PRESENCE OF DENTAL APPLIANCES AND RESTORATIONS
Partial dentures, space maintainers, and orthodontic appliances often encourage the retention of food debris and plaque material and have been shown to result in an increase in the bacterial population. Few patients keep their mouths meticulously clean, and even those who make an attempt may be hampered by the presence of dental appliances that retain plaque material between brushings. Patients who have had moderate dental caries activity in the past might be expected to have increased caries activity after the placement of appliances in the mouth unless they practice unusually good oral hygiene.
Rosenbloom and Tinanoff evaluated the S. mutans level of patients before, during, and after orthodontic treatment.43 S. mutans levels were significantly elevated during active treatment. When samples were taken 6 to 15 weeks into the retention phase of treatment, however, the microbial levels were found to have decreased significantly to levels comparable to those of untreated children.
Dentists have known for many years that the tooth structure at the interface with restorative material is especially vulnerable to recurrent caries. Clinical studies suggest that dentists and their patients should not expect successful restorative treatment to reduce a patient’s risk for future development of carious lesions. Tinanoff and colleagues found higher numbers of salivary S. mutans in patients after they received restorative treatment.44 Wright and colleagues observed significant reductions in the number of mutans streptococci and lactobacilli immediately after restoration; however, mutans streptococci returned to prerestoration levels in many of their subjects.45 Gregory and colleagues observed that postoperative counts of salivary streptococci essentially equaled the preoperative counts after all restorative work had been completed in their patients.46 Effective prevention programs are required to protect the patient from additional caries and to better justify the investment in restorative care.
PRESENCE OF DENTAL APPLIANCES AND RESTORATIONSPartial dentures, space maintainers, and orthodontic appliances often encourage the retention of food debris and plaque material and have been shown to result in an increase in the bacterial population. Few patients keep their mouths meticulously clean, and even those who make an attempt may be hampered by the presence of dental appliances that retain plaque material between brushings. Patients who have had moderate dental caries activity in the past might be expected to have increased caries activity after the placement of appliances in the mouth unless they practice unusually good oral hygiene.Rosenbloom and Tinanoff evaluated the S. mutans level of patients before, during, and after orthodontic treatment.43 S. mutans levels were significantly elevated during active treatment. When samples were taken 6 to 15 weeks into the retention phase of treatment, however, the microbial levels were found to have decreased significantly to levels comparable to those of untreated children.ทันตแพทย์มีชื่อเสียงในหลายปีที่โครงสร้างฟันที่กับวัสดุฟื้นฟูความเสี่ยงโดยเฉพาะการผุที่เกิดซ้ำ การศึกษาทางคลินิกแนะนำให้ ทันตแพทย์และผู้ป่วยของพวกเขาควรจะคาดหวังความสำเร็จการรักษาฟื้นฟูเพื่อลดความเสี่ยงของผู้ป่วยในอนาคตของ carious ได้ Tinanoff และเพื่อนร่วมงานพบจำนวนแมงแลง S. salivary สูงในผู้ป่วยหลังจากได้รับการฟื้นฟู treatment.44 ไรท์ และเพื่อนร่วมงานสังเกตสำคัญลดจำนวนแมงแลง streptococci และ lactobacilli ทันทีหลังจากที่คืนค่า อย่างไรก็ตาม streptococci แมงแลงกลับสู่ระดับ prerestoration ใน subjects.45 ของเกรกอรีและเพื่อนร่วมงานสังเกตว่า ในการผ่าตัดการตรวจนับของ salivary streptococci เป็นตอนนับ preoperative ที่ฟื้นฟูหลังจากทำงานได้เสร็จในโปรแกรมป้องกันที่มีประสิทธิภาพของพวกเขา patients.46 จำเป็น เพื่อปกป้องผู้ป่วยจากผุเพิ่มเติม และต้องการดีกว่า การลงทุนในการดูแลฟื้นฟู
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