Monday 8 August 2016

Flap Design on oral surgery

 Flap Design on dentistry

ochsenbein-luebke flap
indication:
  • prosthetic crown present
  • periapical surgery: anterior region and longer root
  • wide band of attached gingiva





Advantage:
  • ease in incision and reflection
  • enhanced visibility  and acces
  • ease in repositioning
  • maintain integrity of gingival attachment: prevent gingival recession, avoid dehiscences, and prevents crestal bone loss
Disadvantage:
  • horizontal component disrupts blood supply
  • vertical component crosses mucogingival junction and may enter muscle tissue
  • difficult to alter it if size of lesion misjudge
Rectangular flap
Indication:
  • Periapical surgery: multiple teeth, large lesions and long or short roots
  • literally roots repairs: full-length root visualized 
Advantage:
  • provides maximum access and visibility
  • reduce retraction tension
  • facilitates repositioning
Disadvantage:
  • Reduce blood supply to flap
  • increased incision and reflection time
  • gingival attachment violated: gingival recession, crestal bone loss and may uncover dehiscence
  • suturing is more difficult

Triangular Flap
Indication:
  • midroot preparation repair
  •  periapical surgery: posterior areas and short roots  
 Advantage:
  • easily modified: small relaxing insicion, additional vertical insicion and extension of horizontal component
  • easily repositioned
  • maintains integrity of blood supply
Disadvantage:
  • Limited acces and vicibility to long roots
  • tension is created on retractin
  • vertical insicion penetrates alveolar mucosa
  • gingival attachment severed
Gingival Flap
Indication:
  • cervical resorptive defects
  • cervical area perforations
  • periodontal procedure
Advantage:
  • no cervical insicion
  • ease of repositioning
Disadvantage:
  •  limited access and visibility
  • difficult to reflect and retract
  • predisposed to stretching and tearing
  • gingival attachment violated 

Sunday 24 July 2016

dental anxiety questionnaire

Corah’s Dental Anxiety Scale, Revised (DAS-R)
Name ______________________________________________________ Date _____________
Norman Corah's Dental Questionnaire
1. If you had to go to the dentist tomorrow for a check-up, how would you feel about it?
a. I would look forward to it as a reasonably enjoyable experience.
b. I wouldn't care one way or the other.
c. I would be a little uneasy about it.
d. I would be afraid that it would be unpleasant and painful.
e. I would be very frightened of what the dentist would do.
2. When you are waiting in the dentist's office for your turn in the chair, how do you feel?
a. Relaxed.
b. A little uneasy.
c. Tense.
d. Anxious.
e. So anxious that I sometimes break out in a sweat or almost feel physically sick.
3. When you are in the dentist's chair waiting while the dentist gets the drill ready to begin
working on your teeth, how do you feel?
a. Relaxed.
b. A little uneasy.
c. Tense.
d. Anxious.
e. So anxious that I sometimes break out in a sweat or almost feel physically sick.
4. Imagine you are in the dentist's chair to have your teeth cleaned. While you are waiting
and the dentist or hygienist is getting out the instruments which will be used to scrape
your teeth around the gums, how do you feel?
a. Relaxed.
b. A little uneasy.
c. Tense.
d. Anxious.
e. So anxious that I sometimes break out in a sweat or almost feel physically sick.
Scoring the Dental Anxiety Scale, Revised (DAS-R)
(this information is not printed on the form that patients see)
a = 1, b = 2, c = 3, d = 4, e = 5 Total possible = 20
Anxiety rating:
• 9 - 12 = moderate anxiety but have specific stressors that should be discussed and
managed
• 13 - 14 = high anxiety
• 15 - 20 = severe anxiety (or phobia). May be manageable with the Dental
Concerns Assessment but might require the help of a mental health therapist.
DENTAL CONCERNS ASSESSMENT*
Please rank your concerns or anxiety over the dental procedures listed below by ranking them
on the accompanying scale. Please fill in any additional concerns.
Level of Concern or Anxiety
Low Moderate High Don’t know
1. Sound or vibration of the drill 1 2 3 4
2. Not being numb enough 1 2 3 4
3. Dislike the numb feeling 1 2 3 4
4. Injection ("novocaine") 1 2 3 4
5. Probing to assess gum disease 1 2 3 4
6. The sound or feel of scraping during teeth cleaning 1 2 3 4
7. Gagging, for example during impressions of the
mouth 1 2 3 4
8. X-rays 1 2 3 4
9. Rubber dam 1 2 3 4
10. Jaw gets tired 1 2 3 4
11. Cold air hurts teeth 1 2 3 4
12. Not enough information about procedures 1 2 3 4
13. Root canal treatment 1 2 3 4
14. Extraction 1 2 3 4
15. Fear of being injured 1 2 3 4
16. Panic attacks 1 2 3 4
17. Not being able to stop the dentist 1 2 3 4
18. Not feeling free to ask questions 1 2 3 4
19. Not being listened to or taken seriously 1 2 3 4
20. Being criticized, put down, or lectured to 1 2 3 4
21. Smells in the dental office 1 2 3 4
22. I am worried that I may need a lot of dental
treatment 1 2 3 4
23. I am worried about the cost of the dental treatment
I may need 1 2 3 4
24. I am worried about the number of appointments and
the time that will be required for necessary appointments
and treatment; time away from work, or the
need for childcare or transportation 1 2 3 4
25. I am embarrassed about the condition of my mouth 1 2 3 4
26. I don't like feeling confined or not in control 1 2 3 4

*Developed by J.H. Clarke and S. Rustvold, Oregon Health Sciences University School of Dentistry, 1993
[revised 1998]

Tuesday 5 July 2016

Dental anxiety

     Dental anxiety are common problem for many dentist in the world. because it was one of the factor that make the barrier between dentist and patient. dental anxiety usually come from childhood trauma. there are a lot of thing that makes trauma. for instance in Indonesia usually parent using dentist as a threat for their kid, they will tell their kid to do something if they didn't do it or listen to them they will take them to dentist. so, a lot of children always think that dentist are scary thing. the other problem is the dentist. a lot of dentist didn't really care about dental anxiety so they just force the kids to get the treatment and it makes their dental anxiety getting worse.
     Dental anxiety (DA) is a multi-system response to a believed threat or danger. It is an individual, subjective experience which varies among people. DA is a widespread phenomenon which ranks fifth among the most commonly feared situations for individuals. It can have a serious impact on daily life and is a significant barrier to seeking and receiving dental care. It has been estimated that the anxious patient requires approximately 20% more chair time than the non-anxious patient,which has an impact on cost. DA is seen in both children and adults, with child anxiety often manifesting as inappropriate or disruptive behavior. Unfortunately, many general dental practitioners are not willing to provide care for preschool children who display disruptive behavior, especially when more than simple treatment is required.In addition, the use of dental anxiety measures (DAMs) by dentists is lower than it could be.
     In order to consider any pediatric dental anxiety measurement as a gold standard measure, the scale should cover the following criteria: all types of reliability and validity a relatively bias-free method independent of procedural bias or patient/investigator response biases a versatile method that is applicable for both clinical and non-clinical use, which is practical in a variety of different dental settings a method that should yield numbers on an identifiable number scale (nominal, ordinal, interval, or ratio) so that the appropriate statistical analyses can be conducted short in length to maximize response from the children and minimize time for administration include items which are most relevant to the child dental experience easily hold the attention of the child and be simple to score and interpret.
      For self reported measures, the scale must be: age-appropriate and cover the cognitive status of the child; demonstrate reliability in scoring and test-retest reliability; be valid with respect to correlating with other indices such as behavior during treatment, dentists’ ratings of cooperation and mothers’ expectations of behavior and be numerical in order to rank dental anxiety causing items objectively and reliably. Reliability is necessary but not sufficient for validity.
     DAMs for children of age ≥6 years old should also assess information related to underlying beliefs and anxiety, as negative thinking patterns play a crucial role in fear evocation that could make the person apprehensive and difficult to treat, and the degree of belief in negative cognition is associated with the severity of dental anxiety. This will help dentists to understand the specific fears of patients, which in turn might help the patients to control his/her anxiety. Most DAMs only provide an overall estimate of perceived discomfort without understanding the causes of this anxiety. Therefore the objective of this study was to review pediatric dental anxiety measures and assess the statistical
methods that are used for validation and their clinical implications.


courtesy: Evidence-based dentistry:
analysis of dental anxiety
scales for children
A. Al-Namankany,1 M. de Souza2 and P. Ashley3

Thursday 14 April 2016

orthodontic cephalometric analysis

hey guys,
good evening.
it's been a while since i post something right?
today i'll post about my recent activities.
today i have a skill's lab. and for your information skill's lab is time for us when we practicing what we've been learning and try to do it right.
today still about orthodontic.
what i'm going to share are about cephalometric analysis.
it's to know what we suppose to do with our patient. so we learn to tracing their cephalometric to make sure what we have to do.
so in the beginning we need to find few place and draw it. i'll show you the picture below.
so we need to find porion,orbita,nasion,menthon,nasal and gonion.
and after that we start making line from one to another.
if you want me to explain the detail just comment bellow and i'll make the detail as soon as possible.

Tuesday 5 April 2016

orthodontic practice braces

hey guys,
today I'll tell you about my university life.
today i got skill's lab schedule. in Indonesia this mean time for us (dentistry student) to practice about how well our hand works. as you know most of dentistry "thing" are related to art right. so this is how we practice for orthodontic dentistry.
each person got some wire. so we have to bend it into different shape. I'll show you some picture about it. one picture one you can see that there's few pattern that we have to make. and the one that i already finished are pattern that we make from straight wire with tools called bird beak. what's we have to do is, first we need to straighten the wire that we got using the bird beak as the  wire holder, then we bend the wire to the opposite direction to make a straight line. but, it's pretty hard to do. so, i try to just make the straight line just in the beginning and the rest will follow as  we make the pattern. so until now just complete 2 pattern and i still have 3 other pattern. i will update the other as soon as i complete the task.thank you
picture 1. that thing called 3 fingers. it usually use for making circle
picture 2
picture 3









Monday 4 April 2016

Charity day

hello guys,
it's been a while since my lat post. i know i promise to update my charity  when i got home. but, i'm too tired to do that and today is my chance to make my update.
so, let's begin the story.
last time i join charity to play with some children  from orphan near my university. there's lot of them so we divide by group. there are 6 group. which is contain 5 or 6 kids. we play a lot. we play like outbound so there's lot of post. every post have different game. but the most exciting thing is when we move from post to post we start to chasing the other team. because each team have their own powder with different color. so we try to make other team full of our color on their clothes. actually that's all. there's no other exciting activities beside that.
so that end my story.
i know it's too short. but, as you know I'm still beginner in this area so please accept my apologise.
and thank you for anyone who read this. i got 42 view. i know it's too little but 42 better than nothing. and at least i know there's someone who read my post.
Thank you
i will post about dentistry theory and material soon. wait for it.

Friday 1 April 2016

social activity

hey guys welcome again.
this is my first post, except my introduction it doesn't count right?
so, i write this at 01.26 am.
yeah i can't sleep now. today i have a schedule that's to do some charity. today my organization will go to a recreational place and take dozen of orphan with us. as you know they didn't  have parent's so even when they say they are happy. but, they must be feeling empty inside right? don't you agree with me?
so today schedule is take them out and have a lot of fun that' maybe they never have a chance to do that.
that's all for now cause i didn't meet them yet. after my schedule done I'll tell you what happen there and what we do there. wait for it.
thank you.