martes, 7 de julio de 2009

ENDODONCIA

Endodoncia

Un tratamiento de endodoncia es un tipo de tratamiento conservador, refiriéndonos a este termino como un tratamiento encargado de mantener los órganos dentarios (dientes) en su lugar en casos de que estos se encuentren demasiado afectados y en lugar de la extracción existe la opción de dicho tratamiento.

Las causas que provocan un tratamiento de endodoncia son varias, en primer lugar encontramos lesiones profundas por caries: hay tres tipos de lesiones de caries 1) las superficiales: estas caries únicamente dañan el esmalte (tejido protector y mas fuerte de todo el cuerpo) y no presentan dolor; 2) las intermedias o de segundo grado: que dañan tanto al esmalte como a la dentina sin dañar el tejido pulpar y encontrarse aun retirado de este, este tipo de caries ya inician con molestias al comer algo frio o dulce; y 3) las profundas o de tercer grado: con este tipo de lesiones todos los microorganismos que forman la caries entran en contacto con la pulpa y la infectan, no siempre duelen ya que la infección contamina el tejido de la pulpa y lo mata (necrosa) , sin embargo hay que remover el tejido muerto para evitar infecciones de mayor consecuencia (abscesos, quistes).

Otras causas que pueden dañar a la pulpa son las hechas por causas químicas (como blanqueamientos mal aplicados), causas físicas y/o traumaticas (fracturas, golpes) y por fines de restauraciones protésicas.

La endodoncia consiste básicamente en retirar el tejido blando del diente, retirar la pulpa y hacer que las paredes rugosas de la dentina que la recubre se encuentren lisas para eliminar todos los restos pulpares y poder asi eliminar todos los microorganismos que la están dañando; una vez que las paredes se encuentran lisas entonces así podemos obturar la endodoncia para rellenar ese espacio que contenía la pulpa. La endodoncia la podemos manejar como una microcirugía ya que se amputa la pulpa para poder mantener al diente (no vital) dentro de la boca.

En pocas palabras en eso consiste el tratamiento de la endodoncia, sin embargo lo mas importante es identificar la patología que esta involucrando a el diente, las enfermedades pueden ser varias pero las podemos englobar en dos grupos: las patologías pulpares (dentro del diente) y las patologías periapicales (debajo del diente); no podemos separar una de la otra ya que al no tratar una patología pulpar puede recaer en un daño periapical y seguir causando infecciones de mayor problema. Alguna persona que ha tenido alguna inflamación exagerada en la boca que se le observa la mejilla de tamaño mayor, se debe a una infección de tipo periapical y muy posiblemente sea de origen pulpar; independientemente que el daño sea en el periapice se debe de realizar la endodoncia del diente para poder eliminar toda la infección, ya que de no realizarse el tratamiento la inflamación puede reactivarse.

Una endodoncia bien realizada y hecha con todas las medidas pertinentes tiene un éxito programado de 20 años en adelante, siempre y cuando el factor haya sido removido. Es también importante el manejo de medicamentos que nos ayuden a formar barreras de protección contra microorganismos para terminar de garantizar el éxito.

Existen contraindicaciones de la endodoncia, no siempre es factible realizarlo ya que si la rehabilitación o volver a poner el diente en su función natural se ve comprometida es mejor realizar la extracción pero solo en casos extremos; actualmente existen muchos avances en la odontología para poder rehabilitarlos.

La rehabilitación puede ser de varias índoles depediendo de la cantida de caries que exista en el diente o del daño que tenga, esta puede variar desde colocar una resina, una incrustación, una corona (que es lo mas recomendado por la fuerza que en ocasiones pierde el diente) o en destrucción total de la corona del diente entonces se coloca un poste y posteriormente una corona de los diferentes materiales que existen.

Con la endodoncia terminada se le da mayor durabilidad al diente y visto desde otro punto de vista resulta mas económico a largo plazo, ya que una extracción necesita rehabilitarse con un puente fijo o un implante de mayor costo que la restauración de una endodoncia.

Citando las palabras de un colega, cuando la uña de un dedo se te infecta no realizas la amputación de este, entonces ¿por que realizar la extracción de un diente cuando este infectado?, la endodoncia es un excelente tratamiento que al realizarse correctamente da mayor durabilidad y permite la armonía que debe existir en el ámbito de la cavidad bucal.

Para concluir, es muy importante su control de salud bucal ya que, aparte de eliminar el sarro, al realizar su limpieza cada seis meses nosotros podemos darnos cuenta de caries incipientes o caries ya avanzadas y eliminarlas antes de que tengamos que llegar a realizar algún tipo de tratamiento como la endodoncia. En manos de todos, tanto pacientes como dentistas, esta en que podamos llegar a una odontología preventiva y disminuir la odontología reparativa.

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