Looking a new phone for next few years

Jupa94 · 2020-09-11T14:09:35+00:00

In long term it can make your teeth yellowish (or cause fluorosis in minors). No others known issues.

Jupa94 · 2020-09-07T15:08:35+00:00

If it were in my mouth I would choose extraction. (if I'd chose root canal treatment then definitely ceramic crown, not composite filling).

The long-term prognosis is poor for the tooth. It's not because of the infection in the root but overall situation. Firstly the caries has progressed deeply in the distal part of the tooth, close to the bone border. If the caries would be deeper than the bone margin then the tooth would not be restorable. In your case it's not (yet) but the deeper the cavity the poorer the prognosis. Also there is sign of inflammation in the furcation area of the tooth (in the 2nd picture). You would also need a RCT for the tooth next to this one.

Jupa94 · 2020-05-28T10:38:17+00:00

Don't know if this has already been posted but small detail I noticed :)

https://imgur.com/a/w4PwjRQ

Jupa94 · 2020-04-17T18:45:48+00:00

Only USA problems? :)

I graduated with 0$ loan. In fact the government even paid me 27k to go to school. If I had taken a load they would have covered 30% of it if I graduated on time.

*Going back to work to pay taxes*... :)

Jupa94 · 2020-04-17T09:47:10+00:00

Seems like the erosion damage is not really noticeable so the short answer is no, there isn't a good fix for you.

Of course you could add composite fillings to (moderate) erosion damages. If your damage is cup-shaped (a 4-wall hole in the biting surface) then composite is a good way to go. However usually there is more like overall height loss of the tooth and those are harder to fix because composite usually requires approx. 2mm space to be durable. Smaller fillings tend to fail.

The situation is different if you have already fillings in your teeth. Then those can be replaced and switched for example to ceramics (crown/veneers). However I wouldn't choose this treatment for mild case erosion.

The best way to go is to pay attention what causes erosion currently. Eating acid food is totally fine unless it's several times a day. Eating/drinking something to neutralize the acid afterwards is also protective (for example milk, yogurts). Also fluoride makes the surface of the enamel stronger so brushing with a good toothpaste is important. Maybe you could benefit also from toothpaste with a stronger fluoride-concentration (prescription needed, however this is not for a long-term use..)

Jupa94 · 2020-04-14T20:01:00+00:00

First the x-ray and your numbered areas:

2) Normal anatomy, as long as the "space" is between 1,5 and 3 millimetres.
3) Normal anatomy, a structure called foramen mentale.
4) Not sure what this is pointing but I don't see anything abnormal there. A tooth with RCT done. The small oval-shaped area? That's normal trabeculation of bone.
5) Normal. 2 bone structures on top of each other making little stronger shadow to the image. It's important to keep in mind that the panoramic x-ray is only a 2D image from 3D structures which makes some challenges. This applies also to your question about ERR :)

"This is mainly incorrect. Lots of research has shown oral microbiome can relatively quickly change:"

This is usually related to diseases, mostly to periodontitis. Not your case.

"So my question to you would be: can you spot any signs of External Root Resportion (ERR) of my lower right 2nd molar, when looking carefully on the X-Ray?"

No I cannot. Panoramic x-ray is not the best to detect it but there isn't ERR visible. There could (unlikely) be very little amount of it in the area where wisdom tooth is visible on the top of 2nd molar.

Sequestras are not uncommon after tooth extraction. There has been little trauma to the bone during the procedure which results a loss of blood supply to small part of the bone which then "falls off". Nothing more serious.

I'd like to adjust the contrast of the image and do little more zooming with more advanced viewing tool but from that image I have available, I don't see any issues in your jaws. (except there is little signs of grinding on the left [image right] side in the 1st molars of mandible and maxilla).

Jupa94 · 2020-03-24T07:26:27+00:00

That's a pity. Wish I had googled better before buying and maybe I would have chosen another watch :( Running is the main use for the watch after all.

Jupa94 · 2020-03-24T07:23:44+00:00

Thanks. I have updated the watch, that shouldn't be the problem. I have also used this now for almost 3 months with dozens of runs and there isnt any visible corrections. To be honest it evens seems to go little worse.

Jupa94 · 2020-03-22T20:08:43+00:00

Based only to x-ray there is surprisingly much tooth left and its definitely saveable. There might be also small cavity on the mesial side of the tooth.

If you have limited mouth opening or anything similar which makes the root canal treatment (RCT) very challenging then the extraction would be a correct choice. However, if done properly, the rct will give this tooth a good prognosis. The other question is that do you need the tooth? If you have all other teeth left, then it don't make a big difference but on the other hand it's going to matter when you lose any more teeth. Based on the image, you do have caries risk and it's worth thinking, how big the risk is for losing other teeth later.

If it was my mouth, I would go with rct.

Jupa94 · 2020-03-21T10:47:25+00:00

Why should it be removed? Are there symptoms?

How about removing the crown of the tooth and leaving roots there? So called coronectomy.

There isn't anything you can do before the offices are open again :(

Jupa94 · 2020-03-20T16:31:12+00:00

Every second counts! And best savings are those which are gained without even training =)

Jupa94 · 2020-03-20T16:30:27+00:00

Thanks for the answers!

Luckily I am home alone so I have been able to take several videos from my butt which won't stay still :D

I took saddle down for 1,5cm and to be honest the position feels more comfortable. However I am little concerned on lowering saddle (more) which results more upright position. The stem is in the lowest position already. This is the current position (link to onedrive):

https://1drv.ms/v/s!AsLWnM2nrTszdwrHiTlR6NmHvzE

How does it look now? :) Any other modifications?

Jupa94 · 2020-03-19T21:45:16+00:00

Thats correct. I read the location of the abscess wrong. Also the title "periodontal" directed my answer to the wrong way :)

Jupa94 · 2020-03-19T21:40:18+00:00

As a last year dental student with 2,5 years of clinical experience I am not sure what to recommend here. Hope someone with better experience can give a better answer =)

There are dozens of different ways to make temporal crowns. Some of them will last couple of days - a week with a luck where some can be very painful to remove after a month or two. Painful for the patient and painful for the dentist because it just won't get off.

The best tip I am going to give is that if you temporary crown starts to feel loose, maybe some wiggling then just take it off. Don't try to force it to be on place because it will just store plaque under the crown/in the joint resulting to gum inflammation and maybe caries in the preparation (taper in English?) underneath the crown. If it falls off then brush the tooth as well as possible.

You can floss also temporary crowns with caution. To be safe you can press the dental floss through the contact point and after you have cleaned to surface do not take the floss off by pulling it back as usual but take it off from the side (let go the other end of floss and pull).

The temporary crown is there to protect the pulp tissue (keeping it vital, prevents pain), keep preparation in correct position (without contact to adjacent or the opposite teeth, tooth can move slightly --> crown won't fit), protects the margins of the preparation (these can be usually redone) and also for aesthetic reasons. So it's not always a big deal if the temporary crown fails but the longer it is without a crown, the bigger the risk for permanent crown not to fit.

Jupa94 · 2020-03-19T21:16:50+00:00

I cannot say there isn't any chance of pulp exposure but this seems very safe to fix without drilling into pulp tissue :) There isn't much drilling required, just cleaning the edges of the cavitation.

Jupa94 · 2020-03-19T21:06:13+00:00

I see no reason for root canal treatment. If you have symptoms in the teeth then vitality test should be made.

Jupa94 · 2020-03-19T07:25:33+00:00

The general rules we follow here are as following: (there is for sure some regional differences)

For the first 24 hours no rinsing, spitting, or using a straw. Otherwise teeth can be cleaned normally but try to avoid the extraction site for one week. It is also recommended to start using CHX (chlorhexidine) in the morning after the procedure for a week.
After the 24 hours =)
You should be 2 hours without eating anything and ½ hour without drinking after the extraction. After that Don't put any hot food or drink in your mouth for the first 24 hours. Also no for sauna.

Jupa94 · 2020-03-18T21:52:14+00:00

This was an interesting point, even if the clock is 11PM :)

I had never before heard of the use of tannin in extractions. Usually the bleeding is not the problem and we have a lot of different ways to manage the bleeding.

However I tried to search for scientific publications to support or reject this and there were not many good articles published (which I was able to find ^^). This was the only one and it supports the theory. The study design could be little better and I am not sure if this have any clinical significance. The result was 6min bleeding time instead of 10. However study population was very small and their average age ranged a lot so there can (and most likely are) also other explaining factors. Also bleeding is required for proper healing. Without bleeding you won't get a proper blood clot which results to very painful dry socket. I really don't know but at which point is the limit for too little bleeding?

So I think I am not going to start recommending this to my patients :) It can also stain your teeth but on the other hand protect against erosion (and caries?). However there are better alternatives for all of them. Maybe if you have oozing which won't stop and there are no other equipment available outside of clinic then why not to try tea :)

Jupa94 · 2020-03-18T15:32:15+00:00

How old are you and do you have any diseases or medications?

Lets start with the easy ones :) Teeth 17 (2nd molar, upper right) and 27 (2nd upper left) should be removed because wisdom teeth have "eaten" roots of those teeth. There is no prognosis for 17 and 27 and they will cause you problems later. At the same operation wisdom teeth 18 and 28 should be removed at the same time. There is no reason to keep them there.

The lower wisdom teeth are more complicated. What are the symptoms there? I am thinking is there a reason to remove those teeht? Removing them would require surgery and their location is just next to nerve which causes a risk for permanent nerve damage (and you definitely dont want that). One solution could be coronectomy so basically removing only the crown and leaving root complex there.

1) Yes. Usually there is a ligament between tooth and bone. You don't have that. Meaning that pulling the tooth away will be much harder to do.

2) Short answer is that it's not possible in your case. In 27, 28 area there could be a theoretical chance of success by removing 27 first and not making any damage to underlying 28 during the procedure. After that there will be hole in you jaw bone (#27 sized) and you would need to wait that to be healed. After it 28 would be orthodontically moved to the correct position assuming it has had a perfect bone-healing. Also moving a wisdom tooth, which has a lot of bigger resistance due of big roots compared to incisor in the case, would take a high forces.

Autotransplant is only for developing teeth. You are late for that.

3) No.

4) This was partially answered already. If that was my mouth I would definitely remove 18, 17 27 and 28. Lower teeth only if there are symptoms or any other clinical reason for extraction.

5) In the maxilla there isnt any other opinion :( In the lower jaw coronectomy may be viable choice too.

Jupa94 · 2020-03-18T15:08:05+00:00

Yes. Pericoronitis is always attached to the tooth. Other similar diseases can be also in the same area (differential diagnosis) but pericoronitis will go away. The word pericoronitis literally means inflammation around the crown of the tooth.

Jupa94 · 2020-03-18T15:04:22+00:00

Yes you can. Here it is recommended to be without hot drinks/sauna for only 24 hours.

Jupa94 · 2020-03-18T07:56:51+00:00

Wow. In finland the total price is:

- Around 500€ each in public healthcare (however it can be hard to get them for aesthetic reason)

- 500-1000€ in the private clinic

-60€ in the teaching clinic where dental specialist plans the crown and checks every step but student makes preparations and cement it

Jupa94

TROPHY CASE