Treatments in 3D

Caries and filling

Caries in the biting surface of a molar, schematic, in section.

1. 1CariesAcids from bacterial plaque have broken through the enamel; the caries spreads in the dentine.
2. 2RemovingThe destroyed tooth substance is removed.
3. 3FillingThe cavity is filled, here with tooth-coloured composite, applied in thin layers and hardened with light.

Root canal treatment

When the pulp is inflamed, shown schematically on a lower molar.

1. 1InflammationBacteria, usually through caries, have reached the pulp. It has become inflamed.
2. 2CleaningThe tooth is opened and the inflamed tissue removed. The canals are shaped with fine files and rinsed.
3. 3FillingThe canals are sealed tightly with gutta-percha and a sealer, then the tooth is closed.

Periodontitis

How the inflammation attacks the tooth's support, schematic.

1. 1HealthyGum and bone surround the root.
2. 2TartarPlaque turns into tartar, also below the gum line. The gum becomes inflamed.
3. 3Bone lossUntreated, gum pockets form and the bone around the root recedes.
4. 4TreatmentThe pockets are cleaned, plaque and tartar removed, and the inflammation can subside. Cleaning does not bring back lost bone.

Removing a wisdom tooth

An impacted lower wisdom tooth, schematic, in section. It is removed when it causes problems or is likely to; removing wisdom teeth that cause no problems as a precaution has no proven benefit.

1. 1DiagnosisThe wisdom tooth has not fully come through and lies tilted against the neighbouring tooth in the bone; the gum over the crown has become inflamed. Up to 80 % of young adults in Europe have at least one wisdom tooth that has not come through.
2. 2Position of the nerveAn X-ray, and a 3D scan if needed, shows how close the roots are to the nerve of the lower jaw. The risk of altered sensation depends on it.
3. 3Opening the gumAfter a local anaesthetic, the gum over the tooth is cut and folded aside.
4. 4Removing boneAs much bone as necessary is removed over the crown, with a drill or a chisel.
5. 5Dividing the toothIf the tooth lies deep, it is often divided. Here the crown is taken out first.
6. 6Removing the rootsThen the roots follow, and the wound is rinsed.
7. 7StitchesThe gum is stitched. Pain and swelling are usual in the days after; rarely the blood clot comes loose too early (dry socket), rarely there is numbness, mostly temporary.

A molar in section

A lower molar in the jaw, cut open. Point at a layer to highlight it in the model.

• Enamel Enamelumcovers the crown
• Dentine Dentinumforms most of the tooth
• Pulp Pulpa dentisblood vessels, nerve fibres and connective tissue
• Gum Gingivasurrounds the neck of the tooth
• Cortical bone Substantia compactathe firm outer layer of the jaw
• Cancellous bone Substantia spongiosathe inside of the jawbone