[{"id": 134989, "created": "2019-09-04T17:33:34.179514", "project_id": 379, "task_id": 74775, "user_id": 138, "user_ip": null, "finish_time": "2019-09-04T18:21:09.812911", "timeout": null, "calibration": null, "external_uid": null, "media_url": null, "info": {"other": "The last sentence is incomplete with the verb on the next page. This will have to be joined.", "translation": "ensure that this already damaged tissue is kept strong and tough. Thirdly, there is the bite factor. I don't want to load you up with long and tiring details. Suffice to say that through careful grinding, especially into the upper jaw, a flat overbite needs to be achieved, in which at best all teeth align on top of each other and are loaded equally during the final phase of the bite, and during the bite off phase at least six of the upper jaw's front teeth are in contact with those in the lower jaw. Is this not achievable through grinding, more technical work (bridges, cast fillings and removable dentures) has to achieve the necessary modifications. The nightly grinders are best cured through an especially construkted bite rail, which avoids single-point loads on one or several teeth. On the factor of constitution, the dentist best consults the internist, whose specialist diagnosis yields conculusions about the already mentioned internal illnesses. The absolute necessity of collaboration between dentist, the internist, the surgeon and the Otho-Rhino-Laryngologist should be pointed out here.\r\n\r\nA large share of patients underestimate the influence of dental- and jaw diseases on the entire organism. It is not like one could consider ones chewing tools as something less or irrelevant, but as a part , and a very impotant part, of the overall organism. Every human, who has gone through a longer, severe illness, thereafter knows to appreciate the value of their health. Neglect, especially of the oral cavity, which as the entrance to the respiratory organs and the digestive system is particularly sensitive, always takes its toll.\r\n\r\nAfter this small detour, which seemed necessary to me, we arrive at the factor of the soul. This is a particularly difficult problem, which I can only scratch on the surface.  This first requires an absolute trust of the patients in their doctors, who have to be physicians in the best sense. Needs of the soul and pathological inclinations of patients are the doctors' business, who can do a lot, if he is given the necessary trust on the side of their patients. The patients have to feel that the doctor does not want to nose around in their private inner,  but wants to stand on their side as friend and helper, and that there is nothing a human has to be ashamed of in front of their doctor. Together, it is often possible to relieve oneself of their complexes and spiritual needs, which are a contributing cause of the parodontosis.\r\n\r\nWe now get to the last point, the treatment of horizontal and vertical Atrophy (loss) through surgical means. Here I also cannot go too deep due to lack of space. In lesser forms of the atrophy, let's say with a pocket depth of 5-6 mm, and recalling that a normal pocket depth amounts to 1-4 mm, we approach with a thermal cauter. This is a thin needle, which is passed along the gum line with a low voltage current, relatively painlessly burning off the granulations, which are the inflammation-affected tissue parts. Into the pockets themselves, one can insert a mixture of sulphur and ether, which is capable of separating the superficial granulation.If the pockets extend beyond 5-6 mm, but still present a horizontal atrophy, one has to apply a knife. Under application of local anaesthesia (Novocain, Provcain) one removes the gum tissue line like a garland and scratches out the interdental space (the gap between two teeth) clean to the bone rim. In one session, one can generally cleanly treat 6-10 teeth.Thereafter a Trypaflavin cover and  later 8-10 days oral treatment.\r\n\r\nTher treatment of vertical atrophy is probably the most difficult in existence in the field of oral surgery. This not only requires the removal of the granulations (inflammed affected tissue parts) with knife and gum scissors, but one has also, in a very limited space, to ??? the inflammation affected bone substance"}}, {"id": 155125, "created": "2021-03-24T11:27:10.117080", "project_id": 379, "task_id": 74775, "user_id": 427, "user_ip": null, "finish_time": "2021-03-24T11:27:16.050624", "timeout": null, "calibration": null, "external_uid": null, "media_url": null, "info": {"other": "", "translation": "The tissue gives the impression of being badly circulated with blood and suggests that the conversion from oxygenated to more carbonated blood, the so-called capillary circulation, is defective.\r\n3.) The periodontal pockets: It is possible to determine the depth of the bacterial infection of the periodontium by using a probe with a scale in millimetres. Accordingly the thin probe is used along the side directed towards the centre, and afterwards along the far side. When these measurements are taken for the whole maxilla and mandible, every infectious irritation on any point of the tooth sector can be determined on the basis of the probe with the millimetre scale. The measurement with the probe is additionally supported by\r\n4.) X-ray imaging. Actually, X-ray images are even more valuable since they demonstrate the bone deterioration not only to the doctor, but also to the patient, not only horizontally but also vertically.\r\nNow we will talk about the bone deterioration in the horizontal axis, the so-called horizontal atrophy. This clinical picture is classified by an even bone deterioration in the horizontal plane without displaying vertical breakings. The normal depth of the periodontal pockets in every healthy tooth sector is 1-4 mm. Everything over the border of 4 mm points to bone deterioration. When, for example, the average depth of the periodontal pockets is 6 mm, we can speak of a horizontal atrophy, i. e. mid-grade horizontal bone deterioration if the formerly described symptoms are also present. Even though this clinical picture does not cause subjective pain in its chronic process, pain can occur during food intake due to acute flareups. The process of this disease is rather slow, mostly over several years. The pockets can slowly reach a depth of 8 mm and more if they are not treated. Then, tooth loss occurs.\r\nThe vertical atrophy, i. e. the vertical deterioration of the periodontum, proceeds much faster. Usually, it occurs in the 3rd to 4th decade of the patient's life and is, luckily, much rarer than horizontal atrophy. Mostly, groups of teeth are affected, either the lower 4 incisors or the upper 4 incisors. Beside the already mentioned discolouration of the gum line in connection with the degeneration and destruction of the gingival papilla, which is the tip of gingiva between the teeth, extraordinary fluctuations in the depth of the periodontal pockets ranging from 4 to 15 mm are especially important for the diagnosis of a vertical atrophy. When pressed with the fingertip, a sanious-mucous secretion can be drawn from the depth of the periodontal pockets.\r\nFinally it should be said that it is indeed possible to find both clinical pictures in one patient, vertical and horizontal atrophy.\r\nAfter we have clarified the causes and special characteristics of periodontosis, I would like to add something regarding the treatment at the end. Because even if it is certain that 5th grade loose teeth, thus teeth that can virtually be pushed out with the tongue, cannot be preserved, it is on the other hand certain that a timely treatment - presuming a timely diagnosis - can achieve improvement and full recovery. Let us start with the occasional irritant factors (dental calculus, overhanging fillings and crown rims). Naturally these factors have to be examined most acurately. For this, special equipment is used for the regular instruments for dental clearance do not suffice. Control with X-ray later shows if truly all irritant factors have been removed. The danger of infection is tackled on the one hand by surgical treatment which I will get to later and on the other hand, to avoid a reoccurence of the infection, by gum massage twice a day in connection with a carbon dioxide bath once a week as a spray. The massage with something like Kamillosan, for example, and the carbon dioxide spray are to ensure good blood circulation mechanically. For an infection will start spreading easiest at places where the resistance from the tissue is weakest. Thus, I also have to, externally, [...]"}}]