Medical Degree Program in China - Operative Dentistry and Endodontics

 1. Introduction

Operative Dentistry and Endodontics is a discipline about diseases and treatment of the hard tissue of tooth and endodontium, including three aspects: cariology, dental non-caries diseases and dental pulp diseases.
2. Treatment
With the continuous improvement of patients' aesthetic requirements, there are many aesthetic restorative materials to replace most of the traditional silver amalgam filling. Strong bonding agent make the oral cavity doctor can fill the teeth by abrading as few as possible teeth, to retain the tooth tissues as many as possible. Modern root pipe treatment technology replaces the previous mummy treatment and resinifying therapy, making the endodontic treatment more thoroughly with more effective results.
It will not only delay the illness: making the little early caries with no pain sense become the big deep caries with pain sense if the treatment is not on time or incomplete, and even lead to pulpitis, diffusion to the root to cause periapical periodontitis, and the improper treatment or filling can cause secondary caries, continue to damage the teeth around or below the filling and further cause pulpitis. Incomplete endodontic treatment will cause periapical inflammation, inflammation of jaws.
3. Dental Caries
The dental caries occurs in dental hard tissues with high degree of mineralization, so the disease develops slowly. At the beginning, dental caries happens in the enamel, and there is no nerve distribution in the enamel, so in quite a long time there is no self-conscious symptom, which cannot be found easily and results in delay in treatment, so there should be regular oral examination in order to detect incipient caries. Secondly, dental caries is a disease that will not stop its damage without treatment, and if the treatment is not complete, it will recur, so patients must find a professional oral physician for treatment. Third, because the metabolism of dental hard tissue is very weak, inner enamel has no humoral and cell cycle, so it has no repair function, once destroyed, it cannot restore the organization by cell regeneration, while it can only be repaired by artificial materials. Fourth, from the point of view of response to external stimuli, dentin and pulp can be said to be a whole; the corresponding reaction by any stimulation of dentin can cause dental pulp. From the anatomical relationship, tissue of tooth and dental pulp have very close relations, such as early dental caries not timely treatment lesions to the depth development can cause infection of pulp and periapical tissues. So, once discovering of dental caries, it should be treated as early as possible, and in the treatment process must be as far as possible to reduce the stimulation of the pulp.
Caries treatment aims at ending disease process, pulpal protection and recovery of the dental morphology, function and appearance, and to maintain normal physiological and anatomical relationship with adjacent soft tissues. With the development of caries prevention in-depth study and repair materials and technology, caries treatment is also in constant improvement and updating; more and more patients choose a carious tooth aesthetical resin filling materials in order to achieve the best effect of repair.
4. Dental Non-caries Disease
Dental non-caries diseases include developmental abnormality of teeth, tooth damage and tooth hypersensitivity. During the period of tooth growth and development, it is affected by some systemic or local adverse factors, to result in effects in the structure, shape, number and eruption of teeth to lead to tooth abnormal development.
The abnormal development of the tooth may include enamel hypoplasia, dental fluorosis, tetracycline stained teeth, teeth with congenital syphilis, macrodontia, small tooth, central cusp deformity and so on. Different treatments should be taken according to the specific circumstances of the teeth, like tooth filling, whitening treatment, root canal therapy, and the crown restoration.
For patients with dental trauma, attention should be paid to the identification of the jaw or other parts of the body damage. Dental trauma can be divided into tooth concussion, tooth dislocation and tooth fracture, fixation, root canal treatment, tooth replantation or removal treatment is taken according to the degree of injury.
Chronic injury of teeth including wear, bruxism, wedge shaped defect and tooth fracture and root fracture and the damage will cause tooth sensitivity and can lead to teeth not to be retained if serious. Therefore, early treatment is needed to remove the cause of the disease and to prevent further tooth damage.
5. Pulpal and Periapical Diseases
The pulp is the only soft tissue of dental tissues, in the pulp cavity surrounded by dentin, associated with periapical tissue only through the apical foramen stenosis. The pulp is surrounded by the non - let dentin without effective collateral blood circulation, so the pulp damage is generally difficult to restore, and easy to produce pain. When the pulpitis and periapical inflammation occur, timely treatment of root canal is needed, and some apical surgery also needed. After accepting the root canal therapy crown repair is recommended for molar, to prevent splitting.
6. Causes and Prevention of Toothache
Toothache is one of the most common symptoms of diseases in stomatology. A lot of reasons can cause toothache. Odontogenic and non-odontogenic diseases can both cause. For odontogenic diseases, pain can be hypersensitive dentine and pulp pain, periapical pain, or periodontal pain; for non-odontogenic disease, adjacent tissue inflammation, tumor, nervous system disease, systemic diseases can all performed as toothache.

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Anhui Medical University

Wenzhou Medical University

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