Dentalnews (en)

How long should you bother keeping a tooth?

Get a tooth removed, or wait, but for how long? As long as you still have good reason to!

We are talking about severely damaged teeth, teeth that have undergone root treatment but are still causing problems. The picture shows you a tooth that there is no more reason to keep.
The patient underwent root treatment 4 years previously and is still experiencing pain in this area. Root tip resection was performed, but to no avail. During the root tip resection, the tooth received neither an orthograde nor a retrograde filling – more on this topic here

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The patient opted for another resection, but in the course of the operation it became evident that the tooth needed extraction.

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The mucous membrane has been flipped to the side, you can see a small window of bone (highlighted in white), and you can clearly see the tooth (highlighted in black) – the root tip has already been cut. The inside of the tooth is highlighted in blue, inside the pink dot you can see the filling compound. Around the compound, however, the tooth has started to rot  – the black area. There is no more point in keeping this tooth, as faulty root treatment has caused the tooth to rot from the inside. Another root tip resection may help to put off the problem for a while, but not eliminate it completely!

Antibiotics, Tamiflu and medical hygiene

Did you know that between 250 and 300 tons of antibiotics are prescribed in Germany every year?
Austria exhibits similar statistics, proportional to its size. A very large share is prescribed by accredited doctors, „just to be on the safe side“.

Today we would like to talk about why this enormous consumption of antibiotics poses a problem and why patients should pay attention to proper hygienic conditions at the doctor’s office…

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Antibiotics are one of the wonders of modern medicine!

We would even go so far as to say that no other type of medication helps to heal so many illnesses and brings people back from the brink of death.
Alexander Fleming (1881-1955) is famous for discovering penicillin and thus, antibiotics, even though at first he barely knew what a powerful natural tool he had in his hands. Penicillin and all other modern antibiotics fight bacteria and one-celled organisms – but they are absolutely useless against viruses.

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Penicillin is a by-product of a mold, and the actual challenge after its discovery was trying to produce it in sufficient quantities. In the beginning it was even common practice to collect the urine of patients treated using penicillin in order to re-extract the valuable substabce.

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As medicine progressed, ever more valuable antibiotics were discovered and extracted from plants and molds. But why is a high intake of antibiotics bad for patients? The answer is what is known as „developing a resistance“. – Read more about this topic tomorrow!

And until then, watch this!

Bone reconstruction – overview

We have already written several articles on the subject of bone reconstruction, click the following links to see them:
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Iliac crest transplantation is not necessary

Human bone heals best

Dental implants and bone reconstruction

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Now we would like to introduce an innovative new procedure, helping to prepare human bone for bone transplant!

One major problem is that bone replacement materials are often distributed through doctors and chief physicians at hospitals, who then of course get a percentage of the profits, making it difficult to get a truly „objective“ opinion. So you keep hearing great things about e.g. bone replacements made of algae, which does not really correspond to the facts.
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But let us concentrate on human bone for now. Bone from human donors has always been, and still is, cleaned using liquid solvents. The problem with this process, however, is that you can never quite get the bone 100% clean, there are always some cell remains left. After the transplant is performed, the immune system of the recipient tries to break down these remains, leading to an inflammation, which unfortunately also ends up destroying the transplant.
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Instead of solvents, the company Celtis uses highly critical CO2 to clean bone. This is a kind of aggregate state in which the CO2 is neither liquid or gas but somewhere in the middle.

Simply put, you are familiar with H2O in its solid state – ice, in its liquid state water and its gaseous state steam.
An aggregate state is referred to as highly critical when it is between two of these well-known states. CO2 in such a state retains both the excellent fat-soluble qualities of liquid CO2 as well as the excellent diffusion characteristics of gaseous CO2.
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The result is a spanking clean piece of bone, as shown in the picture below after cleaning by Celtis – pure white, and on top of that bone cleaned the usual way, which has a yellowish tinge. The calcium structure of the bone, hydroxylapatite, is white, like that of the company Celtis!
Not only that, but Celtis also refines the bone using an antibiotic. This saves the patient the trouble of having to take antibiotics, receptor cells settle into the new „bone“, which is actually not much more than a calcium matrix, and soon enough the transplant has become a part of the recipient’s own bone – now that’s what we call progress!
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More about this topic here!

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Fistula operation – yes or no?

Yes!

A fistula in the mouth is the body’s reaction to a chronic infection. A fistula can appear just about anywhere in the body, either bone or tissue (e.g. muscles and inner organs).
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Like the Latin said – “Ubi Pus, ibi evacuvave” – wherever you find pus, empty it out!

Doctors are not the only ones who act according to this principle, our body does too! Imagine you have a chronic infection somewhere in your body – for example the bone around the dental root (e.g. due to a badly performed root canal). Pus starts to form, which the body tries to get rid of, the medical term being abscess. The tissue around this bubble of pus  – the abscess – is destroyed, forming a path of pus towards the inside of the mouth.

Fistula:
If the inflammation is not treated, the pus turns into a fistula. As the body tries to „minimize“ both the infection and the extent of the pus, it constructs a special type of granulate tissue around the pus … forming a fistula, protecting the tissue around it while the pus empties out.

A fistula is basically a kind of artificial garden hose made by our body to get pus out of a wound – and in this case into the mouth. You usually notice a bump on your gums, and when you press it, pus comes out!

A fistula on the gums is always a sign that something is wrong, and it should not be left untreated, because the infection will spread and continue to destroy bone, the dark spot on the x-ray!

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Here you can find out how to read an x-ray!

What are cysts, how do they form, and why do we only get them in certain places?

There are many different types of jaw cysts. A cyst is an empty bubble wrapped in a thin membrane and found inside an organ or tissue.

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Jaw cysts are found inside the bone, which is why they are often called bone cysts, or hard-body cysts. A distinction is made between congenital or acquired jaw cysts.

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For example, follicle, globulo-maxillary and median lower jaw cysts are congenital cysts.

Periodontal or reticular cysts, on the other hand, are acquired.
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Cysts are named according to the tissue they originated in, which also provides a clue as to how they form.

Let’s take a look at reticular cysts, which are usually caused by faulty root treatment. For example, if the roots were not filled to the tip, then cysts can form there even years later.

How?

Well, if root canal tissue was left over after treatment, it starts to rot and causes an inflammation in the bone. And this can stimulate tissue to grow.

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Details on reticular cysts in this video!