PLASMA CELL GINGIVITIS

 Clinical cases 

PLASMA CELL GINGIVITIS 

🔸Plasma cell gingivitis is a rare condition characterized by diffuse and massive infiltration of plasma cells into the sub-epithelial connective tissue. 

🔸Clinically, it appears as a diffuse reddening and edematous swelling of the gingiva with a sharp demarcation along the mucogingival border.

The longest tooth in the world.

 

The longest tooth in the world

The patient presented with acute toothache. The tooth had to be removed, but it seemed to the doctor unusually long - 37.2 millimeters. Therefore, the doctor collected all the necessary evidence and sent an application to the editors of the Guinness Book of Records.

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Case study

 When you want to give anesthesia to the lower teeth of a patient, and then you discover there is pigmentation, spread widely along the lower gums as in the picture. You ask the patient and he says, "I don't know, it's old", so here your role as a dentist will appear in the investigation and So after the laboratory examination it says this is Melanoma and it is one of the diseases that are considered Malignancy, Do not waste the opportunity and the patient is in front of you, advise him as much as possible so that he is treated early for this case.

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PERIPHERAL OSSIFYING FIBROMA (POF).

 PDL pluripotent cells may transform into osteoblasts, fibroblasts and/or cementoblasts in response to a chronic low-grade stimulus. The result is a unique inflammatory hyperplastic lesion called the PERIPHERAL OSSIFYING FIBROMA (POF). A pyogenic granuloma (produced by similar stimuli) may undergo fibrous maturation and internal calcification to become a POF.

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Ciliated epithelium

 Ciliated epithelium.

Epithelium lining the upper respiratory tract. Its role is that it "pushes" mucus with dust from the lungs back into the mouth and nose. The cilia on its surface constantly oscillate from bottom to top, pushing the mucus.

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Wegener's granulomatosis

 

Wegener's granulomatosis. Strawberry gingivitis. (Specific inflammation of the gums).

● Wegener's granulomatosis (malignant granuloma, rhinogenic granuloma, etc.) - systemic hyperergic panvasculitis, combined with the development of necrotizing granulomas in the tissues. It belongs to the number of rare diseases.

● A rare case of localization of the disease on the mucous membrane of the gums of the upper and lower jaw is described in the form "Strawberry gingivitis" and on the skin of the face of a young woman. Primary lesion of the oral mucosa in

the form of gingivitis is a unique rare manifestation of Wegener's granulomatosis.

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Cancer

 Cancer is rapid and uncontrolled cell division that leads to the appearance of a tumor in a person's tissues or organs. This disease belongs to those that may not appear for a long time. It affects human organs and tissues. As a result, the organs cease to function.14 million people are diagnosed annually.

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Ectopic tooth

 

Ectopic tooth in soft palate area with surrounding erythema. It caused pain and discomfort during swallowing. Feeling of foreign body in the throat. 

Rx:

- Assess the dentition and make sure all teeth are present. 

- Extract the ectopic tooth carefully to avoid injury to adjacent vital structures.

- Reimplantation may be done in place of a missing or displaced tooth. 

**In the above case however, the tooth fell off by itself and symptoms improved thereafter.

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How to prescribe a medication drug correctly

How to prescribe a medication drug correctly:

In order;

1. Drug form:

Cap : Capsule

Tab: Tablet

Amp: Ampoule

Syr: Syrup

Eff: Effervescent

Drop: Droplet

Inj: Injection

Liq: Liquid

.

.

2. Scientific name of medication drug:

Amoxicillin

Co.Amoxiclav

Fluoxetine

Haloperidol

Dexamethasone

Ibuprofen

.

.

3. Dosage of drug

mg: 400mg

mg/ml : 4.0 mg/ml

mg/dl

.

.

4. Number (n)

n=10 or # 10

 (lower case N always => n)

 (never write # = ..)

.

.

5. Time (frequency of taking)

q12h

q8h = one per 8 hrs.

q6h

qd= once a day

bid: bds= two times a day

tid: tds= three times a day

qid: qds= four times a day

Prn = when needed

6. Routes of administration:

PO: Per oral

Top: Topical

Rect: Rectal

IM: Intra mascular

IV: Intra venous

SC: Sub cutaneous

TD: Trans dermal

.

.

e.g:

Inj. Dexamethasone, 4.0 mg/ml, n=2, qd, IM.

Tab. Co-Amoxiclav 625 mg, n=10, q8h, P.O.

Tab. Ibuprofen 400mg, n=10, q8h, P.O

 H file:

Sharp edged, H-Files are used for probing, permeabilization or extraction of debris. Made of stainless steel or NiTi, these files can only be used in traction because of their profile. Consequently, their use is essentially for widening after passage of the K-File of the same number and for evacuating debris and organic tissue.

Ø ISO 6, 8, 10, 15, 20, 25, 30, 35, 40 (NiTi/Sst)

Ø ISO 45, 50, 55, 60, 70, 80 (Sst)

Lengths: 21, 25, 31 mm

Taper: 2%

Calcified Canals

One Tip .. every night .. for everyone...

▫️Gaining entrance to calcified canals can be very difficult and at times impossible. With the aid of the EDTA-Urea preparation (RC-Prep, Premier Dental Products, Norristown, Pa.) and the surgical length contra-angle burs, the task can be facilitated. The use of the multipurpose probe reduces the problem of perforation. We may now be able to gain access and treat a greater number of calcified canals.

▫️Calcification occurs in a coronal to apical direction. As such, calcification is worst in the coronal third of roots. As one progresses apically, canals become more easily negotiable. The clinical implication is that it should become easier to negotiate canals with the apical progression of hand files. Inherent in the answer to the question are several methods without which achievement of complete canal negotiation would be difficult or even impossible. Let’s take a look at those methods.

1) The clinician must use a rubber dam. Combined with a rubber dam, a surgical microscope for ideal visualization and lighting would give the greatest overall visual command over the canal.

2) The clinician must have, in such a case, an optimal supply of No. 6-8 K files with which to attempt negotiation. If, after a given insertion, the K file comes out of the canal bent or deformed, it must be discarded and another new file used. Sharp new files are essential for breaking through such calcifications. These files ideally will be precurved with EndoBender pliers (SybronEndo, Orange, Calif.). It is possible they can be curved by hand, or less optimally, with cotton pliers. Precurving them will allow the file to more easily follow natural canal curvatures that may be present, as opposed to trying to passively place a straight instrument into what is always a curved canal space.

3) The clinician must be careful to always have an adequate supply of irrigant in the chamber as a reservoir. With each insertion of the small K files, irrigant is being introduced into the canal space. With each removal of the file, the space it once occupied becomes filled with the irrigant present in the chamber reservoir. For a calcified tooth, the optimal irrigant would be a small quantity of 5.25 percent sodium hypochlorite since it dissolves pulpal tissue, is antibacterial, and is clear (and hence can be seen as an aid in canal location). Especially under a surgical microscope, it is easy to visualize the canal through the sodium hypochlorite. In addition, where it is difficult to locate the canal, the necrotic tissue will bubble (dissolve) in the sodium hypochlorite. This functions as an aid in canal location. An alternative irrigant would be a liquid EDTA solution like SmearClear (SybronEndo). A comprehensive discussion of the relative merits of two irrigants will be discussed in a future column.

4) Given the above strategies for approaching such a calcified tooth, it is vital that the clinician not rush down the canal and that files be inserted passively. Literally, in a significant calcification, it may be necessary to advance the file only 1 mm at a time, followed by irrigation and placement of another file of the same size - usually a No. 6 in severely calcified cases. It is vitally important that the clinician does not advance debris apically beyond the level of the file tip, especially in a calcified or constricted canal of the type discussed here. It is easy to push such debris into the narrow lumen of the canal, and create a blockage of such magnitude that future negotiation may not be possible. Said in different terms, a difficult canal can be made impossible if an impassable blockage of debris is created and/or a ledge develops. Both these entities are situations that could have been avoided, rather than obstacles that were imposed upon the clinician and, thus, were out of the clinician’s control.

" Dr. Richard Mounce "

Private endodontic practice in Portland

Dentistry

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