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Bacterial infections of the tooth and the surrounding tissues progress rather slowly,
but every step is so much more severe than the previous one.
Cariogenic bacteria will first tear enamel down.
Then they'll bore through dentin.
When they or their toxic waste get into the pulp, pulpitis occurs.
Without immediate treatment, pulpitis can cause irreversible damage and require a root
canal.
If no treatment is performed, the pulp will eventually die off through necrosis.
At that point, the tooth is considered dead, and in essence, it becomes a staging area
for bacteria to spread further.
Our immune system will, at that point, try to stage a defense around the apices of the
dental root.
We call that "battlefield" apical periodontitis, which is one of the periapical lesions.
The primary form of defense our body has against infection is the polymorphonuclear leukocyte,
also known as the neutrophil.
It is the finest soldier serving our body, and its task is to locate and destroy microbes
that intrude into the body, wherever that might be.
This is usually a very effective force, and most of the times sufficient.
When an infection occurs, neutrophils will mobilize in huge numbers, head to the site
of infection, and leave the circulatory system, searching for bacteria to destroy.
They achieve this through three methods.
First is degranulation, where neutrophils release a bunch of granules containing various
enzymes, that hurt bacteria.
Then, they will use neutrophil extracellular traps, or NETs, to immobilize the wounded
bacteria.
These are actually nets, made out of neutrophil DNA!
Finally, neutrophils will then gobble up the bacteria through phagocytosis as a final means
of its destruction.
All of this works really well, most of the time.
But, fighting infection is a bloody affair and many of the neutrophils perish during
the fight.
Macroscopically, the battlefield, containing neutrophil remains, released enzymes, NETs
and dead bacteria, makes up pus.
And a lot of it can accumulate, given the severity of the infection.
Enzymes from the pus will irritate the surrounding tissues, creating an acute phase of apical
periodontitis.
The accumulation of pus is called a periapical abscess, as it surrounds the root.
This abscess can eventually form a sinus tract, which is a narrow passageway that extends
from the abscess to the mouth, through which the pus can drain out.
The periapical abscess can also progress into a periapical cyst, which is when fibrous tissue
and immune cells surround an area of chronic infection containing pus.
In less fortunate cases of periapical lesions on the maxillary teeth, the cyst can form
a fistula to the maxillary sinus, causing a severe case of sinusitis.
If the external drainage fails to happen, and the cyst or abscess continues to grow,
the lesion might progress to osteomyelitis, which is the inflammation of the underlying
bone, or cellulitis, which is the inflammation of the throat.
One severe form of cellulitis is called Ludwig's angina, where the inflammation of soft tissues
is so severe, it may lead to death through suffocation.
Treatment of periapical lesions usually involves antibiotics to curb the infection.
Then, an endodontic therapy is performed where the decaying pulp is removed and the abscess
is drained.
The pulp space gets thoroughly cleaned and disinfected, while the tooth crown is repaired,
allowing the dead tooth to continue doing its mechanical function of chewing.
Endodontic therapy has a high success rate, however, the treated tooth can sometimes reinfect
and an extraction may be required.
All right, as a quick recap.
Periapical lesions are inflammatory in origin, and involve apical periodontitis, which may
evolve into periapical abscess or a periapical cyst.
Abscesses can drain into the mouth or cause cellulitis.
Treatment involves antibiotics, pus drainage, endodontic treatment of the tooth, and failing
all that, extraction of the affected tooth.
For more infomation >> Periapical lesions - causes, symptoms, diagnosis, treatment, pathology - Duration: 5:26.-------------------------------------------
Arsenal legend says fans may turn on Unai Emery over treatment of one player - News Today - Duration: 1:55.
Unai Emery is running the risk of making Arsenal fans "twitchy" over a lack of progress in the Mesut Ozil situation, according to former Gunner Lee Dixon
The German has only made one start for the club since Boxing Day, with a variety of illness and injury issues blamed for his absences
Emery has challenged the playmaker to produce the consistency required to keep him in the side but Dixon thinks that, having already proven that he isn't going to be pushed around by Ozil, Emery now has to get hold of the situation
"It's going to take time," Dixon told the 5 Live Football Daily podcast . "I know it's an easy thing to say, but a new manager coming in has got to be given time as well and he's had his handcuffs on as well behind his back, he's got the problem with Ozil
"I thought he's dealt with the Ozil situation pretty well, to be honest, with the media situation and how it's been
How he's talked about it and how he's left him out. "But now the fans have started to get twitchy saying: 'look, you've done that little bit of keeping him out the side and then trying to educate him on what is needed to get in the side, but we don't care anymore
"We just want some quality in there. "Because they've seen the likes of Alexis [Sanchez] leaving the club, and they've seen Ramsey leaving in the summer, and they're now looking and saying: 'where is the creativity from midfield?' "That's a real big problem for Arsenal at the moment
" Read More Mirror Football's Top Stories
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New breakthrough treatment for women with hardest-to-treat breast cancer - Duration: 9:08.
New breakthrough treatment for women with hardest-to-treat breast cancer
An experimental 'magic bullet' drug has the potential to change the way women are treated for one of the most deadly forms of breast cancer, an expert has said.
Sacituzumab, is an antibody that zeroes in on cancer cells. Like a homing missile, it delivers a 'warhead' in the form of a potent chemotherapy drug. Since it directly targets tumours while avoiding healthy cells, side effects are kept to a minimum.
In a clinical trial involving 108 women with triple-negative breast cancer that had spread around the body, the infused drug caused 'significant' tumour shrinkage, researchers reported.
The women had all previously failed to respond to two or more previous treatments. All had a poor prognosis. Overall, a third of the patients responded to the drug and typical survival time was 13 months.
Nine long-term responders remained free of any disease progression for more than a year.
Senior investigator Dr Kevin Kalinsky, from Columbia University, New York, said: 'I think this drug has the potential to change practice, because the data looks so compelling, even with the relatively small number of patients in the trial.
There's an unmet need for patients with metastatic (spreading) triple-negative breast cancer, and we see significant tumour shrinkage with this new therapy. Triple negative breast cancers are notoriously hard to treat.
They are impervious to normal types of hormone therapy and drugs that target the cancer-fuelling HER-2 protein.
The new drug is also being tested against other types of breast cancer as well as bladder and prostate cancers, said researchers writing in the New England Journal of Medicine.
During the trial only 3 percent of patients stopped taking the drug due to adverse side effects. The main effects seen were hair loss, diarrhoea and fatigue.
Dr Kalinsky added: 'Having smaller tumours can be incredibly meaningful to a patient's quality of life. When tumours shrink, patients are more likely to experience improvement in symptoms, like pain.'.
An experimental 'magic bullet' drug has the potential to change the way women are treated for one of the most deadly forms of breast cancer, an expert has said.
Sacituzumab, is an antibody that zeroes in on cancer cells. Like a homing missile, it delivers a 'warhead' in the form of a potent chemotherapy drug. Since it directly targets tumours while avoiding healthy cells, side effects are kept to a minimum.
In a clinical trial involving 108 women with triple-negative breast cancer that had spread around the body, the infused drug caused 'significant' tumour shrinkage, researchers reported.
The women had all previously failed to respond to two or more previous treatments. All had a poor prognosis. Overall, a third of the patients responded to the drug and typical survival time was 13 months.
Nine long-term responders remained free of any disease progression for more than a year.
Senior investigator Dr Kevin Kalinsky, from Columbia University, New York, said: 'I think this drug has the potential to change practice, because the data looks so compelling, even with the relatively small number of patients in the trial.
There's an unmet need for patients with metastatic (spreading) triple-negative breast cancer, and we see significant tumour shrinkage with this new therapy. Triple negative breast cancers are notoriously hard to treat.
They are impervious to normal types of hormone therapy and drugs that target the cancer-fuelling HER-2 protein.
The new drug is also being tested against other types of breast cancer as well as bladder and prostate cancers, said researchers writing in the New England Journal of Medicine.
During the trial only 3 percent of patients stopped taking the drug due to adverse side effects. The main effects seen were hair loss, diarrhoea and fatigue.
Dr Kalinsky added: 'Having smaller tumours can be incredibly meaningful to a patient's quality of life. When tumours shrink, patients are more likely to experience improvement in symptoms, like pain.'.
An experimental 'magic bullet' drug has the potential to change the way women are treated for one of the most deadly forms of breast cancer, an expert has said.
Sacituzumab, is an antibody that zeroes in on cancer cells. Like a homing missile, it delivers a 'warhead' in the form of a potent chemotherapy drug. Since it directly targets tumours while avoiding healthy cells, side effects are kept to a minimum.
In a clinical trial involving 108 women with triple-negative breast cancer that had spread around the body, the infused drug caused 'significant' tumour shrinkage, researchers reported.
The women had all previously failed to respond to two or more previous treatments. All had a poor prognosis. Overall, a third of the patients responded to the drug and typical survival time was 13 months.
Nine long-term responders remained free of any disease progression for more than a year.
Senior investigator Dr Kevin Kalinsky, from Columbia University, New York, said: 'I think this drug has the potential to change practice, because the data looks so compelling, even with the relatively small number of patients in the trial.
There's an unmet need for patients with metastatic (spreading) triple-negative breast cancer, and we see significant tumour shrinkage with this new therapy. Triple negative breast cancers are notoriously hard to treat.
They are impervious to normal types of hormone therapy and drugs that target the cancer-fuelling HER-2 protein.
The new drug is also being tested against other types of breast cancer as well as bladder and prostate cancers, said researchers writing in the New England Journal of Medicine.
During the trial only 3 percent of patients stopped taking the drug due to adverse side effects. The main effects seen were hair loss, diarrhoea and fatigue.
Dr Kalinsky added: 'Having smaller tumours can be incredibly meaningful to a patient's quality of life. When tumours shrink, patients are more likely to experience improvement in symptoms, like pain.'.
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FDA warns against buying 'young blood' for treatment against aging - Duration: 1:53.
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Keranique Hair Growth - The Best Formula Hair Regrowth Treatment - Duration: 1:45.
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'Everything went perfectly well' Khedira reveals heart treatment went well and targets Juventus retu - Duration: 4:06.
SAMI KHEDIRA revealed he underwent successful heart treatment this morning and hopes to back in a Juventus shirt soon
The midfielder was diagnosed with arrhythmia after tests on Tuesday showed he had an irregular heartbeat
Khedira, 31, took to Twitter to share his update and thank fans for their support - who could see him back in action towards the end of March
He said: "I've had a successful interventional therapy today in the morning with an ablation of an arrhythmogenic atrial focus
"Everything went perfectly well and I will be able to get back to work after a short rest
Thank you so much for all your messages and get well wishes!" In a statement of their own, Juventus said: "Today in the morning the player Sami Khedira underwent electrophysiological study and successful interventional therapy with ablation of an arrhythmogenic atrial focus, performed by Prof
Fiorenzo Gaita, JM cardiologist consultant for Juventus." Arrhythmia can lead to blood clots, stroke, heart failure and other complications if left untreated
It is most common in people over the age of 65 but is often not life threatening
Khedira added: "A big thank you to Prof. F. Gaita as well. Now I'm wishing my team mates all the best for tonight's game in Madrid
" Unfortunately for Khedira, it appears his team-mates did not get the message. They fell to a disappointing 2-0 defeat against Diego Simeone's side to put qualification for the Champions League quarter-finals in serious doubt
Late goals from Uruguayan defenders Jose Maria Gimenez and Diego Godin, the latter's deflecting off Cristiano Ronaldo, put the La Liga side firmly in control
And it could have been worse had it not been for the introduction of VAR for the knockout stages of this season's competition
Atletico Madrid had a penalty changed to a free-kick and then Alvaro Morata's thumping header was ruled out for a push on Giorgio Chiellini
Juventus now have a mountain to climb when they try and overturn the deficit in the second leg at the Allianz Stadium on March 12
Cristiano Ronaldo reminds Atletico Madrid fans how many times he's won Champions League on return to Madrid
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Family-Based Treatment Group Home | New Heaven Dominion - Duration: 0:52.
The need for intensive treatment services for emotionally troubled children and adolescents
in the Department of Children & Families District Four is reflected in the large number of such
youths currently residing in or on waiting lists for a family home setting.
New Heaven Dominion strives to meet the needs of such youths by developing and maintaining
a family-based oriented treatment group home.
NHD, Inc. is a 501(c) 3 Christian family-based treatment group home organization.
Our purpose is to build relationships that enhance the development of skills, build self-esteem,
new behavior patterns, foster a sense of worth and embrace a belief in each resident's
individual potential.
We build a foundation that will be their lifelong guide to successful living.
We invite you to change lives with us!
Your prayers and financial support is greatly needed and appreciated.
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TMJ Treatment with an LVI Dentist - Duration: 1:06.
There are two school of thoughts for treating the TMJ. One of them is a
conventional way, treating based on anatomy. You go to them, they take
impression and then the next time you go they give you a mouthpiece. How do they know
how much to open your jaw, what direction to open from and most of the time it doesn't
work. But at the same time a broken clock is right in two times in 24 hours. In some
people, this magic works. But majority of the people don't
respond but with the physiologic - the other school of the thought. The
physiologic neuromuscular base, we have better success with it
because what we do is measuring the muscle activity, finding the
lower joint because the lower jaw is a floating bone. Finding the right
position of the lower jaw, where the jaw wants to be in the relaxed position base
of the muscle. That's the one the patient get better response utilizing technology
utilizing the computer and TENSing we are very successful. We are trained
dentists to treating the tension with the TMJ
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