealants are mostly used in school-based settings. Most of the clinical studies have demonstrated that glass ionomer has lower retention rates compared with Resin based sealants

Hedlund et al. compared the clinical performance of Composipost and Endopost which is another carbon fiber post with different morphological characteristics, specifically created for narrow root canals. They evaluated 48 posts (either type) on 68 patients over mean period of 2.1 years. A failure rate of 3% was determined which is related to a premolar that was part of a cantilever fixed partial denture and an upper canine. Both failures were reparable and recovered through recementation where the restorations were functional for another 10 months. (12)

Different materials and techniques have been currently available for instrumentation and obturation of root canal system. Currently, root canal preparation with rotary nickel-titanium (NiTi) instruments has become popular because they shape the root canals easily, rapidly, and more efficiently while reducing preparation errors

it was claimed that the failure rate is owing to particular anatomical problems linked with the child and the less satisfactory microstructural possessions of the primary teeth for adhesive procedures (15.16)

A tooth is composed of the crown and root as shown in the diagram (Fig 2.1). The crown is the visible part of the teeth [1]. Enamel is the protective covering over the surface of the crown with an approximate density of 2.9 g/cm^3. Cementum is the covering of the root that attaches the tooth to the connective tissue fibers of the membrane located between the tooth and the tooth socket to hold the tooth in place. A tooth is mainly composed of dentine. Dentine is a highly elastic internal structure within the enamel and cementum with an approximate density of 2.5 g/cm^3. Pulp is the soft tissue in the central area of the dentine that hosts blood vessels and nerves. It is important to note that enamel, dentine, and cementum are calcified. This means these three components can be used for the EPR dosimetry.

The study showed significant differences in compressive strengths of the materials. Fluorocore had the highest and vitremer had the lowest compressive strengths (2).There was also significant differences in flexural strength with fluorocore being the highest(2) and amalgam being the lowest. The low flexural strength of the amalgam is evident in both studies(1,2). The study concludes that dual cure core resins are great replacements for amalgam in posterior teeth due to their high strengths. The use of GIC is not indicated for core

Teaching during my sophomore year was very basic because I did not have the knowledge or confidence necessary. I was still learning the foundations of the disease processes, and really just trying to correlate my readings with what I was introduced to in the hospital. One example of teaching performed during this semester was with my 84 year old male urinary tract infection patient. He was not in the right frame of mind for teaching, but I tried to explain how eating can help improve his wound healing time, and how important wearing the SCD’s are to prevent DVT, since he is bed bound. During my time on the unit, there was also teaching that needed to be done about medications, administering medications, why I was doing a full assessment, and so forth. The teaching was endless, but I also was the one being taught a lot as well. I realized this semester that a lot of these patients with chronic diseases know about their diseases and what they should be doing, they just are not doing it or able to do it..

There are two main theories relating to orthodontic tooth movement, which are crucial to understand the assessment of the ‘ideal’ force for tooth movement. The bone-bending theory, otherwise referred to as the biological electric theory, proposes that forces applied to teeth stimulate electron release, which are then involved in remodeling alveolar bone. Possibly more accepted, however, is the pressure-tension theory. This theory suggests that forces applied to a tooth result in compression of the periodontal ligament on one side of the root, and a tension force applied to the other. Compression for an extended time, exceeding approximately four hours, results in a release of chemical mediators, including prostaglandins and cytokines, in addition to decreased oxygen associated with reduced blood flow. These mediators act to directly, and indirectly through secondary messengers

Study the way teeth occlude for diagnosis and treatment planning diagnosis and treatment planning „ Allow formation of occlusal occlusal surfaces during lab preparation and adjustment during lab preparation and adjustment of fixed and removable prostheses and of fixed and removable prostheses and indirect dental restorations indirect dental restorations

In developing countries like India, accident falls are the main cause of dental trauma and anterior teeth are frequently affected10.The treatment options are decided by the position of the fracture line, length of the remaining root segment and the presence or absence of a coronal segment. The chances of healing with calcified tissue is poorest in cervical-third fractures.1,11 If the fracture line extends below the level of the alveolar bone crest and the apical root segment has sufficient length, the treatment alternatives are crown lengthening, orthodontic extrusion, reattachment, post crown and extraction.