30 Oral Pathology Fig 1
Fig 1: Black stains at the gingival margin of teeth due to chromogenic bacteria Fig 2
Fig 2: Orange stains on palatal upper anterior teeth due to chromogenic bacteria
Direct extrinsic tooth staining is adsorbed onto tooth surface deposits such as plaque or the acquired pellicle. The possible etiological agents include dietary components, beverages, tobacco, mouth rinses and other medicaments.1, 4, 5
Tobacco from cigarettes, cigars, pipes, and chewing tobacco causes tenacious dark brown and black stains that cover the cervical one third to midway on the tooth. Chewing of paan results in the production of blood red saliva that results in a red-black stain on the teeth, gingiva and oral mucosal surfaces.2, 7 Chromogenic bacteria have also been suggested as an etiological factor in the production of stains typically at the gingival margin of the tooth.8 Particular colors of staining are said to be associated with certain mouths, for instance, green and orange (fig.1) in children with poor oral hygiene and black/brown stains (fig.2) in children with good oral hygiene and low caries experience.1, 3, 5 Black stain may be clinically diagnosed as pigmented dark lines parallel to the gingival margin8, 9 or as an incomplete coalescence of dark dots rarely extending beyond the cervical third of the crown.10 Iron supplementation during pregnancy and in childhood may also promote Black stain development.6, 11, 12 The most convincing evidence for the extrinsic method of tooth staining comes from the differing amount of stain found in a comparison of smokers and non-smokers.1, 5, 8
Pre-Op
Post-Op
Tooth 38 Dx : Acute pulpitis Tx : Root canal treatment Final preparation : 30/.04
We love endo ! Dr Ahmed Abdel Rahman Hashem, Egypt «The superb flexibility of ScoutRace enabled me to reach predictably to the working length in this extremely curved lower third molar. The excellent spacing between files and the 4% taper of iRaCe Volume XXII, Number IV, with 2015confidence and ease to the end of the root canal.» madeDental it easyNews, for me to prepare this case
Case completed with ScoutRace Scouting iRace, iRace plus Shaping XP-endo Finisher Finishing TotalFill Obturation FKG Dentaire SA www.fkg.ch