Prophylaxis (from the Greek phylassein, "be vigilant") is a collective term for all measures taken to prevent from the outset any impairments to health, their persistence, increase or reoccurrence. Chronologically, therefore, it mainly occurs prior to examinations for screening or early detection and minimally invasive treatment. Nowadays the modern terms prophylaxis and prevention are often used synonymously.
Prophylactic measures are classified according to various criteria:
Target group: They can be targeted at individual persons (individual prophylaxis), a specific population (group prophylaxis) or the entire population (collective prophylaxis). They are differentiated according to age group as infant-, child-, adolescent-, adult- and geno-prophylaxis and also according to the current physical status as pregnancy prophylaxis or handicapped prophylaxis.
Methods: Different types of methods can be used for prophylaxis, e.g. clarification about and application of behaviour patterns, mechanical and technical aids, preventive use of pharmacological and chemical active agents or vaccines.
Performed by: Measures can be performed by the person affected (oral self-care) or by other persons, mainly medical specialists (professional oral-care).
Disease pattern: Prophylaxis, which is completed on healthy patients (primary prophylaxis), should be differentiated from early detection of incipient disease processes (screening, secondary prophylaxis) and the prevention of relapses after completed treatment (tertiary prophylaxis). Primary-primary prophylaxis is used for pregnant women and is aimed at the unborn child.
Dental prophylaxis is mainly targeted towards caries prevention and periodontitis prophylaxis. One of the central objectives of dental prophylaxis is clarification about and implementation of measures for the control and regular removal of dental plaque (plaque control). It is mainly completed via domestic oral hygiene using aids for mechanical cleaning of occlusal, oral and buccal tooth surfaces (manual and electric toothbrushes, toothpastes), the interdental spaces (dental floss, interdental brushes, toothpicks). Bacterial reduction using disinfectant mouthwash (e.g. with chlorhexidine) can also be a sensible measure (chemoprophylaxis). The dentist can support prophylactic treatment by performing professional tooth cleaning.
Cleaning the tongue (tongue scraper) achieves halitosis prophylaxis.
Periodontal prophylactic measures include restricting or giving up the consumption of tobacco products, correct cessation of manifest diabetes and gingivitis prophylaxis.
Restriction or avoidance of drinks (soft drinks) or food (honey, sweets) with a high sugar content is an effective method of caries prevention. Sealing of caries-free fissures and pits by the dentist is also effective. Fluorides are also used for this purpose, e.g. collective prophylactic fluoridation of drinking water and salt, group and individual prophylactic measures using the application of fluoride gels and varnishes as well as by the use of fluoride toothpastes.
In the case of patients with serious pre-existing diseases or heart abnormalities, administration of antibiotics for endocarditis prophylaxis is required prior to invasive dental procedures.
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attachment apparatus | Zahnhalteapparat, Parodont, Parodontium, Zahnbett, Desmodont, Desmodontium, Wurzelhaut, Wurzelperiost |
Composites also composite (from the Latin componere = to compose) are tooth-coloured filling materials with plastic properties used in dental treatment. In lay terms they are often referred to as plastic fillings, also erroneously sometimes confused with ceramic… Composites also composite (from the Latin componere = to compose) are tooth-coloured filling materials with plastic properties used in dental treatment. In lay terms they are often referred to as plastic fillings, also erroneously sometimes confused with ceramic fillings due to their tooth colour. After being placed in a cavity they cure chemically or by irradiating with light or a combination of the two (dual-curing). Nowadays, composites are also used as luting materials. The working time can be regulated with light-curing systems, which is a great advantage both when placing fillings and during adhesive luting of restorations. Dual-curing luting materials are paste/paste systems with chemical and photosensitive initiators, which enable adequate curing, even in areas in which light curing is not guaranteed or controllable. Composites were manufactured in 1962 by mixing dimethacrylate (epoxy resin and methacrylic acid) with silanized quartz powder (Bowen 1963). Due to their characteristics (aesthetics and advantages of the adhesive technique) composite restorations are now used instead of amalgam fillings.
The material consists of three constituents: the resin matrix (organic component), the fillers (inorganic component) and the composite phase. The resin matrix mainly consists of Bis-GMA (bisphenol-A-glycidyldimethacrylate). As Bis-GMA is highly viscous, it is mixed in a different composition with shorter-chain monomers such as, e.g. TEGDMA (triethylene glycol dimethacrylate). The lower the proportion of Bis-GMA and the higher the proportion of TEGDMA, the higher the polymerisation shrinkage (Gonçalves et al. 2008). The use of Bis-GMA with TEGDMA increases the tensile strength but reduces the flexural strength (Asmussen & Peutzfeldt 1998). Monomers can be released from the filling material. Longer light-curing results in a better conversion rate (linking of the individual monomers) and therefore to reduced monomer release (Sideriou & Achilias 2005) The fillers are made of quartz, ceramic and/ or silicon dioxide. An increase in the amount of filler materials results in decreases in polymerisation shrinkage, coefficient of linear expansion and water absorption. In contrast, with an increase in the filler proportion there is a general rise in the compressive and tensile strengths, modulus of elasticity and wear resistance (Kim et al. 2002). The filler content in a composite is also determined by the shape of the fillers.
Minimally-invasive preparation and indiscernible composite restoration
Composite restorations Conclusion |