LESSON 9. ENDODONTICS (ROOT CANAL THERAPY). DENTAL ANOMALIES. GRAMMAR. PASSIVE VOICE (REVISION).

Exercise 1. Learn the following definitions:

1. Dentistry - treatment and care of the teeth and associated oral structures. Dentists are concerned with tooth decay, diseases of the supporting structures (such as the gums), faulty positioning of the teeth, and tooth replacements, as well as prevention of these problems.

2. Qrthodontia / orthodontics - a branch of dentistry concerned with straightening of teeth.

3. Orthodontist - a dentist who specializes in straightening teeth and correcting improper bite (occlusion).

4. Prosthodontics - a branch of medicine concerned with diseases and conditions involving muscles, tendons, joints, ligaments, cartilages and bones.

5. Prosthesis - an artificial body part, such as a limb, tooth or eye, to take the place of a missing one.

6. Periodontics - a dental speciality which concerns itself with tissues immediately surrounding the teeth.

7. Periodontist - a dentist who specializes in conditions which affect tissues surrounding the teeth.

8. Pedodontics - children's dentistry.

Exercise 2. Active vocabulary to the text. Learn the following words:

to deal with - иметь дело

to derive - происходить (от)

to cleanse - прочищать, очищать

to involve - вовлекать, вызывать

to seal - герметизировать

procedure - процедура, методика

i.e. = that is - то есть (т.е.)

periradicular - перирадикулярная (ткань)

removal - удаление, устранение

tip - кончик

to infect - инфицировать, заражать

to save - спасать

background - 1. предыстория; 2. образование, опыт

reason (for) - причина

cause - причина

irritation - раздражение

to reach - достигать

to result in - приводить к (в результате)

harmful - вредный

to swell - опухать

to accompany - сопровождать

to confirm - подтверждать

to avoid - избегать

to prohibit - запрещать

Exercise 3. Read and translate the text into Russian.

ENDODONTICS

Endodontics is a subspecialty of dentistry whose broad purpose is to treat the diseases of pulp and related structures. Derived from Greek (endoinside and donto - tooth) Endodontics deals with problems developing inside the tooth. This involves careful cleansing of the interior spaces, germicidal treatment of these spaces and filling and sealing them. Endodontists are capable of performing a wide variety of treatment procedures.

Endodontics is that branch of dentistry which is concerned with the diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular tissues, i.e. root canal therapy. This involves the removal of diseased pulp tissue and filling of the prepared root canal space with an inert filling material, normally gutta-percha. In addition to non-surgical treatment, endodontists also perform surgical procedures to remove diseased tissues from the area immediately surrounding the tip of the root(s).

Root canal therapy corrects disorders of the pulp or nerve of the tooth. Teeth with infected nerves were once generally removed as corrective therapy. In case of pulp infection, natural tooth can be saved through modern endodontic procedures. The restoration of a natural tooth is always preferable in addition to prosthetics for a wide variety of oral health reasons.

The most common causes of pulpal nerve damage are:

•  physical irritation, generally brought on by aggressive tooth decay reaching down to the nerve or through deep fillings which allow harmful bacteria to reach the nerve resulting in infection and decay;

•  trauma: many forms of dental trauma can affect the health of pulpal tissue. Blows to a tooth or the jaw can cause damage to sensitive nerve tissue within the tooth.

Diagnosis of pulpal nerve damage is generally the result of pain and discomfort in the tooth that can be accompanied by facial swelling of varying degree. Once pulpal decay has been confirmed by an endodontist, through an oral examination, corrective therapy should begin quickly to avoid tooth loss and alleviate pain.

Treatment begins with the initial removal of the tooth crown, or top, to allow access to the pulpal tissue. Once the affected pulpal tissue is exposed, the endodontist carefully removes all of the affected area. The area is carefully cleaned, enlarged and shaped to provide a clean, bondable surface for eventual filling. When the endodontist has completed the evacuation and shaping of the pulpal canal, it is then filled with a permanent filler to prohibit any further infection and discomfort. Upon completion of this filling an adequate crowning is then fabricated to complete the rescue and restoration of your natural tooth.

Exercise 4.Read and translate the text into Russian using a dictionary.

DENTAL ANOMALIES

This text is designed to help the learner perform the following:

•  Identify variations from the normal (anomalies) for the number of teeth in an arch.

•  Identify anomalies in crown morphology and, when applicable, identify the anomaly by name and give a possible cause (etiology).

Definition: An anomaly is a deviation from normal, usually related to embryonic development that may result in the absence, excess, or deformity of body parts. Dental anomalies are abnormalities of teeth that range from such «common» occurrences as malformed permanent maxillary lateral incisors that are peg-shaped, to such rare occurrences as complete anodontia (no teeth at all). Dental anomalies are most often caused by hereditary factors (gene related) or by developmental or metabolic disturbances. While more anomalies occur in the permanent than primary dentition, and in the maxilla than the mandible, it is important to remember that their occurrence is rare. For example, only 1-2 % of the population have some form of anodontia (one

or more missing teeth), while another 1-2 % have supernumerary (extra) teeth. When specific deformities or abnormal formations of teeth occur with greater frequency, it is difficult to determine whether the deviation is a «true» anomaly or simply an extreme variation in tooth morphology.

Familiarity with dental anomalies is essential to the clinical practice of dentistry and dental hygiene. Recognition and correct labeling of anomalies is important for your communication with other dental team members, especially in the case of referral to or from another dentist. Additionally, your communication with the patient (or, in the case of a child, the parent) should reflect knowledge of abnormal oral conditions. Even with your assurance that the fused front tooth of a 4-year-old child occurs with 0,5 % frequency and rarely affects the number of teeth in the permanent dentition, you will have to work hard to explain and promote the patient's confidence in you and the office. Likewise, the informed patient who understands why the accessory cusps on the buccal of his maxillary or mandibular molar is more prone to decay than normal, will likely be more receptive to home care instructions that are specific to his mouth and his needs. Finally, understanding the etiology (cause) of the anomaly is important in determining the course of treatment, if any. Additional information related to the etiology of the following anomalies is found in the study of both oral histology/embryol- ogy and oral pathology.

Notes:

likewise - аналогично

prone to - подвержен

occurrence - зд. случай

VOCABULARY EXERCISES

Exercise 1. Give the English equivalents to the following words and word combinations:

вовлекать, широкий, продолжительность, область интересов, поражения пульпы, окружающие ткани, нехирургическое удаление, инертный, пломбировочный материал, патология (нарушения), широкое разнообразие причин, как правило вызываемый, сильный (глубокий) кариес, удары, чувствительные ткани.

Exercise 2. Find in the text and translate the derivatives of the following words: to affect, to relate, care, to cleanse, to treat, to fill, prevent, disease, to remove, to add, pulp, to prefer, harm, to correct, quick

Exercise 3. Match the words in column A with those in column B. Translate them into Russian.

А. affected B. treatment

interior interest

harmful tissues

diseased removal

careful area

greatest spaces

non-surgical bacteria

aggressive cleansing

endodontic tooth

natural training

pulpal procedures

Exercise 4. Put a correct preposition into each gap:

1. ... many cases a crown restoration is recommended ... completion ... root canal therapy.

2. Discoloration is not dangerous ... the health of a tooth.

3. This discoloration can be treated . bleaching . the affected tooth.

4. The main clinical sign ... success is the removal ... pathology.

5. . the endodontist has completed the evacuation and shaping ... the pulpal canal, it is then filled ... a permanent filler.

6. ... 95% ... cases ... pulpal infection a natural tooth can be saved ... endodontic procedures.

7. ...the diagnosis is confirmed ... an endodontist, corrective therapy can begin.

8. In the USA, one person ... three ... the age .... 35 needs dentures.

9. These dental problems can be made worse ... the kinds ... food we eat.

Exercise 5. Find the English equivalents to the given words from text «Dental Anomalies». Learn the words.

отклонение, избыток, порок развития (изъян), обычный случай, наследственные факторы, тогда как, ген, сверхкомплектные зубы, определять, знакомство, частота, уверенность, существенный, направление (к специалисту), доверие, более приемлемо.

Exercise 6. Match the words in column A with those in B.

A B

1. common a. cause

2. malformed b. development

3. possible c. anodontia

4. hereditary d. dentition

5. dental e. parts

6. primary f. practice

7. missing g. anomalies

8. clinical h. factors

9. complete i. incisors

10. embryonic j. occurrence

11. body k. teeth

Exercise 7. Find the basic word which the given words are derived from. Say what parts of speech the given words are. Translate both words.

Occurrence, development, developmental, referral, deviation, recognition, malformed, deformity, formation, disturbances, variation, familiarity, dentistry, dental, additionally, assurance, confidence, likewise, likely.

How are they formed? Do you know any other derivatives from the same basic word?

Exercise 8. Form the new words using the given suffixes. Translate them into Russian.

- tion dictate, define, locate, determine, create, add, promote, vary,

identify

- er/or learn, teach, write, play, create, design, compute, translate

- ance/ence assure, occur, confide, ignore, depend, refer, differ

- ment develop, advertise, place (verb), employ, arrange

- ic class, economy, character

- al economy, essence, music, development, norm, origin, refer

(the derivative is a noun)

- able rely, accept, comfort, read, prevent

- ous danger, vigor, pore, fame, gas

- ive prevent, mucus, inform, relate, effect

- ly final, additional, like, real, possible, careful, effective, local,

private

Exercise 9. Use the derivatives of the words in column A to fill in the blanks in column B. Translate the sentences into Russian.

A B

1. care The dentist had to work very......... as the walls of the tooth

were very thin.

2. prevent Dentists should inform patients that proper oral hygiene is

the best. .measure against dental caries and pulpitis.

3. danger If you start jogging at an elderly age, consult your doctor,

otherwise it can be..

4. correct The teacher had to make only some small... in this student's work

5. differ The twins (близнецы) were so alike that we could see

no.. between them.

6. real The doctor asked the patient's relatives if they ...how seri-

ous the situation was.

7. develop The doctor has carefully followed up the child's....since

the very first days after birth.

8. confide Can you keep a secret? The matter is very.........Please, don't

tell anyone.

9. identify ... of a problem is the first step towards solving it.

10. like The doctor thought that complications were not.....

11. character The disease is...............by spontaneous pains which

spread to the ear or temple

12. occur Such rare.....can be observed for the most part in

elderly patients

GRAMMAR EXERCISES

Exercise 1.Find sentences with verbs in the Passive Voice in the text «Endodontics». Translate them into Russian.

Exercise 2. Determine the tense and the voice of the predicate. Translate the sentences into Russian.

1. Disorders of the pulp and nerves of the tooth are corrected by the root canal treatment.

2. Diagnosis of pulpal nerve damage can be made by the symptoms accompanying pain such as discormfort in the tooth, facial swelling of varying degree.

3. Root canal therapy of the diseased tooth will be performed with the removal of the pulp tissue and filling the root canal with an inert filling material.

4. The health of pulpal tissue may be affected by blows to the tooth or the jaw.

5. While treating the pulp and the related structures, special attention has to be paid to careful cleansing of the tooth interior spaces.

6. Care is to be taken to correct disorders of the pulp or nerve of the tooth.

7. In this article attention has been called to the exposed and affected pulpal tissue.

8. The procedure of the evacuation and shaping of the pulpal canal was followed by permanent filling.

9. An adequate crowning has been done to complete the rescue and restoration of the diseased tooth.

10. Mention has already been made of the pulpal decay prevention.

11. It has been found that thorough oral examination and corrective therapy help to avoid tooth loss and alleviate the pain.

12. A most interesting research has been carried out in regard to the root canal therapy of different pulp and nerve disorders .

13. The importance of preventive dentistry is so evident that it need not be discussed.

14. The term endodontics is referred to the treatment of the diseases of the pulp and related structures.

15. A proper therapy must be administered to avoid the tooth loss.

16. Pulp decay having been confirmed, a corrective therapy had to be performed.

Exercise 3. Use the correct form of the verbs in brackets in the Passive Voice.

1. Unfortunately , such conditions . ( to describe ) and .. (to investigate) poorly.

2. Certain precautions should . (to take) to avoid unfavourable reactions.

3. Drugs must . (to protect) from direct sunlight .

4. According to the protocol of the study the test sub-group ... (to administer) ibuprofen prior to the surgery.

5. New treatments ... (to research) currently.

6. Cavity preparation can . (to perform) with a round steel bur in a lowspeed handpiece.

7. Tomorrow an X-ray ... (to take) to check the root canal filling.

8. The drug ... (to monitor) for possible side-effects now.

9. Local inflammation ... (to accompany) by various reactions in other parts of the body.

10. Surgical procedures . ( to perform) by the endodontist now.

11. Medicine and pharmacology are two sciences which ... (to change) a great deal recently.

12. The soft tissue . (to remove) because it . (to infect ) heavily.

Exercise 4. Translate into English using the Passive Voice. 1. Поражение нерва пульпы часто вызывается физическим раздражением и травмой.

2. Послетогокакпораженнаятканьпульпыбылаудалена,пульпарный канал был отформирован и запломбирован.

3. Прежде всего потребуется удаление пораженной ткани.

4. Вчера во время операции была открыта полость пульпы и гной был удален.

5. Как нехирургическое лечение, так и хирургические процедуры выполняются эндодонтом.

6. Повреждение чувствительной нервной ткани внутри зуба может быть вызвано ударами в зуб или челюсть.

7. Сейчас эндодонт пломбирует полость зуба.

8. В последнее время я лечусь у эндодонта, так как у меня запущенный кариес.

9. Как лечат заболевания пульпы и связанных с ней структур?

10. Операции часто выполняют под общей анестезией.

Exercise 5. A: Find present and past participles in the text «Dental Anomalies». Are there any cases of past participle in post position? Translate, if you have found it/them.

B: Choose the correct participle. Sometimes both are possible. What is the difference? Translate into Russian. developing/developed countries

determining/determined factor

determining/determined person

applied/applying sciences

missing/missed teeth

identified/ identifying reasons

recognized/recognizing anomalies

correcting/corrected mistakes

decaying/decayed teeth

reflected/reflecting light

gene related/relating

questions referring to/referred to

SPEECH EXERCISES

Exercise 1. Match the medical terms in column A with the descriptions in column B. А В

Pedodontics an artificial part, such as an artificial limb, denture or eye Periodontics a branch of dentistry concerned with straightening of teeth

Orthodontics children's dentistry

Prosthesis a dentist who specialises in straightening teeth and correcting improper bite (occlusion)

Endodontics a branch of dentistry concerned with the treatment of diseases of the pulp and related structures.

Periodontist a branch of medicine concerned with diseases and conditions involving muscles, tendons, joints, ligaments, cartilages and bones

Orthopedics a dentist who specialises in conditions which affect tissues surrounding the teeth

Orthodontist a speciality which concerns itself with dental tissues immediately surrounding the teeth

Exercise 2. Answer the following questions to the text «Endodontics»:

1. What is the purpose of endodontics?

2. What is endodontics concerned with?

3. What is another name for endodontics?

4. What stages does root canal therapy involve?

5. What material is used to fill root canals?

6. What kind of disorders can root canal therapy correct?

7. In the past, what was the general procedure in relation to teeth with infected nerves?

8. Can such teeth be saved? If yes, how?

9. Why is endodontic restoration preferable to prosthetics?

10. What are the most common causes of pulp nerve damage?

11. What helps dentists diagnose pulpal nerve damage?

12. What can be done to confirm the initial diagnosis?

13. How is the treatment begun?

14. When can the pulpal canal be filled with a permanent filler?

15. What is done upon completion of this procedure?

Exercise 3. Answer the questions to the text «Dental Anomalies».

1. What is the definition of anomaly?

2. What are dental anomalies?

3. Is anodontia an anomaly?

4. What can cause dental anomalies?

5. Is it true that metabolic disturbances can cause dental anomalies?

6. In what dentition are dental anomalies more frequent, in primary or permanent?

7. How often do dental anomalies occur?

8. Do dentists often observe supernumerary teeth?

9. What can explain the fact that sometimes specific deformities of teeth occur with greater frequency?

10. Why is it essential for a dentist to the familiar with dental anomalies?

11. What dental anomalies are you familiar with?

12. Should a dentist give his patients or their parents some special information about dental anomalies? Why?

Exercise 4. Translate the text into Russian in written form without a dictionary. Answer the questions to the text.

ABSENCE OF TEETH

A. Total Anodontia

True anodontia is the total congenital absence of a set of teeth. Total anodontia is characterized by the absence of the entire primary and secondary dentitions, and is extremely rare. It is most often associated with a generalized congenital deformation (a sex-linked genetic trait) such as the abnormal development of the ectoderm or outer embryonic cell layer. Faulty ectodermal development further affects such structures as hair, nails, sebaceous and sweat glands, and salivary glands.

B. Partial Anodontia

Partial anodontia, also referred to as congenitally missing teeth, involves one or more missing teeth from a dentition. Though not proven to be a hereditary trait, tendencies toward missing the same tooth do run in families.

1. Most commonly missing permanent teeth

The most commonly missing permanent teeth are third molars, with the maxillary thirds absent from the dentition more often than the mandibular thirds.

2. Second most commonly missing teeth

The permanent maxillary lateral incisors are the next most commonly missing teeth. Approximately 1 - 2 % of the population is missing one or both of their maxillary incisors.

3. Third most commonly missing teeth

The mandibular second premolars are the third most frequently missing permanent teeth, with 1 % of the population missing one or both. Some studies indicate the order of most commonly missing teeth to be: third molars, maxillary and mandibular premolars, and maxillary lateral incisors.

Some observers state that missing teeth follow evolutionary trends in that the teeth most commonly missing from the dentition (third molars) are those that are most expendable in terms of their role in oral function. On the oposite, the most stable teeth in the permanent dentition, the canines, are the least likely to be absent from the dentition.

Notes:

expandable - несущественный; то, чем можно пренебречь in terms of - в том, что касается; с точки зрения

Questions to be answered:

1. What is total anodontia characterized by?

2. What is it associated with?

3. What is a professional term for congenitally missing teeth?

4. Is partial anodontia a hereditary trait?

5. What are the most commonly missing permanent teeth?

6. Do mandibular second premolars refer to the most commonly missing

teeth?

7. What percent of population miss them?

8. What evolutionary trait can be observed at the example of missing teeth?

9. Are canines or incisors often missed? What can be said about these teeth?

Exercise 5. Use a dictionary to read and translate this text. Answer the questions.

FUSION

Fusion is the union of two adjacent tooth germs, always involving the dentine. Upon clinical examination, this condition appears similar to germination since the fused teeth have one crown that appears doubled in width. However, unlike germination, radiographs usually reveal two separate but fused roots with separate pulp chambers. Another way to differentiate fusion from germination is to count the teeth in the arch. If the fused teeth are counted as two, the total number of teeth will reflect the normal number of teeth in that arch.

Like geminated teeth, fused teeth occur more commonly in the anterior portion of the mouth (in less than 1 % of the population), and more often in the deciduous dentition than in the permanent dentition. The mandibular incisor area is affected more often than the maxilla.

Fusion is thought to be caused by pressure or force during development of adjacent roots. Many of the reports of fusion involve a supernumerary

tooth joining with an adjacent tooth, such as the fusion of a mandibular third and fourth molar, and the fusion of a maxillary lateral incisor and anterior supernumerary tooth.

Accessory cusps or tubercles

Any tooth may exhibit extra small enamel projections called tubercles, or extra accessory cusps. These enamel projections may result from developmental localized hyperplasia (increase in volume of tissue caused by growth of new cells) or crowded conditions prior to eruption where fusion of a supernumerary tooth may be viewed as an extra cusp.

Enamel pearls are small, round nodules of enamel with a tiny core of dentine. They are found most frequently on the distal of third molars and the buccal root furcation of molars. Radiographically enamel pearls appear as small round radiopacities (that is, areas appearing light or white on the exposed film). Being covered with enamel, they prevent the normal connective tissue attachment and consequently may channel disease (periodontal problems) into this region.

1. What disorder is called fusion in dentistry?

2. The teeth in which jaw are more often affected by this disorder?

3. What can cause fusion?

4. Are fusion and germination the same thing?

5. What are tubercles?

6. What is hyperplasia?

7. What can it cause in teeth?

8. What makes enamel pearls pathologically dangerous?