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Showing posts from May, 2014

A complication of LA

Today I perfomed a buccal infiltration of the 18 and the patient had a sharp reaction and after the LA complained of a tingling sensation below his right eye. I observed a blanching below his eye of irregular shape about 6-7cm in size. This was a phenomenon of the needle tip coming into contact with the sympathetic nerve plexus surrounding the maxillary artery causing a chain reaction spanning down the length of the artery causing vasoconstriction. This presents as blanching of the tissues suppled by the infraorbital artery of the ipsilateral side due to local vasoconstriction of the blood vessels. This will last as long as the LA is effective in the area. What to do? Assure the patient that it is normal and will wear off over time. You can show it to them in the mirror if they'd like. Say people wouldn't normally notice it but it will wear off as the LA wears off. Monitor their condition to see if there are any changes in vision or heart rate which would indicate injection ...

Fuji II LC

Had a go with Fuji II LC the other day on a 45DB. It's a pretty weird thing... RMGIC so it partially sets as a GIC and must be light cured as a resin. This 45 in particular had terrible access. the adjacent 46 was absent and the caries was on the distal surface meaning I had a choice of either performing a traditional box preparation or approaching from the distal surface in the gap between the 45 and 47. I chose the latter and visibility was terrible! after quite a bit of guesswork, I prepped the cavity which extended buccally under a class V composite. I removed this and cleaned the margins of deminned enamel. The demonstrated, a fill in Dr. L suggested I somehow incorporate the RMGIC in the restoration as it had potential to be aesthetic. She suggested RMGIC on the buccal aspect and FujiIX on the distal. She suggested the use of Hawekerr clear matricies? It had a clear triangular form with a handle to hold with tweezers. The idea was to fill the cavity from the buccal and when t...

Fabrication of a michigan splint. Lab steps

Today I witnessed an educational demo of the fabrication of a michigan splint from start to finish. 1) take alginate impressions of upper and lower. Make sure there are no tears and distortions and that the alginate hasn't come away from the tray at all as that will distort the tooth shapes of the cast 2) Pour the cast up in dental stone and trim. Don't remove bubbles as removal can be unpredictable and excessive removal of stone will result in high spots on the acryllic which though small can cause rocking of the final appliance as it will not fit closely to the fitting surface. When it will interfere with occlusion, you can use a sharp scalpel to trim it slightly. 3) Take a wax bite of the pt at the desired bite opening. a good estimate is 3mm anteriorly and 2mm posteriorly to allow for bulk of acryllic. The idea of a splint is to disocclude the teeth to avoid locking movements during grinding. the wax bite should cover all the teeth and have sufficient bulk. take the wax ...

specialisation?

A set of tips from a pediatric dentist in gaining specialty. -Show you are interested in the specialty. Go for observations in the field and keep a log book of patients and things you've seen -Mphil helps.../Honours/or later study -Racds?

A thought about perio probing

It should be beneficial to scan the gingival margin before commencing perio probing looking for classical signs of gingivitis: redness, loss of knife edge contour and height of gingiva. This may hone in on places of interest. Burnished calculus may not be immediately obvious to the tip of your probe so a more perpendicular position to the surface of the tooth may be needed. When scaling possibly the ultrasonic may be unnecessary and hinder progress in very light deposits of calculus and may aid in burnishing them.