🌹‏إِنَّ رَبِّي لَسَمِيعُ الدُّعَاءِ🌹

مساء الخير هناك تساؤلات حول خلع الاسنان لدى مريض السكر هذه بعض الاحتياطات المهمة إحتياطات عند الخلع لمرضى السكري : لتتم عملية خلع الأسنان دون حدوث أي مضاعفات لمريض السكري ، هناك عدة إحتياطات يجب الإهتمام بها ، حتى تمر عملية الخلع دون أي خطر أو قلق . 1 – مصارحة الطبيب : يلجأ بعض مرضى السكري بعدم إخبار الطبيب بحقيقة مرضهم ، وهو أمر غاية في الخطورة ، وقد يترتب عليه أضرار خطيرة ، وبالتالي على المريض أن يخبر طبيبه بحالته تفصيليآ ، حتى يتمكن الطبيب من التعامل مع حالة المريض بشكل جيد ، دون أن يسبب له أي ضرر . 2 – فحص السكر في الدم : من الضروري جدآ ألا تتم عملية الخلع لمرضى السكري دون أن تكون نسبة السكر في الدم مقبولة ، لأن الخلع مع إرتفاع السكر أمرآ خطيرآ ، وبالتالي فقد يلجأ الطبيب لقياس السكر للمريض كما ذكرنا ، أو يطلب من المريض أن يحضر له نتيجة فحص حديث للسكر لم يمر عليه إلا يومين على الأكثر ، حتى يحدد الطبيب الوقت المناسب للخلع . 3 – الراحة النفسية : يجب أن يكون المريض مرتاحآ ومسترخيآ أثناء عملية الخلع ، حتى لا يصاب بزيادة في الأدرينالين وبالتالي يرتفع السكر في الدم . 4 – خلع سن واحد : في حالة كان المريض يحتاج لخلع أكثر من سن أو ضرس ، يقوم الطبيب بخلع سن واحد فقط لا غير في الجلسة الواحدة ، حتى لا يتعرض المريض للنزيف الشديد ، ولا يتم تكرار عملية الخلع إلا بعد تعافي المريض تمامآ . 5 – عدم استخدام الأدوية الكاوية : ان استخدام الأدوية الكاوية بعد عملية الخلع تضر بحصة مرضى السكري بشكل كبير و من الواجب تجنب هذه الأدوية ، حيث انها تحتوي على نترات الفضة ، والكروم وغيرها من المواد القوية . 6 – البنج : يعد الأمر الأهم في عملية خلع الأسنان هو استخدام بنج أو مخدر للأسنان لا يحتوي على الأدرينالين ، وهذا الأمر بالنسبة لمرضى السكري ممن يعانون من أحد أمراض القلب أو إرتفاع ضغط الدم أيضآ .

- قال ﷺ "أكثِروا الصَّلاةَ عليَّ يومَ الجمُعةِ و ليلةَ الجمُعةِ ، فمَن صلَّى عليَّ صلاةً صلَّى اللهُ عليهِ عَشرًا. جْــــمٌـــْعـــتْـــكِـــمٌ طِـــــــيَـــــــبّـــــةِ..✨

what is the difference between: 1/acute apical abscess. 2/chronic apical abscess. 3/acute apical periodontitis. 4/chronic apical periodontitis. Clinically and radio graphically? 1/ Acute periapical abscess is either well defined swelling due to pus or diffused swelling which is called cellulitis,, it could be happened either when the tooth has an acute pulpitis chronic pulpitis or necrosis nothing clear on radiograph 2/ the chronic periapical abscess is when fistula or sinus has been formed,, and it could be happened either when the tooth has a chronic pulpitis or necrosis Radiograph could show bone destruction and radiolucency So..the tooth is even positive or negative for pulp testing. 3/ Acute periapical periodontitis is a PDL inflammation with pus or without,, it could be happened either when the tooth has an acute pulpitis chronic pulpitis or necrosis… with tender to percussion nothing clear on radiograph. 4/ chronic periapical periodontitis is :- either a PDL enlargement or radio-opacity around the apex as a defense mechanism of the body>>with pus and fistula or without,, it could be happened either when the tooth has a chronic pulpitis or necrosis.. with no or little pain for percussion Radiograph could show radiolucency or radiopacity So.. the tooth is even positive or negative for pulp testing So by few words… acute and chronic apical abscess are signs while acute and chronic apical periodontitis are the disease so whenever the abscess has found, there is an apical periodontitis. but the opposite is not necessarily true (because apical periodontitis could be without pus, just a PDL inflammation at the apex or a bone deposition)

GUM RECESSION Gum recession or gingival recession is the process in which the margin of the gum tissue that surrounds the teeth, pulls back, exposing more of the tooth, or leaving part of the tooth's root naked. gum recession Receding gums can be scary and uncomfortable for many patients; gum recession can change the look of your teeth (they will appear longer than normal) and can lead to an increased teeth sensitivity to cold, sugar, and brushing. @densitysecond99 The healthy gum In a healthy situation, teeth erupt into the mouth with the roots fully centered in, and surrounded by jawbone. The gum tissues operate like an investing curtain covering the bone; they surround the necks of the teeth acting as a seal to prevent food from settling in between the teeth. healthy gum tissue healthy gum tissue healthy gums types of gingiva There are two types of gingiva in the mouth: attached gingiva: a 2-3 mm band of bright pink tissue firmly attached to the underlying bone (marked with a, image above) the mucosa, or unattached gingiva: a darker, larger area of unattached gum tissue that folds into the cheeks (marked with b, image above) Gingival recession occurs when the edge of the attached gingiva (called the gingival margin) moves away from the crown of the tooth. Many times, the spaces between teeth can open up as the gum recedes, allowing food to get trapped.

What are the causes of gum recession ? Gum recession is not inevitable. It is true that gum recession can occur as we age, even in a healthy mouth, but a lot can be done to keep this process to a minimum. There are a number of factors that can cause gingival recession: @densitysecond99 Periodontal disease Periodontal diseases are probably the most common causes of gum recession. Periodontal diseases are plaque-induced inflammatory conditions that affect one or more of the periodontal structures : gingiva, alveolar bone, cementum, periodontal ligaments. progression of periodontal disease Gingival recession is a sign that usually occurs in the later stages of gingivitis. When gum recession is caused by periodontal disease, the gums are normally bright red and swollen, tender or painful to the touch and may be bleeding after brushing or flossing. As a result, if your oral health habits are questionable, gum recession may be a result of periodontitis. Abnormal tooth positioning Crooked or misaligned teeth (or bite) can cause gum recession. Here is the reason: When a tooth is not in its normal position, it will erupt outside of the protective bony housing. This means that at least on one side, the bone surrounding the tooth is thin or non-existent. Since the gum tissue has to cover the bone, a thin or non-existent bone will result in thin or no gum tissue. This is an important consideration for orthodontic tooth movement. During orthodontic treatment, if tooth roots are moved outside the bony housing, gum recession is likely to follow. Genetics Some people are born with an inherently thicker type of gum tissue, while others have very thin tissues. Another important factor is the band of attached gingiva. If this band is too thin, it can be easily compromised by trauma or periodontal disease, both of which contribute to gum recession. Moreover, if one or both of your parents have gum recession, you're at a higher risk for receding gum. Aggressive tooth brushing Over aggressive tooth brushing can traumatize, inflame and tear gingival tissues, resulting in gum recession. Of course, it is great to be keen about oral care, but remember that it doesn't take force to remove bacterial plaque. First, use a soft toothbrush and make sure to change it as often as needed (every 4 weeks for a manual toothbrush and every 3 months for an electric toothbrush head). Brush gently and use a toothpaste that is not too abrasive (see tooth brushing technique). Bruxism or grinding your teeth Involuntary grinding of the teeth (especially during the night) can cause many dental problems. Clenching or grinding your teeth can put too much force on the teeth, causing gums to recede. Be sure to inform your dentist right away if you think you are grinding your teeth. Teeth grinding can be treated with a nightguard (you should wear it at night while you sleep) and several other options. Other causes Trauma to gum tissue -- The gum tissue may recede when a traumatic injury has occurred on a tooth or teeth. Tobacco products -- Tobacco users are more likely to have sticky plaque on their teeth that is difficult to remove and can cause gum recession. Piercing of the lip or tongue -- Piercing can rub the gums and irritate them to the point that gum tissue is worn away

How can we prevent and treat gum recession ? A lot can be done to prevent and treat gum recession. Many times, gingival recession is a result of a combination of factors and its causes are not always simple to determine. To figure out why your gums are receding it is best to see your dentist. Your dentist will help you identify the cause and will instruct you on how to address it. Treatment methods vary according to the type and severity of the recession: If gum recession is due to excessive or aggressive brushing, a staff member can show you more effective oral hygiene methods. You may also have to re-evaluate your flossing habits, get a mouthguard (in case of bruxism) and buy a softer and better toothbrush. If recession is due to periodontal disease, the first step usually involves a special cleaning, called scaling and root planing (see gingivitis treatment). For many patients, this treatment along with excellent oral hygiene at home and regular dental checkups can help stop periodontal disease and prevent further gingival loss. Sometimes gum recession can be caused by crooked or misaligned teeth or an improper bite. If this is the case, your dentist may recommend orthodontic tooth movement to reposition teeth within their bony housing. Some cases with a more advanced recession may need a surgical approach. The procedure is called gum graft. A gum graft is a relatively simple surgical procedure which aims to cover an area of exposed tooth root surface with grafted oral tissue. gum graft an example of gum graft to cover an area of exposed tooth root In any case, when minor recession is ignored, continued recession and bone loss around teeth are likely. Catching the disease in an early stage may reduce the treatment procedure to some simple instructions: gentle brushing and flossing, avoiding trauma, cleaning the gum line gently etc. Therefore, it is best to see your dentist as soon as you notice the first signs of gum recession.

أضرار تراكم الجير

ارتفاع ضغط الدم المتسرع أو اسمه الثاني ضغط الدم الخبيث Malignant hypertension or accelerated hypertension تحجي عن هل مرض : هو ارتفاع ضغط الدم بشكل سريع جدا اي ممكن يوصل ضغط الدم 200/120 وهنا كلش يكون ضغط الدم عالي 🧑‍⚕️احنه دورنا أطباء نقلل ضغط الدم لان أذى بقى هذا ضغط الدم عالي راح يسبب retinopathy اي اعتلال الشبكيه وايظا يسبب renal dysfunction اي فشل الكلوي وايظا encephalopathy خل اركز بشغله مهمه اذا كان مرض قوي ويسبب كل هل مشاكل اني اصير اقوى منه واعرف اعالجه بطريقه صحيحه .. اي كل فعل رد فعل طريقه علاج : اول شي نستخدم ادويه خافظه للضغط عن طريق الفم مع الراحه التامه للمريض ونراقب وضع الضغظ عندما ينزل خطر بدماغي شغله ليش ما استخدم ادويه تخفظ الضغط عن طريق الوريدintravenous أو عن طريق parenteral هنا راح يكون اسرع وقت لتخفيض ضغط الدم . اجي اجاوبك خطأ هذا الاحتمال انو استخدم ادويه عبر وريد وايظا عبر parenteral السبب هوه انو من راح نخفظ الضغط بسرعه راح يصير عدنه مشكله بالدماغ اي جلطه دماغيه تحدث هذا جلطه دماغيه stock or cerebral damage نتيجه alter autoregulation لكن في بعض حالات الطارئه كلش ⛑ ممكن نستخدم هذا الادويه للمريض وبشرط نراقب المريض كل ربع ساعه ونشوف خفظ ضغط الدم وايظا اشوف علامات حيويه للمريض

31. Instruments Used In Composite Filling:- 1) packable composite 2) Polishing disc 3) Micro brush 4) Mylar strips 5) Curing light 6) Bonding agent 7) Etch 8) Dycal (base & crystal) 32. Class I Cavity 33. Class II Cavity 34. Class III Cavity Class V Cavity 35. Class IV Cavity 36. Die Stone Dental stone (Yellow Colour) Dental plaster (white Colored) Peech Colour Flourescent Yellow

14. GIC Powder and Liquid 15. Alloy Powder Mercury Dispenser Amalgam Alloy powder + Mercury 16. Varnish Function:-  It prevent microleakage.  when marginal seals break it can cause secondary caries so varnish is applied.  GIC is soluble so varnish prevent water contemination. 17. Alginate Spatulla Used for mixing alginate. 18. Wax Knife Used for cutting excessive wax. Wax Carver Used for carving wax. 19. Plaster Spatula Used for mixing gypsum and plaster products. 20. Cavity Conditioner Work similar as etch, use to prepare the tooth for glass ionomer restoration. 21. Flowable Composite Low viscosity, use in small areas and before the placement of packable composite. 22. Plaster Knife Use for cutting extra plaster. 23. Manipulative Variables Of Amalgam Filling:-  Examination  Cavity prep  Application of matrix band  Lining  Trituration/mixing  Dispensing of amalgam  Condensation  Pre-carve burnishing  Carving  Post-carve burnishing  Finishing  Polishing 24. Some Terms Are Defined Here 1. Mesio-Occlus0-Disatl (MOD) caries on mesial & distal surface of class-II and on occlusal surface of class I. 2. Compound Caries on 2 surfaces. 3. Complex Caries on 3 surfaces. 25. MANIPULATION Of Amalgam 1- Examination:- Before making cavity in patients mouth, we will examine the patient by examination instruments that is there any carious region or only stained area. Examination instruments are: dental mirror, probe/explorer, tweezer. We will use probe to check the caries. If probe moves smoothly on the surface of tooth so it means there is no caries only stained area is there but if probe moves roughly on the surface of tooth it means there is caries and then we will cavity prep. 2- Application Of Matrix band:- Fix the matrix band into tofflimire matrix band retainer . 3- cavity Prep:- Cavity is prepared on the patient’s tooth where carious region is present. Cavity can be of many types i.e. class-I cavity, class-II cavity, class-III, class-IV, class-V. the depth of the cavity is normally 1.5 but mostly it depends on caries. Hand piece is an instrument which is used for cavity prep. 26. 4- Lining:- Lining is done before amalgam filling to protect the pulp b/c amlgam can cause microleakage. It can harm the pulp. Most commonly GIC powder & liquid is used for lining but some time calcium hydroxide is also used. GIC powder & liquid is taken on a glass slab with cement spatula to make a mixture of it for lining. It is applied in cavity for lining by using dycal applicator. Note:-always mix powder in liquid. 5- Mixing / Trituration:- After lining alloy powder & mercury is mixed. Take alloy powder & mercury in mortar and mix it with pestle to make a homogenous mixture. Carry amlgam with amalgam gun and dispense it in cavity for filling. 6- Dispensing Of Amalgam:- 7- Condensation:- After applying or dispensing amlgam into cavity, we have to pack amalgam properly into cavity with the help of condensor. 27. 8- Pre-carve Burnishing:- Pre-carve burnishing is done to bring excessive mercury on surface. 9- Carving:- To remove excessive material with carver and also carving is done to reproduce normal tooth anatomy. 10- Post-carve Burnishing:- It is done to smoothen the surface and finish the surface and to give shine the surface with the help of burnisher. 11- Finishing:- By smoothing the surface and removing excess material. 12- Polishing:- Polishing done by polishing discs. 28. Instruments Used For Cavity Prep:- 1) High speed hand piece 2) Probe 3) Bur 1) 2) 3) 29. Examination Instruments:- 1) Probe(explorer) 2) Tweezer 3) Mouth mirror 1) 2) 3) 30. Instruments used In Amalgam Filling:- 1) Tofflemire matrix band retainer 2) Matrix Band 3) Mortar & pistile 4) Amalgam gun 5) Cement spatula 6) excavator 7) Dycal applicator 8) Fraham’s carver 9) ward’s carver 10) Burnisher 11) Condenser 12) wooden wedge 13) plastic instrument 14) Alloy 15) Mercury 16) GICpowder & liquid for lining 17) Plastic instrument

#Dental instruments 1. INTRODUCTION OF DENTAL INSTRUMENTS USED IN AMALGAM FILLING 2. Dental Mirror:- • Used for indirect vision. • To hold retract your tongue, lips or cheeks. • Tendor to perkashan (TTP). • From the back portion of the mirror we check tht tooth is realy fractured or not. • We wil strike the back portion of the mirror to the patient’s tooth if patient wil blink his/her eye it means tht it is painful and it is fractured. 3. Tweezer:- •To hold cotton roll. • To hold different material. • To transfer any material in and out of cavity. Probe:- (Explorer) • It is sickle shaped. • Used to detect the tooth decay. • To check bifurcation & furcation. Furcation mean branches. • To check the carious region. If we apply probe on tooth and if it move smoothly on surface so it means there is no carious region, there is only stain so we wil not cavity prep and filling. 4. Mortar & Pistile:- Mortar is thick like a bowl and pistele is thin like a pencil. • Used to mix the alloy powder and mercury to make a homogenous mixture. Amalgam Gun:- (carier) Gun shaped. • Used to carry amalgam and dispense the amalgam in cavity. OR 5. Cement Spatula:- • Used for mixing. Tofflemire matrix band retainer:- • Used to hold the matrix band. • To maintain stability of matrix • band during condensation of • restorations Parts Of Tofflemire Matrix Band Retainer:-  Adjusting Nut  Locking Nut used for tight.  Retaining screw  Two slots  Head (u-shaped)  Vise (box shaped) Locking Nut Adjusting Nut Slots Head Vise Retaining Screw 6. Matrix Band:- It has a concave surface (upward) & one convex (downward). The conxity of matrix band should put up on the occlusal surface. • Used to support the wall of class II. • To replace missing proximal walls of • cavity preparation for condensation • of restorative material Wooden Wedge:- Pointed sharp part should be apply b/w the teeth. • Used to tight the matrix band. • Used to comress the gingiva. • used to separate the very tight band. • To hold matrix band in place • along gingival margin of class II. Wooden wedge absorb saliva then they expand and fill the space b/w tooth, and it has low strength as compared to plastic wedge. Matrix bands 7. Condenser:- • Used to condense the amalgam. • Used for packing the amalgam into cavity. Burnisher:- One end of burnisher is egg type shaped & other end is T-shaped. • Used for burnishing. 8. Excavator:- Spoon shaped. • To remove temporary fillings. • To remove soft caries or dentine. • Scoope out/excavate soft dentine. Dycal Applicator:- Small ball shaped at the tip of it. • Used for application of lining. Carver:- 1-Fraham’s Carver: kite shaped. 9. 2-Ward’s Carver:- Pointed, sharp edges. • Both carver is used to remove the excessive material. • To produce the normal tooth anatomy. Plastic Instrument:- Hockey shaped. • Used for application of composites. • To carry composite material for • cavity preparation, and shape • composite, 10. Micro Brush:- Small plastic instrument with small fiber bristled head. • Use to apply primer, dentine bond, enamel bond, sealants. Mylar strips:- Straight strips same as matrix band. • Thin clear strip used to isolate cavity prep. • Able to use cure light b/c it is plastic strip. 11. Curing Light:- Material must be cured in increments of 2 mm or less, need to be above 300 wavelength. • To harden light-cure materials, bonding, composites, sealants, cements, build up. Bonding Agents:- Differs in generation, all in one unit, 3 step, 2 step, brands require different techniques • Acts as an adhesive between the tooth and the composite material. 12. Etch:- White syringe in which blue gel type material is filled. • To remove smear layer and prepare tooth for bonding. Dycal (Calcium Hydroxide Composition):- A base and catalyst paste, mixes together to form a tan paste, self sets. 1:1 ratio mix . • Used for indirect pulp cap, protective liner for deep cavities . 13. Packable Composite:- Different grits: coarse to extra- fine; various sizes; snap-on (with metal center) or screw-on To contour (coarse grit) or polish and smooth

Did u know?!! THAT OVER TRITURATION AND OVER CONDENSATION CAUSE AMALGAM SHRINKAGE

Q/What is AMALGAMATION and TRITURATION ?🤔 A/ AMALGAMATION : is a mixing process between mercury and a metal alloy other than silver (gold,tin,copper)in a capsule using a device called “Amalgamator” . TRITURATION : is a mixing process between mercury and silver in a capsules using a device called “Triturator” .

. كيف نتعامل مع المريض الي عنده قصور كلوي احنا دورنا كطبيب اسنان ونريد نقلع السن ؟؟؟؟ 1-اول شي لازم نشوف الفحوصات الاتية + نفحص ضغط الدم الفحوصات : مستوى اليوريا بالدم = الطبيعي = 6- 20 مليغرام اذا زاد معناته مشكلة عامة قد تكون وظائف الكلية "لكن مو شرط" ... ثانيا تصفية الكرياتينين من الدم , فاذا كان نسبته 1.2مليغرام للمرأة و 1.4 مليغرام للرجل فهاي علامة ضرر بالكلية -وفحص وظائف الكلية : GFR 2-هل المريض ديغسل كليته بشكل مستمر ؟؟؟ اولا الافضل القلع بعد يوم من الغسل... والتاكد من عدم اجراء قلع على الاقل 4 ساعات بعد الغسل حتى لا يصير نزيف بسبب الهيبارين الي ينطوه اثناء الغسل وثانيا مثل هالمرضى يكونون معرضين للاصابة بالتهاب الكبد الفيروسي او الايدز فلازم نتأكد ما بيهم هالامراض وناخذ الاحتياطات اللازمة حتى لا ينتقل المرض النا . 3- هل المريض زارع كلية؟؟؟ وبهالحالة ياخذون ادوية تثبط المناعة فممكن يصير عدوى بعد قلع السن نتيجة لنقص المناعة فلازم ننتبه لهاي النقطة وننطي مضادات حيوية 4- الادوية الي لازم نتجنبها بمريض الكلية او ننقص جرعتها او نباعد باوقاتها هي الاتي بالنسبة لادوية الالم الي نتجنبها : الاسبرين , براسيتامول بجرعات كبيرة مضادات الالتهاب الغير ستيرودية ( بروفين) مضادات الالتهاب: البنسلين , السيفالوسبورين, امينوكلايكوسايد __ وبعد استشارة طبيبة وحسب مرحلة نقص بوظائف الكلية حاد او بسيط نقوم بتنقيص الجرعة او تضبيطها مثلا ببدال انو ياخذ اموكسيل 3 مرات نحوله الى جرعة اقل ومرة باليوم اذا حاد وهكذا ... او الافضل نعطيه دواء اخر تكدرون تنطوه ارثرومايسين , كليندمايسين -بالنسبة للبنج الموضعي عمليات الايض تتم في الكبد فهو مو مسبب لضرر الكلية