The phone is ringing
Patient’s father: Good morning.
Receptionist: Good morning. How can I help you, Sir?
Patient’s father: I would like to make an appointment for my daughter to Doctor Zaniewski. It’s for the treatment of a tooth under the microscope.
Receptionist: Is it urgent?
Patient’s father: I think so. In ten days we are going abroad and I wouldn’t like to go without knowing what the problem is.
Receptionist: I see. How about seeing the doctor tomorrow about 11 a.m.
Patient’s father: Oh, I work until 4 o’clock. How about meeting in the afternoon?
Receptionist: The only afternoon opening I have is Friday next week.
Patient’s father: I see. So we’ll come tomorrow. That is, my daughter’s grandma will come with her.
Receptionist: Of course. If you have any X¬ rays, please bring them.
Patient’s father: Yes. We have a photo and we’ll take it with us. Goodbye!
Receptionist: Goodbye!

Next day
Patient’s grandma: Good morning. We have an appointment with doctor Zaniewski at 11 o’clock.
Receptionist: Hello, please sit down. Doctor will be with you momentarily and he’ll take care of your granddaughter.
Doctor: Hello. Please come in and take a seat. Do you have any pictures?
Patient’s grandma: Yes, I do. One from yesterday. Here you are.
Doctor: Thank you. My colleague spoke with the father of the girl, and actually I have nothing to add at this moment. Such a tooth can be treated in various ways, but the latest method is called revascularization. After some work is done in the root canal and there is no living pulp, some tissue quite similar to it should appear. Of course, the procedure may fail, but then there are other ways for treatment. We will have to wait for the result. You will also have to take a photo from time to time. We’ll be able to say that the treatment was successful after a year, and maybe even after 2-3 years.
Patient’s grandma: Yes. My son told me about this. He also asked me to find out whether he will be able to call you and talk to you.
Doctor: Of course. Today I’m going to open the tooth and apply some dressing. Your granddaughter will have to see me again in three weeks for further treatment. Of course, you will be able to go on your holiday abroad.
Patient’s grandma: You’ll discuss all the details with my son. My son asks you to treat tooth with the best materials.
Doctor: This is a new way of treatment. I hope it will work. I  have already treated  successfully two such teeth. I’ll talk with your son about possibility of complications and effectiveness of such a treatment. Anyway, I’ll ask him to sign an information leaflet about treatment, when he comes here with his daughter in three weeks.
Patient’s grandma: Very well, Doctor. How long will the treatment last today?
Doctor: I think that no longer than 40 minutes.
Patient’s grandma: And will it hurt?
Doctor: No, it won’t. The tooth is dead. Therefore there is no need for anesthesia.
Patientֹ’s grandma: That’s good, because my granddaughter is afraid of injections.
Doctor: Well, next time I will have to do anesthesia. Now please wait in the waiting room. If necessary, I will ask you to my office.
Patient’s grandma: Of course. I haven’t had time for reading newspapers for ages!

VOCABULARY PRACTICE

Read the text below

There are some factors that affect the results of regenerative endodontic treatment. To achieve successful results of the treatment procedure, a thorough understanding of these factors is very important.

The first factor is the disinfection of the canal. The absence of bacteria is critical for successful revascularization because the new tissue will stop at the level it meets bacteria in the canal space. In necrotic cases with apical periodontitis it must be recognized that the vital tissue might not be normal pulp tissue, despite the fact that root development continues and dentine maturation occurs. In teeth with open apices and necrotic pulps, it is possible that some vital pulp tissue and Hertwig’s Epithelial Root Sheath remain. When the canal is properly disinfected, the inflammatory process reverses and these tissues may proliferate.

The second factor is the apex diameter. A tooth with an open apex allows the migration of mesenchymal stem cells into the root canal space, and this could allow host cell homing to form new tissue in the root canal space. An apical opening of 1.1 mm in diameter or larger is beneficial, with natural regenerative endodontic treatment occurring in approximately 18% to 34% of teeth with immature roots.

The third factor is the patient age. Most of endodontic treatment procedures have generally been limited to patients who are reaching adolescence, mostly aged from 8­‍‑16 years. It would not be advisable to perform regenerative endodontic treatment procedures in children younger than 8 years or older than 16 years.

In addition, the procedure of revascularization may carry some complications and limitations. Firstly, it must be noted that it’s difficult to achieve success in fully formed permanent teeth. Secondly, there is some potential for clinical and biological complications such as crown discoloration, development of resistant bacterial strains (due to long­‍‑term use of antimicrobial agents), and allergic reaction to intracanal medicament. Next, if tissue is reinfected, there is a potential risk of necrosis. What’s more, the concentration and composition of the stem cells entrapped in the fibrin clot is unpredictable, particularly in older patients, and may lead to the disparity in the result. And last but not least, lack of long­‍‑term follow­‍‑up studies still makes revascularization procedure a supplement but not a substitute to the already existing treatment protocols such as apexogenesis, apexification, or partial pulpotomy.

 

On the basis of what you’ve read, mark the sentences True (T) or False (F)

1. Revascularization is ineffective in the presence of bacteria. T/F
2. The pulp like tissue may develop and grow only if the channel is properly cleaned. T/F
3. The wider the opening of the apex is the lower the chances of sucessful revascularization are. T/F
4. Revascularization seems to be most effective in children of any age. T/F
5. It is impossible for pulp reinfection after the procedure of revascularization. T/F

 

Look at the text above. Find synonyms to words and phrases below

1. outcomes – ________________
2. alive, living – ______________
3. to go backwards – _______________
4. to cause to expand, grow or spread – __________________
5. a straight line that crosses a circle through the centre, or the length of this line – __________
6. to aim at something and move quickly and directly to it – ________________
7. having a good effect or influence on someone or something – _______________
8. the period of your life when you change from being a child to being a young adult – ___________
9. not harmed or affected by something – ______________
10. a condition in which part of the body has decayed and no longer works normally – ___________
11. to be in a dangerous situation that is difficult to escape from – _____________
12. a difference between things – ______________
13. a phrase used when you mention the final person or thing in a list, in order to say that they are equally important – ________________
14. something extra – ______________
15. something new or different instead of what is normally used –  _____

Lesson_74_answers