Dental Hygiene and Treatment - Essay Example

 Dental Hygiene and Treatment Dental amalgam Dental amalgam is a durable and strong material of a dentals filling. It can also be referred to as an alloy that contains a mixture of powder of a ratio of forty-six percent to fifty-seven percent tines, silver, and copper. In some cases, a little amount of palladium, zinc or indium bounded by about fifty-seven to forty-six percent of elemental liquid mercury. These dental amalgams filling are silver or gray in color and in some cases they are referred as mercury feeling or silver feelings. In the early 1800's, dental amalgam was invented (Marquez, Murr & Agüero, 2000). Dental amalgam is the frequently used material for the restoration of a tooth that has decayed in the world. Furthermore, dental amalgam has widely been used in the United States of America for the last one hundred years. The only viable alternative to gold and cast silver before the introduction of composite resin filling was dental amalgam. Background to the Minamata Convention on Mercury The Council of governing of the United Nations Environmental Program (UNEP) agreed on the importance of developing a globally binding instrument on mercury (Pacyna, Pacyna, Sundseth, Munthe, Kindbom, Wilson & Maxson, 2010). It mandated the government to negotiate through the Intergovernmental Negotiation Committee (INC) about the use of mercury. The Intergovernmental Negotiation Committee had five meeting which started in June 2010 and ended in January 2013. The resulting instrument for international was referred as Minamata Convention on Mercury. It was opened for signature in October 2013. It had the mandate to provide reduction and control across a variety of products, industries and processes where mercury released, emitted or used. The name was obtained from a city in Japan. The residents of that city suffered lethal and debilitating health effect as a result of the effect of mercury pollution in the mind in the 20th century (FDI World Dental Federation, 2015). What the Convention addresses The convention talked of different variety of products and processes related to mercury use and emission around the globe. They include: Mercury supply and trade, the process of manufacturing in which mercury compounds and mercury are used. In addition, areas covered were also the sources of mercury emission and mercury compounds emission to the atmosphere, small-scale and artisanal gold mining and mercury-added products (FDI World Dental Federation, 2015). The Minamata Convention and dental amalgam The provision of the Convention for dental amalgam (products containing fifty percent mercury) is highly important to the professionals in dental. It should be noted that dental amalgam is a key restorative material in the war against the fight of the causes of teeth decay, and dental carriers. These teeth decays and dental carriers' affects about ninety percent of the words total population making it a public health issue that affect the world. Dental amalgam is one of the products that contain mercury that has been subjected to phase- down. In addition, all other uses of mercury in the production of products that were discussed in the Convection are to be ban or phase-out. These bans are to be effected at a later date (FDI World Dental Federation, 2015). Composite versus amalgam Composite restoration placed on the posterior for Clinical survival is in an amalgam restoration range with some studies seeing it as slightly lower (Bernardo, Luis, Martin, Leroux, Rue, Leitão & DeRouen, 2007) or slightly higher (Manhart, Chen, Hamm, & Hickel, 2004) time for survival as compared to amalgam restoration. Because of the preference of composite to amalgam is as a result of the improvement of the technology and its technique of application. However the use of composite in cups is capping, and larger restoration situation is still under debate (Shenoy, 2008). According to Demarco et al. of the year 2012, which covered relevant 34 clinical studies, was impressive. Ninety percent of the study showed that the annual failure was rated between one and three percent and was achievable with class ii and class I rear teeth composite restoration depending on how failure has been defined. Furthermore, several factors which included the location and tooth type, socioeconomic, dentists, behavioral element and demographic (Demarco, Corrêa, Cenci, Moraes & Opdam, 2012). This obtained result is almost similar to that of three percent mean annual failure rate that was report in the year 2004 review article (Manhart, Chen, Hamm, & Hickel, 2004) for the posterior stress bearing cavity amalgam restoration. According to Demarco review, the main reason for the failure for the posterior composite restoration was the secondary caries. Secondary caries is to mean, a cavity that are acquired following the restoration. Furthermore, the failure was also due to the patient behavior and fracture and notably bruxism. However, when it comes to amalgam restoration, the causes of failure reported also included secondary caries (Manhart, Chen, Hamm, & Hickel, 2004). They included the amalgam or tooth fracture, marginal ditching and cervical overhang (Shenoy, 2008). The review by Demarco et al. of composite restoration study also noted that patients' factors affected the restoration longevity. This was obtained by comparing patients who had a good dental health to those patients who had a poor dental health. This poor dental health was mainly because of poor dental hygiene, genetics, diet, and frequency of dental check-ups. Those with poor dental hygiene experienced a high composite restoration failure due to subsequent tooth decay (Demarco et al., 2012). Another factor that also played a role is the socioeconomic factors. People who lived in the poorest status of the total population experiences more failure in the restoration as compared to those people who stayed in the richest layer (Demarco et al., 2012). The reported statistic may be affected by the definition of failure applied in the clinical study. Failed restorations are restorations that present small defects which are mainly treated by frequent replacement by most of the clinicians. As a result of this, for most of the years, the defective restoration has been listed as the most common treatment in the general dental practice (Demarco et al., 2012). In addition, when both the replaced and repaired restoration was classified in one study as a failure, the rate for annual failure was 1.9 percent. However, when the restoration that was repaired was classified as success and not a failure, there was a decrease in the AFR to about 0.7 percent. The classification of the repairable minor defect as success and not as a failure is reasonable. When there is a replacement of a restoration, a considerable amount of a tooth structure is removed, and the preparation is enlarged (Moncada, Martin, Fernández, Hempel, Mjör & Gordan, 2009). The application of the narrowed definition of failure will improve the composite restoration reported longevity. The composite restoration can always be easily extended ended or repaired without replacing or drilling out the entire filling. Resin composite will attach its self to the tooth. Amalgam fillings are strongly held in place by the void shape being filled instead of the adhesion. This means that it is of need to replace or drill out the entire amalgam restoration instead of adding the amalgam that remains. Question Two Causes of orofacial pain Most of the orofacial pains are mainly related to dental diseases (Scully & Felix, 2006). Another cause of orofacial pain is a mucosal pain. The pain from mucosal lesions can either be diffused or localized. Localized pains are mainly linked to a mucosal break, the loss of a slight epithelium thickness, loss of the entire epithelium thickness. The difference between these painful conditions is not easy to identify, and most of the people always suffer from both the pain. Diffusion pain can also be caused by the systemic underlying state of deficiency, infection, or other factors and are always. Other local causes of orofacial pain The jaws pain can be caused by direct trauma, infection, malignancies, and rarely caused by Paget's diseases. Unless the plan is associated with jaw fracture or infection, impacted teeth and retained root, and lesions such as cysts are mainly painless (Scully & Felix, 2006). Malignant tumors always produce boring pain, deep pain, which are mainly associated with anesthesia or paraesthesia. However, odontogenic and some benign tumors of the bones mainly don't produce pain (Sarlani, Schwartz, Greenspan & Grace, 2003). The silvery gland pain is always by the abstraction of the duct. However, it can also be caused by tumor or infection. The pain is usually restricted to the gland that is affected, may be increased with the increased production of the saliva before and with meals, may be very severe. The examination may a salivary gland that is sometimes swollen with a degree of trismus and tenderness. Some of the diseases of the nasopharynx and paranasal sinuses which can cause facial or oral pain include tumors and sinusitis. Tumours can remain undetected until the reach a point at which they are at an advanced stage. Any suggestion of obstruction from birthing or a discharge coming from the nose, lips tingling, swelling or numbness should be seriously taken as they may herald an antral carcinoma (Siccoli, M. M., Bassetti, C. L., & Sándor, P. S. (2006). Diagnosis of orofacial pain For a proper diagnosis of the orofacial pain, the key point about the pain should be determined. These may include the location, character, duration, periodicity, and frequency, precipitating, relieving, aggravating factors, associated features. Location: important information can be obtained by the dentist by asking the patient where he or she is feeling the pain or diffuse and watching the reaction of the patient. For example, most of the patients use there finger to point when they need to locate the dental pain or trigeminal neuralgia plain. However, a distinctive facial pain is more of diffuse, and may radiate throughout the mind line. Character: the character and pain severity should be asked by the dentist, for example, whether the pain is dull, aching, sharp, shooting or throbbing. However, the dentist should have in mind that the patient always finds it hard to get the right word to adequately describe the pain. The dentist should ask the patient to rate the severity of the pain on a zero to ten scales. The zero scale will mean that there is no pain while the ten scales will mean that the pain is most servers. Furthermore, the patients can be asked to mark the pain on a line that is divided into ten sections that are equal or the dentist may use an instrument of assessment like Mc Gill Pain Questionnaire (Melzack & Katz, 2001). The tools provided will help the patient assess the severity of the pain, always accepting that it is subjective. The tools for assessing pain will also be useful in monitoring the treatment response. In assessing the severity of the pain, the dentist should also note the disturbance of the pattern of the normal sleep by pain. Duration: another helpful factor in the diagnosis is the average duration of each episode. For example, pain from a dentine that is exposed will only last for seconds while the pain from a pulpitis will take a much longer period (West, 2008). Trigeminal neuralgia is a lancinating pain that can take few minutes (Minagar & Sheremata, 2000). Although some of the patients complaints persistence background pain, that is less server. However, migrainous neuralgia can last to about thirty to forty-five minutes while atypical facial pain is usually persistent (Evans & Mathew, 2005). Periodicity and frequency: at this point, the dentist needs to ask the patient if the pain he or she is experiencing occur at a specific time or is related to a specific event. At this point, a patient pain diary can be of help to the dentist. For example, the temporomandibular pain dysfunction syndrome (Al‐Ani, Davies, Gray, Sloan & Glenny,2004) may be very great in walking if it is mainly linked to nocturnal parafunctional activity such as tooth grinding or clenching. The sinusitis pain is always provoked by lying down. Periodic migrainous neuralgia mainly affects the patient's sleep each night at a specific time (Scully, n.d). Precipitating, relieving factors, and aggravating: the dentist may resort to leading question to ask if biting, analgesics, posture, and alcohol affects the pain. For example, always heats worsen dental pain. Touching the zone of trigger may precipitate the attack of a trigeminal neuralgia attack, and alcohol may provoke episodes of migrainous neural (Felix, Luker, & Scully, 2012), stress may increase atypical facial pain. Associated Features: some types of pain may have some of the features which can help in the diagnostic. These pains may include swollen face as a result of swollen dental, vomiting and nausea in migraine, lacrimation in migraines neuralgia or stuffiness of the nasal. The causes of most of the orofacial pain are mainly established from the history. Furthermore, examination finding is also of help, not least in without pathologies that are local. The usefulness of a specialist who can arrange the addition investigation, mainly the imaging of both the neck and the head using MRI and CT should also be considered (Neubauer, 2006). These specialists are important for the correct interpretation of the patient pain result obtained by various tools. Question three Evaluation of the Abutment Suitability The abutment tooth suitability can be evaluated by looking at the size of the zone in relation to the tooth size. The inability of attainment of sufficient zone of attached mucosa around the abutment teeth that is proposed for the 3 unit fixed-fixed bridge should be provide guard against inflammation should be looked at as a contraindication. The abutment tooth mobility may be evaluated. Excessive mobility of abutment teeth may also bring concern, but improvement of mobility may occur due to clinical crown reduction. This results to a more positive crown to root ratio (Block et al. 2001). The abutment teeth position should be evaluated. The position of abutment tooth in the arch should be considered carefully. The ultimate situation occurs when the three teeth are going to spread out over as large rectangular area as possible. This configuration gives a maximum stability to the denture. Three widespread remaining teeth would generally provide a tripod effect which would give the next most arrangement that is favorable. Several millimeters should be preferred in space between subsequent retained teeth to reduce compromises in health of the soft tissue. Limited availability of interarch space may results into a complication of denture teeth positioning over the abutment teeth. The potential weakness of base of acrylic resin denture over these areas may call for need of fabrication of superstructure of cast metal increasing the treatment time and cost. The cuts availability in the abutment teeth should be evaluated. Any undercuts present around the abutment teeth is suppose to be relieved in the base of the denture, if their blockage was not carried out during impression appointment, for achievement of complete overdenture sitting. Attachment used should be secured to the base of denture at overdenture insertion time or during processing (Rahn et al 2009).The size of the hole for pulp fitting should also be evaluated. The abutment should be in the position to fit firmly onto the pulp. His allows for the firmness of the abutment thus enhancing the strength of the denture Evaluation of the shape of the abutment tooth is crucial. The shape of the tooth allows for the fitting of the tooth within the ridge between the teeth. This allows for nice teeth arrangement and appearance as the abutment will bring out the same resemblance in size with the related teeth. The dentist needs to evaluate the occlusal scheme in the restoration that has been finished. The eventual occlusal plane should be analyzed carefully in the preparation of teeth for restoration. Considerable reduction is always required to supraeruption of abutment teeth compensation. This in turn shortens axial wall height preparation of tooth, with mechanical consequence associated for resistance and retention reduction. The evaluation of the axial side is also important. Gingival inflammations are associated with fixed abutments with more axial contours. The preparation of tooth must therefore provide enough space for good axial contours development. This allows the junction between the tooth and restoration to be free of abrupt direction changes and smooth. Pulp Injury Prevention Dental pulp represents the highly vascular soft tissue structure serving a major role in the formation of the teeth. During the procedure of teeth restoration, precautions are supposed to be taken by the dentist before and in the process of restoration to minimize causing injury to the pulp (Baumgartner et al 2002). The pulp is usually connected to the root canal which may also be injured together with the pulp during restoration. Great care is usually required to prevent the injury of the pulp at the time of 3 unit fixed-fixed procedures (Terry et al. 2003). Specific care is needed during grooves preparations since coolants are not in a position the bur cutting edge. Prevention of build up of heat requires preparation of these retention features at low rational speed. During the procedure and before restoration, root canal therapy is very important for the prevention of pulp injury. The dentist is first involved in the numbing of the area around the tooth. Sedations such as nitrous oxide may be given or some anxiety-reducing techniques may be offered. A hole should then be made at the back or the top of the tooth to reach the pulp chamber, this allows for the removal of some of the diseased pulp. The dentist should be involved in the measurement of the root canals. Knowledge of the length of the canal allows for the removal of all the damaged tissue and the cleanliness of the entire canal. There is then the need to fulfill the entire canal. The canal is cleaned by the use of antiseptic (Crisp et al 2008). The dentist then ensures that the infection has been removed and the root filled completely. During restoration, various precautions should be put in place to prevent pulp injury. The dentist should use cutting rotary instruments without end. Use of instruments with ends which are protruding may come into close contact with the pulp resulting to pain. Minimal canal enlargement should be allowed. A very wide enlargement has high chances of exposing the pulp to external injuries by the equipment. The dentist should ensure of length of at least equivalent to height of crown. The existence of short and longer posts increases the fracture of the root. This also increases the chances of injury to the pulp. The dentist should ensure diameter of one-third width or less of the root. The small diameter covers pulp exposes very little of the pulp during restoration. There should also be a minimum of 4-5mm gutter percha left. Post modification should also be carried out to fit the canal. There should be enough ferrules about 1.5-2mm between crown margins and core. During the restoration, the extent of vibration caused by the instrument should be monitored as this may also cause harm to the pulp since they cause an increase in temperature (George et al 2009). Question four At any time a lesion is observed on radiography, the lesion has to be first described as the attempt of a differential diagnosis. These may include questions like; is the lesion radiolucent, mixed or radiopaque (combination of radiopacity and radiolucency)? The second question is the location of the lesion, the involved apices of the teeth, and the size of the lesion. Furthermore, is the lesion margin well or ill-defined? Is the bone surrounding the lesion porous, sclerotic, or normal? The appearance of various radiographic of the lesions margins and change of the surrounding bone have been interpreted clinically, various diagnosticians based mainly on intuitive analysis instead of the research data. However, the importance of this signs is sometimes doubtful, they are vital in the interpretation radiographic. An- ill-defined margin is indicative of an enlarging lesion by the invading of the bone that is surrounding. A margin that is well-defined is indicative of a self-contained lesson enlarging through expansion. A margin that is well defined with a hyperostotic radiopaque margin is indicative of a very slow growing self-contained lesion enlargement through expansion. If there is no sign of change by the bones surrounding the lesion, the analysis of a clinical is that of a static lesion. If there is an evidence of porosity, the analysis is that of a process that is invasive resulting from the activity of osteolytic. If sclerosis is evidenced, the analysis is that of pathologic process resistance resulting from an activity that is osteoblastic. The pathologic conditions that are most common are inflammatory lesions of periapical and pulp areas (Gröndahl, & Huumonen, 2004). Once there is the spread of the inflammation of the dental pulp, a variety of apical pathologic change can be produced. Some of the most common pathologic change is the radicular cyst, periapical granuloma, and apical abscess. Different factors such bacteria virulence and the host's resistant of the bacteria affects the inflammatory response that is local in the area of periapical. Without the use of a microscopic diagnosis, a clinician is mostly found it hard to differentiate between radicular cyst, periapical granuloma and an apical abscess (Dias, Prasad & Santos, 2007). There is an inadequacy of the radiographic examination in making a specific diagnosis. There are various clinical characteristics that are common in the lesion of inflammatory periapical. These characteristics are four. The first one is a history of pulpitis that are painful leading to the pulp death. The second is the nonvital reaction to electronic pulp testing. In a tooth that is multirooted in which one root is associated with the pulpoperiapical pathosis, a vital reaction will frequently be given by the tooth. The third one is the presence of various lesions that are deep exposing the pulp, fractured tooth or discolored crown and a restoration that is close to the pulp. The fourth and the final is the distraction that results from an interrupted lamina dura of the tooth that is involved. A granuloma is produced from the periapical tissues (Lin, Huang, & Rosenberg, 2007) successful attempt to confine and neutralize the irritating product that is toxic escaping from the root canal. The inflammation tissue that is low grade continues to induce the vascular granulation tissue proliferation. A granuloma may change into an apical abscess or a radicular cyst. Clinically, the lesion is always asymptomatic but most of the time it may show sensitivity and soft pain to percussion. The affected tooth is nonvital. Radiographically granulomas form a radiolucency that is small and well-defined. They are the periapical lesions that are most common and compose of about fifty percent of all the periapical radiolucent lesions. A radicular cyst, which is also referred as a dental cyst, periapical cyst, and periodontal cyst, originates from the cell rests of Malssez (Rincon, Young & Bartold, 2006). These cell rests are present in the periapical ligament, periodontal and periapical granulomas. Most of the radicular cysts come from granuloma that is pre-existing. Clinically, the lesion is always asymptomatic although it may sometimes show sensitivity and soft pain to percussion. The tooth that is affected is non-important. A radicular cyst may enlarge slowly, and when it is large, it may cause cortical plate expansion. Radiographically, a ridicule cyst forms a radiolucency that is large and well defined without or with a radiopaque border. The more the hyperostic border is pronounced, the more likely the lesion becomes a radicular cyst. It is a periapical lesion that is the second common and contains about forty percent of the entire periapical radiolucent lesion. In about ninety percent of the cases (LSUSD, 2015), a radiolucency that is well-defined at the apex of the asymptomatic tooth that is untreated with a diseased pulp or a nonvital is either a radicular cyst or a dental granuloma. There differentiating future are their size. A radicular cyst is large while a granuloma is small. Practically, it is very hard to differentiate a radicular cyst from a periapical granuloma. The difference is hard because both lesions react well to the root canal therapy that is conservative. An apical abscess, which is also referred as a dentoalveolar abscess or dental mainly, develops from a pulpo- periapical inflammatory condition (Brook, I. (2004). The onset of the infection is so saddened in the acute stage that there is no present of an evidence of radiographic of an apical lesion. An apical abscess may also develop from a cyst or granuloma that is pre-existing. The tooth that is linked is nonvital, extremely sensitive, and very painful to percussion and is slightly extruded. The patient will complain of the tooth feeling high when it collides with the tooth that is opposing. The tooth will not respond to a pulp tests that is electronic. An increase of heat at that point will magnify the pain while the application of ice at that point will relieve that pain. Increased mobility will be demonstrated by the tooth. Radiographically, large radiolucencies are formed from apical abscesses with irregular borders that are diffused. Of the three pulpo-periapical lesion, they are of the least common and constitute about two percent of the entire periapical radiolucent lesion. Reference Al‐Ani, M. Z., Davies, S. J., Gray, R. J., Sloan, P., & Glenny, A. M. (2004). Stabilisation splint therapy for temporomandibular pain dysfunction syndrome. The Cochrane Library. Baumgartner, J. C. (2002). Korean Academy Of Endodontics 27th Scientific Meeting. Australian Endodontic Journal, 28(3). Bernardo, M., Luis, H., Martin, M. D., Leroux, B. G., Rue, T., Leitão, J., & DeRouen, T. A. (2007). Survival and reasons for failure of amalgam versus composite posterior restorations placed in a randomized clinical trial. The Journal of the American Dental Association, 138(6), 775-783. Block, M. S., Lirette, D., Gardiner, D., Li, L., Finger, I. M., Hochstedler, J., ... & Worthington, P (2001). Prospective evaluation of implants connected to teeth. The International journal of oral & maxillofacial implants, 17(4), 473-487. Brook, I. (2004). Microbiology and management of endodontic infections in children. Journal of Clinical Pediatric Dentistry, 28(1), 13-17. Crisp, R. J., Cowan, A. J., Lamb, J., Thompson, O., Tulloch, N., & Burke, F. J. T. (2008). A clinical evaluation of all-ceramic bridges placed in UK general dental practices: first-year results. British dental journal, 205(9), 477-482. Demarco, F. F., Corrêa, M. B., Cenci, M. S., Moraes, R. R., & Opdam, N. J. (2012). Longevity of posterior composite restorations: not only a matter of materials. Dental Materials, 28(1), 87-101. Dias, G. J., Prasad, K., & Santos, A. L. (2007). Pathogenesis of apical periodontal cysts: guidelines for diagnosis in palaeopathology. International Journal of Osteoarchaeolog 17(6), 619-626. Evans, R. W., & Mathew, N. T. (2005). Handbook of headache. Lippincott Williams & Wilkins. FDI World Dental Federation, (2015). Dental restorative material and the Minamata Convection on Mercury. Web < http://www.fdiworldental.org/media/54670/minamata- convention_fdi-guidelines-for-successful-implementation.pdf > accessed May 11, 2015. FDI World Dental Federation, (2015). Minamata Convention on Mercury: Guidelines for Successful Implementation . Web < http://www.fdiworldental.org/oral-health/dental- materials/minamata-convention-on-mercury-guidelines-for-successful- implementation.aspx> accessed, May 11, 2015. Felix, D. H., Luker, C. S. J., & Scully, C. (2012). Oral medicine. 9: Orofacial pain. Dental update, 40(6), 493-501. George, R. (2009). Laser in dentistry-Review. International Journal of Dental Clinics, 1(1). Gröndahl, H. G., & Huumonen, S. (2004). Radiographic manifestations of periapical inflammatory lesions. Endodontic Topics, 8(1), 55-67. Lin, L. M., Huang, G. T. J., & Rosenberg, P. A. (2007). Proliferation of epithelial cell rests, formation of apical cysts, and regression of apical cysts after periapical wound healing. Journal of endodontics, 33(8), 908-916. Louisiana State University School of Dentistry(LSUSD), (2015). CHAPTER 7 APICAL LESIONS Periapical granuloma. Web < http://www.lsusd.lsuhsc.edu/Documents/Thunthy_book/Chapter%2007%20Apical%20L esions.pdf> accessed May 13, 2015. Manhart, J., Chen, H. Y., Hamm, G., & Hickel, R. (2004). Review of the clinical survival of direct and indirect restorations in posterior teeth of the permanent dentition. OPERATIVE DENTISTRY-UNIVERSITY OF WASHINGTON-, 29, 481-508. Marquez, J. A., Murr, L. E., & Agüero, V. (2000). A study of alternative metal particle structures and mixtures for dental amalgams based on mercury additions. Journal of Materials Science: Materials in Medicine, 11(8), 469-479. Melzack, R., & Katz, J. (2001). The McGill Pain Questionnaire: appraisal and current status. Guilford Press. Minagar, A., & Sheremata, W. A. (2000). Glossopharyngeal neuralgia and MS. Neurology, 54(6), 1368-1370. Moncada, G., Martin, J., Fernández, E., Hempel, M. C., Mjör, I. A., & Gordan, V. V. (2009). Sealing, refurbishment and repair of Class I and Class II defective restorations. The Journal of the American Dental Association, 140(4), 425-432. Neubauer, S. (2006). MRI and CT. Medicine, 34(4), 157-161. Pacyna, E. G., Pacyna, J. M., Sundseth, K., Munthe, J., Kindbom, K., Wilson, S., ... & Maxson, P. (2010). Global emission of mercury to the atmosphere from anthropogenic sources in 2005 and projections to 2020. Atmospheric Environment, 44(20), 2487-2499. Rahn, A. O., Heartwell, C. M., Ivanhoe, J. R., & Plummer, K. D. (2009). Textbook of complete dentures. Shelton, Conn: People's Medical Publishing House. Page 270 Rincon, J. C., Young, W. G., & Bartold, P. M. (2006). The epithelial cell rests of Malassez–a role in periodontal regeneration?. Journal of periodontal research, 41(4), 245-252. Sarlani, E., Schwartz, A. H., Greenspan, J. D., & Grace, E. G. (2003). Facial pain as first manifestation of lung cancer: a case of lung cancer-related cluster headache and a review of the literature. Journal of orofacial pain, 17(3), 262-268. Scully, C. Oral medicine for the General Practitioner: pain. Scully, C., & Felix, D. H. (2006). Oral Medicine—Update for the dental practitioner Orofacial pain. British dental journal, 200(2), 75-83. Shenoy, A. (2008). Is it the end of the road for dental amalgam? A critical review. Journal of conservative dentistry: JCD, 11(3), 99. Siccoli, M. M., Bassetti, C. L., & Sándor, P. S. (2006). Facial pain: clinical differential diagnosis. The Lancet Neurology, 5(3), 257-267. Terry, D. A. (2003). Adhesive reattachment of a tooth fragment: the biological restoration Practical Procedures and Aesthetic Dentistry, 15(5), 403-409. West, N. X. (2008). Dentine hypersensitivity: preventive and therapeutic approaches to treatment. Periodontology 2000, 48(1), 31-41. Read More