This section is a work-in-progress, devoted to the interdiscipline of orthodontics, periodontics, and dental implants ("implants"). The intended readers are general dentists and orthodontists who are interested in periodontal surgery and dental implants, which are related to orthodontic treatments.
As an alternative to infiltration injection of local
Strong Topical Anesthetics
As an alternative to infiltration injection of local anesthetics, for some minimally invasive dental procedures, dentists can use strong topical anesthetics which are given as follows
where phenylephrine is a vaso-constrictor. Note that these strong topical anesthetics must not be allowed to stay on the soft tissue for long because they will cause the soft tissue to slough off.
Gingiva & Mucosa
In the mouth, keratinized tissue is gingiva and non-keratinized tissue is mucosa. Gingiva is tough, whereas mucosa is easy to tear. The border of mucosa and gingiva is called the mucogingival junction (MGJ). It may be easy to identify the MCJ on some patients, but that is not always the case.
Gingiva is divided into 2 types: free gingiva and attached gingiva. The coronal part of the gingiva from the cementoenamel junction (CEJ) is the free gingiva, where the apical part of the gingiva is the attached gingiva. For the most part, the free gingiva attaches to the enamel of the tooth by the junctional epithelium. The attached gingiva attaches to the root surface of the tooth by the connective tissue attachment.
Why are the distinctions important?
Many people suffer gingival recession, and one of most common causes is that these people tend to brush their teeth too hard. And the two most fundamental procedures for treating this condition is Free Gingival Graft (FGG) or Connective Tissue Graft (CTG). To be more precise, the latter is also called Subepithelium Connective Tissue Graft.
In FGG, the gingiva must be harvested as a superficial layer, the keratinized tissue, of the palate, whereas in CTG, the excised connective tissue is underneath the keratinized tissue of the palate.
In regeneration and soft tissue management, some common questions include the two controversial products: Emdogain (enamel matrix derivative, a product of Straumann) and AlloDerm Tissue Matrix (a skin product of LifeCell, distributed by BiHorizons).
The root of the tooth must be conditioned mechanically and chemically prior to certain grafting procedures. The process of cleaning the root mechanically will inevitably create a smear layer which must then be removed. The best way to remove this smear layer chemically is by using ethylenediaminetetraacetic acid (EDTA) which is an amino polycarboxylic acid, a chelating agent, and a colourless, water-soluble solid.
Traditionally, dentists and endodontists use EDTA solutions to remove the smear layer and lubricate the root canals in endodontics. The EDTA solution for this application is in a liquid form.
RC-Prep is routinely used for the chemo-mechanical preparation of root canals. Contents: 10 % urea-peroxide, urea peroxide and 15% EDTA in a paste form (special water-soluble base).
EDTA in a gel form is commercially available as PrefGel, a pH neutral, 24% EDTA, a product of Straumann. It is a root surface conditioner, for topical application onto exposed root surfaces.
Citric acid: Its use for root conditioning must be avoided because it is acidic and it may cause root resorption. Its pH is typically reported as 2.2, but this value varies depending on the concentration.
The most common and less expensive sutures are
Other more expensive sutures are
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