Study material.
Date: 2015-10-07; view: 434.
| Character of complication | Causes of development | Prevention and the way of elimination |
| 1. Aspiration or swallowing of small dental instruments. | Bad fixation of instruments in the dental tip. | Urgent hospitalization of the patient (department of thoracic surgery) and administration of appropriate specialized treatment, supervision of the patient with roentgenological examination. |
| 2. Trauma of the oral cavity mucosa | - inadequate fixation of instruments in the dental tip; - dentist's malpractice | Small traumatic injuries are treated as usual. At traumas of large vessels we require urgent hospitalization and specialized treatment, the wound is previously swabbed. |
| 3. Perforation of walls of the carious cavity | - dentist's malpractice during work; - thin walls and floor of the cavity; - careless work with the turbine engine ; - wrong choice of size and shape of burs; - bad knowledge of the dental cavity topography, peculiarities of the temporary and permanent teeth anatomy in children. | - maximum attention of the doctor during work; - adequate disclosure of the carious cavity and careful removal of softened dentine with an appropriate excavator or spherical bur; - in case of perforation of the wall of the carious cavity after arresting bleeding and drying the cavity - Cavity drying, we should eliminate the sealing material; - in case of pulpal injury we treat the traumatic pulpitis. |
| 4. Affected crowns of the adjacent teeth. | - dentist's during work; - mistakes at teeth preparation. | - isolation of the adjacent teeth with a matrix; - according to the degree of affection the defect is sealed, smoothed with the paper disks and polishers with the further processing by fluoride-containing materials. |
| 5. Disordered composite sealing hardening. | - application of photo polymerization equipment with low light intensity; - application of healing layer with phenol-, iodiform- and eugenol- containing pastes without further covering with isolating layer; - application of materials which are out of use terms. | - checking the polymerization equipment light intensity ; - changing the healing layer; - isolation of the layer from the sealing material with a cement or water artificial dentine; - - not using the sealing materials which are out of use date. |
| 6. Decreased adhesion of the sealing material for the tooth. | - mistakes at sealing; - mistakes at application of the adhesive systems; - extra saliva and liquid; - at sealing of the carious cavity with composite materials- using the equipment with oil compressor- contact of oil with the carious cavity, with air, through the turbine tip; - tooth overdrying; - absence of isolating layer between the paste and sealing material; - application of a very thick layer of a paste. | - keeping to instructions of application of sealing materials and adhesive systems; - waiting for the required time period to stain the dental tissues; - application of isolating layer; - repeated correct sealing; - at sealing with composites- work with compressors without oil |
| 7.Change of the sealing color. | - mistakes at preparation of the sealing material; - staining the sealing with dyes in food; - inadequate individual oral hygiene; - insufficient sealing processing; | - sealing change - polishing the composite sealings with the diamond heads, polishers and paper disks; - keeping from eating food with dyes ( berries, coffee, tea)- at administration of composite materials of the first generations; - keeping to personal oral hygiene rules; professional dental brushing twice a year. |
| 8. Split of a sealing part. | - mistakes at formation of the carious cavity; - mistakes at making sealing material and sealing itself; - wrong choice of sealing material. - application of amalgam with a phase γ-2; - bad condensation of layers of sealing material (amalgams, composites). | - we should keep to the instructions of preparation and indications for usage of the sealing material; - at formation of the cavity we shouldn't make thin junctions; - application of amalgam without a phase γ-2. |
| 9.Split of a tooth part. | - extra thinning of the carious cavity walls (especially at amalgam application); - inadequate choice of sealing material; - mistakes at preparation of the carious cavity; - preparation of the carious cavity with a vibrating bur. - progressing of the carious process. | - restoration of anatomical tooth shape with a sealing, inlay or artificial crown. |
| 10.Sealing falling out. | - recurrent caries; - the cavity is formed without minding the peculiarities of its localization and physical-chemical peculiarities of the sealing material and its adhesive properties; - splits of the cavity walls; - mistakes during material preparation and sealing of the carious cavity (insufficient isolation of teeth from the saliva, gingival liquid, bad condensation of the sealing material). | - we should keep to the rules on every stage of treatment. |
| 11.Development of secondary caries. | - insufficient cavity preparation; - wrong formation of the enamel margin; - wrong application of isolating layer; - wrong marginal contact of the sealing ( splits, absorption, wrong adhesive technique, etc) | - repeated sealing with absence of these mistakes. |
| 12.Inflammation or pulp necrosis. | - burns of the pulp with hot instruments during the cavity preparation ( absence of water cooling, dull bur, continuous work); - traumatic processing of the carious cavity floor, administration of strong substances; - wrong choice or technique of layer application; - mistakes at staining the teeth; - sealing without the layer (especially at sealing with an amalgam and composites); - mistakes at the technique of usage of the layer materials; - application of glass-ionomer cements for very deep cavities without the layers. | - treatment of appropriate pulp disease or periodontal disease) |
| 13. Papillitis or localized parodontitis. | - contact of the sealing material into the interdental space during sealing of the 2nd class defects; - false contact points. | - to eliminate the impending over the cavity margins sealing material and restore the contact points. |
| 14.Progressing of the initial dental caries at non-invasive treatment methods. | - mistakes at caries diagnosis; - decreased resistance of the body and hard dental tissues; - inadequate choice of means and methods of remineralising therapy; - mistakes at performing the impregnation treatment methods. | - to prevent this complication the remineralizing caries treatment is performed in combination with the general treatment |
| 15. Increased tooth sensitivity after sealing with : а) glass-ionomer cements; б) composite materials. | а) -overdrying of the dental tissues; - disordered ratio of the liquid and powder during preparation; - application at very deep cavities without healing layer; - mistakes at the layer-by-layer application of the sealing material for reduction of polymerization shrinkage; б) - mistakes at application of adhesive systems; - bad marginal contact of the sealing (for the polymerization shrinkage) | - keeping to the rules of application of the sealing materials and adhesive systems; - re-sealing of the carious cavity in case of a continuous tooth sensitivity preservation. |
| 16. Burns of the oral cavity mucosa. | - contact of strong substances with the oral mucosa (etching gel, high concentrations of silver nitrate, etc). | - attentive work of the dentist; - administration of solutions of the required concentrations; - treatment of burns of the mucosa with anti-inflammatory regenerating substances, - administration of copherdam. |
Control questions:
1. What mistakes and complications are possible on every stage of preparation of the carious cavities of the temporary and permanent teeth at different age periods?
2. What mistakes and complications are possible at sealing of the carious cavities of the temporary and permanent teeth in children?
3. What are the possible causes of perforation of the pulp chamber of the permanent and temporary teeth in children?
4. What may cause inflammation and necrosis of the pulp at treatment of the dental caries?
5. What complications may develop at wrong choice of pastes and sealing material at caries treatment?
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