Management of Invasive Cervical Resorption | Case Report

Management of Invasive Cervical Resorption | Case Report Management of Invasive Cervical Resorption with Heithersay approach: a case report. Abstract: Invasive Cervical Resorption (ICR) is a relatively uncommon clinical finding, characterized by invasion of cervical region of the root by fibro-vascular tissue derived from periodontal ligament. In this case report, a 45 year old female patient came with dislodged restoration in maxillary left lateral incisor. She revealed history of trauma she had undergone ten years back with blow from utensil. Her history also stated that she had developed decay in distal aspect of the same tooth for which she had got filling done 4 years back. Here, trauma and intra coronal restoration might be the predisposing factors for ICR. Since this case of ICR was class 3 defect, the Heithersay approach was treatment of choice. Key words: Invasive Cervical Resorption, Heithersay approach, non surgical, trauma, Intra coronal restoration. Introduction: Invasive Cervical Resorption (ICR) is a relatively uncommon clinical finding. This may occur in any tooth in the permanent dentition at the cervical location and invasive in nature and leads to progressive loss of tooth structure1. This pathological process is characterized by invasion of cervical region of the root by fibro-vascular tissue derived from periodontal ligament. There is progressive resorption of cementum, enamel and dentine to eventually involve pulp in the later stages2. The exact etiology of ICR is poorly understood but several predisposing factors have been identified. These were documented following first report by Harrington and Natkin in 19793. Orthodontics was the most common sole factor (21.2%) followed by trauma (14%); intracoronal bleaching was sole predisposing factor for lesser extent and to a greater extent it was in combination with trauma and/ or orthodontic treatment. Surgery involving cemento enamel junction (5.9%), periodontal therapy (4%), bruxism (2%), and intra coronal restorations (15.3%) were less common as predisposing factors. 15% of the patients showed no definite potential predisposing factor2. A clinical classification has been developed by Heithersay not just as research tool but allows for complete assessment of results of cases of ICR by non-surgical or surgical regimen. Treatment of ICR should aim at the inactivation of all the resorptive tissue and the restoration of resorptive defect. For the small, localized lesions (class 1 or 2), he reported that successful treatment was close to 100%. For the moderate-size lesions (class 3), he reported a 77.8% success rate. For the extensive, class 4 lesions, his success rate was only 12.5%2. Part of the confusion about ICR is that it is identified in the literature by at least nine different names. Heithersay1 coined the name invasive cervical resorption used in this article. It is sometimes referred to as extracanal invasive resorption based on an article by Frank and Backland in 1987 4 and was recently labeled as external cervical resorption (ECR) by Patel et al in 20095. The case we are presenting falls under class 3 category of classification based on clinical and radiological findings. Case Report: A 45 year old female patient reported to Department of Conservative Dentistry Endodontics with dislodged restoration in relation to upper left lateral incisor. Her history also revealed trauma she had undergone ten years back with blow from utensil. Her history stated that she had developed decay in distal aspect of the same tooth for which she had got filling done from local dentist 4 years back, which is dislodged now. On examination of 22, there was class III arrested caries and dislodged restoration on distal aspect. In the cervical area of the tooth, red coloured defect was noted (figure 1). On probing this resorptive cavity wall, hard mineralized tissue was felt accompanied by sharp scraping sound. The tooth was asymptomatic. Electric pulp test was negative. No periodontal pockets on probing. Radiograph revealed an irregular ‘moth eaten’ appearance in the cervical area and there were no periapical changes seen(figure2). Management: Since this case of ICR was class 3 defect, the Heithersay approach was treatment of choice. The maxillary left lateral incisor is treated under rubber dam isolation. Trichloroacetic acid (TCA) 90% is applied on small cotton pellet to resorptive tissue on the palatal aspesct of the tooth for 3-4 minutes (figure 3). The TCA is replenished atleast twice till resorptive tissue undergoes coagulative necrosis (figure 4). The resorptive tissue is removed by curettage. Root canal treatment is carried out with hand instruments.(ICR 10) K-files (Mani, Inc. Japan). Sodium hypochlorite 2.5% (Prevest Denpro Limited Jammu, India), Normal saline (Preet International Pvt.ltd. New Delhi, India) and EDTA (Dentsply Maillefer, Switzerland) are used as irrigants during root canal treatment. The canal is obturated with zinc oxide eugenol cement (Vishal Dentocare, Ahmedabad, Gujarat, India) and gutta-percha (Dentsply). Now the resorptive defect is restored with glass ionomer cement (figure 5). A post operative radiograph revealed satisfactory filling of resorptive defect. (figure 6) At a follow-up period of one year, radiograph showed satisfactory treatment outcome and no signs of further resorption. Discussion: Whatever be the treatment modality of treating ICR, ultimate goal should be removal of resorptive tissue and restoration of the defect1. The chosen material which should be esthetic, biologically acceptable and the one that provides strength to already weakened tooth structure 6. Here, trauma and intra coronal restoration might be the predisposing factors for ICR. Since this case of ICR was class 3 defect, the Heithersay approach was treatment of choice. The topical application of trichloracetic acid as an adjunctive measure in the removal or inactivation of active resorptive tissue in cases of invasive cervical rà ©sorption provides an alternative approach to other methods that have been reported 7-11. Since 1977, Heithersay wrote a classic series of articles in which he describes the predisposing factors, features and recommended treatment regimen for treating ICR. He describes class 3 defect can be best treated by Heithersay approach 2. The clinical advantages of this approach are: better patient comfort, avoidance of flap procedure, avoidance of bone removal while gaining access to the defect, control of hemorrhage and inactivation of small, fibro-vascular tissue 6. This treatment regimen is well accepted by patients as it is least traumatic and cost effective and carries good prognosis. Trichloroacetic acid 90% causes coagulation necrosis of resorptive tissues. The additional advantage of TCA is its effect on periodontal ligament tissue adjacent to resorptive site where it is able to destroy actively resorptive cells by same mechanism of coagulation necrosis while expecting uncomplicated repair of the tissues 6. The insertion of suitable restorative material is facilitated by moisture control of both blood and tissue fluids following application of TCA. Thus a moisture-free field was created for placement of glass ionomer cement. Glass inomer cement(GIC) provides some reinforcement to weakened tooth structure 12. While many of the restorations need to be placed subgingivally, the glass ionomer cement used was well tolerated owing to its fluoride release and subsequent antimicrobial effect 13.Conditioning prior to insertion of GIC is not necessary as TCA has been shown to condition enamel and dentine 14. Early and accurate diagnosis of ICR along with well planned treatment regimen can lead to successful treatment outcome and long-term retention of the affected teeth

Gerdes Psychological Services Essay

E3-1B| (Transaction Analysis—Service Company) Brown is a licensed CPA. During the first month of operations of her business (a sole proprietorship), the following events and transactions occurred. | | | April| | | | | | | 3| Purchased supplies on account $1,610.| | | | | 11| Completed a tax assignment and billed client $2,530 for services rendered. | | 12| Received $7,360 advance on a management consulting engagement.| | 17| Received cash of $5,290 for services completed for Calunga Co.| | 21| Paid insurance expense $253.| | 30| Owe the secretary-receptionist $2,668 for the month.| | 30| A count of supplies indicated that $276 of supplies had been used.| | 30| Purchased a new computer for $14,030| (LO 4)| | | InstructionsJournalize the transactions in the general journal. (Omit explanations.)Problem #3| | E3-3B | (Corrected Trial Balance) The trial balance of Cervantes Corporation, below, does not balance. | | | CERVANTES CORPORATIONTRIAL BALANCEAPRIL 30, 2010| | Debit| Credit| Cash| $11,824| | Accounts Receivable| 10,480| | Supplies on Hand| 5,934| | Furniture and Equipment| 12,200| | Accounts Payable| | $14,088| Common Stock| | 16,000| Retained Earnings| | 4,000| Service Revenue| | 10,400| Office Expense| 8,640| | | $49,078| $44,488| An examination of the ledger shows these errors. | 1. | Cash received from a customer on account was recorded as $2,760 instead of $3,660.| | 2. | The purchase on account of a computer costing $6,400 was recorded as a debit to Office Expense and a credit to Accounts Payable.| | 3. | Services were performed on account for a client, $4,500, for which Accounts Receivable was debited $4,500 and Service Revenue was credited $450.| | 4. | A payment of $190 for telephone charges was entered as a debit to Office Expenses and a debit to Cash.| | 5. | The Service Revenue account was totaled at $10,400 instead of $10,560.| | (LO 4)| | | InstructionsFrom this information prepare a corrected trial balanceProblem #4| | | | | | | | E3-5B | (Adjusting Entries) The ledger of Chan Rental Agency on March 31 of the current year includes the following selected accounts before adjusting entries have been prepared. | | | | Debit| Credit| Prepaid Insurance| $ 2,700| | Supplies| 2,100| | Equipment| 18,750| | Accumulated Depreciation—Equipment| | $ 6,300| Notes Payable| | 15,000| Unearned Rent Revenue| | 6,975| Rent Revenue| | 45,000| Interest Expense| –0– | | Wage Expense| 10,500| | An analysis of the accounts shows the following. | 1. | The equipment depreciates $188 per month.| | 2. | One-third of the unearned rent was earned during the quarter.| | 3. | Interest of $375 is accrued on the notes payable.| | 4. | Supplies on hand total $637.| | 5. | Insurance expires at the rate of $225 per month.| | (LO 5)| | | InstructionsPrepare the adjusting entries at March 31, assuming that adjusting entries are made quarterly. Additional accounts are: Depreciation Expense; Insurance Expense; Interest Payable; and Supplies Expense.| | | | Problem # 5 | | | | E3-8B | (Adjusting Entries) Dement is the new owner of Fung Computer Services. At the end of August 2010, his first month of ownership, Dement is trying to prepare monthly financial statements. Below is some information related to unrecorded expenses that the business incurred during August. | 1. | At August 31, Dement owed his employees $2,280 in wages that will be paid on September 1.| | 2. | At the end of the month he had not yet received the month’s utility bill. Based on past experience, he estimated the bill would be approximately $720.| | 3. | On August 1, Dement borrowed $36,000 from a local bank on a 15-year mortgage. The annual interest rate is 6%.| | 4. | A telephone bill in the amount of $140 covering August charges is unpaid at August 31.5.During August, Dement earned $1000 of $6000 that was received from a client at the end of July.| | (LO 5)| | | InstructionsInstructionsPrepare the adjusting journal entries as of August 31, 2010, suggested by the information above.| | | | |

Activities of Youth for Environment in Schools Essay

Background of the Study Pursuant to its promising mission and vision, the Department of Education (DepEd) for years, has been implementing and adhering numerous means and methods to improve and empower the quality of education in the Philippines: be it a new alternative teaching method or a new policy that shall formalize education or any possible way. One of the DepEd’s accredited organizations is the Youth for Environment in Schools Organization (YES-O) with the mission: to preserve and conserve our natural resources through environmental awareness of the community resulting in their active involvement on environmentally-related issues to achieve sustainable development and to protect mother nature; and vision: the Youth for Environment in Schools-Organization as an effective and respective school- based environmental organization linked with the agencies/ institutions for conservation and preservation of natural resources towards sustainable development. (DepEd Region V) Article XVIII: Mandated Projects and Activities of Youth for Environment in Schools-Organization’s Constitutions and By-Laws for School Year 2010-2011 includes the projects and activities that YES-O should implement through the School Year 2010-2011. The study aims to determine whether the activities and projects stated in Article XVIII of YES-O by-laws has been implemented throughout the school year 2010-2011. Specific Questions: 1. What is the mission and vision of YES-O in the Bicol Regional Science High School for the School Year 2010-2011? 2. What are the projects, programs and activities implemented by Youth for Environment in Schools Organization as indicated on their accomplishment report or year-end reports in accordance of Article XVIII: Mandated Projects and activities? 3. Which among their projects, programs and activities in accordance to the mission and vision indicated in the Article XVIII which is not implemented? 4. What are the factors affecting the implementation of Article XVIII of Mandated projects and Activities? Significance of the Study The Article XVIII: Mandated Projects and Activities which is stated in YES-O By-Laws states that the Youth for environment in Schools- Organization shall be required to implement, conduct or attend the following programs, projects, and activities; namely, clean-up drives, waste management, segregation and recycling, awareness campaigns, symposia or training, nursery establishment, tree planting activities, fun run and Youth for environment Summer Camp. Through this, the researchers will analyze the year-end report of YES-O in BRSHS school year 2010-2011 to determine whether all the mandated projects and activities stated in Article XVIII of YES-O by- Laws were implemented through the school year. Teachers, students, officers of Youth for Environment Schools- Organization and other organization will be benefited with this study through the improvements of their projects and activities. Also, through this study the researchers will be able to determine the factor that affects the implementation of the projects and activities. With this, other organizations including YES-O would have solutions to those factors and can have better improvements with their programs and activities. Scope and Limitations The study will only focus on the implementation of Article XVIII: Mandated Projects and Activities of Youth for Environment in Schools Organization (YES-O) of Bicol Regional Science High School (BRSHS) through the school year 2010-2011. The study aims to determine whether all the mandated projects and activities stated in Article XVIII was implemented by YES- O through the school year 2010-2011. Also, the study aims to determine the factors affecting the implementation of Article XVIII of YES-O by-laws. Conceptual Framework Article XVIII Mandated Projects and Activities The Youth for Environment I Schools- Organization (YES-O) shall be required to implement, conduct or attend the following programs, projects and activities; namely, clean-up drives, waste management, segregation and recycling, awareness campaigns, symposia or training, nursery establishments, tree- planting activities, fun run and Youth for Environment Summer Camp. Vision The Youth for environment in Schools organization as n effective and respective school-based environmental organization linked with the other agencies/ institutions for conservation and preservation of natural resources towards sustainable development. Mission To preserve and conserve our natural resources through environmental awareness of the community resulting in their active involvement on environmentally related issues to achieve sustainable development and to protect mother nature. Chapter 2 Review of Related Literature and Studies The Department of Education (DepEd), the Commission on Higher Education (CHED), and the Technological Education and Skills Development Authority (TESDA), in coordination with OCD, the National Youth Commission (NYC), the Department of Science and Technology (DOST), the Department of Environment and Natural Resources (DENR), the DILG- BFP, the Department of Health (DOH), the Department of Social Welfare Development (DSWD), and other relevant agencies, shall integrate disaster risk reduction and management education in the school curricula of secondary and tertiary levels of education including the National Service Training Program (NSTP), whether private and public, including formal and non-formal, technical-vocational, indigenous learning and out-of-school youth congress and programs. (Sandra C. Velacruz,2011) It is important to put a prime on disaster risk reduction and management. When our systems are efficient, it increases and enhances human security. Republic Act No. 10121 also known as the Philippine Disaster Risk Reduction and Management (DRRM) of 2010 strengthens the Philippine disaster risk reduction and management framework, institutionalizes the National Disaster Risk Reduction and Management Council (NDRRM), and appropriate funds for the use of its implementers. It calls for the development of a framework that taps the different sectors, agencies, and communities that will address disaster risk reduction and management concerns. (Sandra C. Velacruz, 2011) The Department of Education (DepEd), in partnership with the Department of Environment and Natural Resources (DENR), establishes the Youth for Environment in Schools Organization (YES-O) as the only recognized co-curricular environment club or organization in the school with the main and primary programs or projects for the environment on ecology in the said organization. (DepEd, 2003) The Youth for Environment in Schools Organization (YES-O) is the youth arm of both Department of Education (DepEd) and the Department of Environment and Natural Resources (DENR) to heighten pupils and students’ participation and action towards environment protection and conservation at the school level. As a co-curricular organization, it shall implement programs, projects, and activities that address various environmental issues and concerns such as global warming, climate change adaptation, deforestation, watershed protection, disaster risk reduction, among others. (Yolanda S. Quijano, 2010) The Regional and Division Education Supervisors in Science, as Regional and Division coordinator respectively, shall lead, coordinate and monitor the conduct of activities pertinent to the Youth for Environment in Schools Organization in the respective areas of jurisdiction. The Science Department Head/ Coordinator and Teacher, herein designated as School –based Moderator respectively, shall lead operate the Youth for Environment in Schools Organization (YES-O) activities in the school level with the guidance of School Head/ Principal. (Edilberto C. De Jesus, 2003) In view of the increasing global concerns for environmental action against threats to mother earth and consequent need to consolidate all efforts in safeguarding, protecting, and conserving the environment, and pursuant to the Department of Education order No. 72, s. 2003 on the establishment of the Youth for Environment in Schools Organization (YES-O), the Department of Environment and Natural Resources (DENR) is announcing the Thrusts and Activities of the Youth for Environment in Schools Organization (YES-O). (Vilma L. Labrador, 2007) The Youth for Environment in Schools Organization (YES-O) on its partnership with concerned government and non- government organizations undertake tree planting and growing, awareness campaigns and symposia on Environmental Issues and Actions, Outreach programs, Waste management, Segregation, Recycling and Entrepreneurship programs, watershed Protectin and Conservation, Environmental/ Science Camps. (Vilma L. Labrador, 2007) The Youth for Environment in Schools Organization (YES-O) which is one of the Department of Education accredited organization helps to strengthens the government program concerning global warming, climate change, adaptation, reforestation, watershed protection, and disaster risk reduction. The Youth for Environment in Schools Organization (YES-O) is advised to conduct the activities in increasing global concerns for environmental action against threats to our planet in partnership with the government agencies such as the Department of Environment and Natural Resources (DENR) . Chapter 3 Methods of Research and Procedures Methods of Research The method of research used in the study is the descriptive method, specifically the content analysis. Content analysis focuses on the documentary materials that shall be analyzed. The documents to be analyzed are the year-end report or the accomplishment report of the Youth for Environment in Schools Organization (YES-O) for the school year 2010-2011. The programs, projects, and activities which were stated in Article XVIII: Mandated Projects and Activities of Youth for Environment in Schools Organization will be the basis for the analysis of the year-end report. The year-end report of the YES-O contains the projects, programs, and activities which were implemented in the school year 2010-2011. Method of Collecting Data and Development of the Research Instrument The researchers will conduct interviews with selected members and non-members of the YES-O and its officers in Bicol Regional Science High School. Interview Schedule will be the instrument to be used during the interview. This will include specific questions on how the YES-O implemented the mandated projects and activities which are stated in Article XVIII of the YES-O Constitution and By- Laws. Sampling Design The study will determine if the programs, projects, and activities stated in Article XVIII of the YES-O Constitution and By-laws for the school year 2010-2011 are implemented through analyzing their year-end report or accomplishment report. The organization has forty-three members, twenty of them will be chosen through random or lottery sampling. This type of probability sampling is used so that everyone in the population has equal chance of being selected to be included in the sample. Since the population has no differentiated levels or classes, pure random sampling is used. The researchers will conduct three separate random samplings for the YES-O members and non- members. The size of the population for the YES-O members is forty- three (43) and the study population is twenty (20). For the non-members of YES-O, the size of population is one hundred thirty- one (131) and the study population will also be twenty (20) and for the officers, the study population is seven (7). Statistical Treatment The researchers conducted an interview with the members, non-members, and officers of the Youth for Environment in Schools- Organization (YES-O). With this, the researchers will use tables and other graphical forms for the interpretation of data as statistical treatment. Interview Schedule 1. Are you aware of the mission and vision of the YES-O? ____ Yes ____ No If yes, what do you think are the mission and vision of the YES-O? 2. What are the projects, programs and activities conducted or implemented by the YES-O that you are aware of? 3. How satisfied are you with the programs and activities of the YES-O for the school year 2010-2011? ___ Very satisfied ___ Satisfied ___ Poorly satisfied ___ Not satisfied 4. Do you think the projects, programs and activities implemented by the YES-O in the school year 2010-2011 would benefit the students, teachers, the school, and other organizations? ___ Yes ___ No 5. What do you think are the benefits of the students, teachers, the school, and other organizations from the implementation of the projects, programs, and activities by the YES-O? 6. What do you think are the factors affecting the implementation of the programs, projects, and activities of the YES-O? Chapter 4 Results and Discussions The study shows the implementation of Article XVIII: Mandated Projects, Programs and Activities of Youth for Environment in Schools Organization in the school year 2010-2011. The researchers had conducted interviews with the members, non-members and officers of the Youth for Environment in Schools Organization to determine if the programs, activities, and projects were implemented throughout the school year 2010-2011. The tables below show the results of the interviews: The interview shows that among the twenty selected members of the YES-O, three are aware of the mission and vision, while seventeen of them are not. On the other hand, four of the twenty non-members are aware of the mission and vision, and sixteen of them are otherwise. Ninety-five percent of the YES-O and non-YES-O members convey that the students, teachers, school and other organizations can be benefitted by the projects, programs, and activities implemented by the YES-O while 5% of the said that there is no benefit. On the other hand, 100% of the YES-O officers say that the students, teachers, school and other organizations can be benefitted by the projects, programs, and activities implemented by the YES-O. From the interviews with the YES-O and non-YES-O members, and the officers of the organization, environmental awareness is the most identified benefit with 15 responses from the members, eight responses from the non-members, and three from the officers. The budget for the projects of the YES-O has the highest number of responses from the members, non-members and officers, with 14, nine and five, respectively. Five YES-O officers also cited the factor of time and schedule. Article XVIII: Mandated Projects and Activities includes clean-up drives, waste management, segregation and recycling, awareness campaigns, symposia or training, nursery establishments, tree-planting activities, fun runs, and the Youth for Science and Technology Environment Camp (YSTEC). In the YES-O accomplishment report for school year 2010-2011, all projects and activities stated in article XVIII are included, except for the waste management, segregation and recycling and nursery establishments. The interview results show that the students are all aware of all the projects and activities stated in article XVIII. SUMMARY, CONCLUSIONS AND RECOMMENDATIONS Summary The main purpose of the study is to determine if the projects, programs and activities held by the YES-O is in accordance to Article XVIII: Mandated Projects and Activities of the constitution and by-laws of the YES-O. The method of research used is the descriptive method, specifically the content analysis. Based from the results of the interviews, all the activities stated in Article XVIII, except for waste management, segregation, recycling and nursery establishment are implemented. Conclusion With reference to the results gathered, it can be concluded that the clean-up drives, awareness campaigns, symposia or training, nursery establishment, tree-planting activities, fun run, and Youth for Environment Summer Camp stated in Article XVIII: Mandated Projects and Activities are implemented by the YES-O school year 2010-2011, while the waste management, segregation and recycling and nursery establishment are not implemented based on their constitution and by-laws. Recommendations The researchers recommend that researches on future YES-O year-end reports be conducted in order to strengthen the foundation of this study. The researchers further recommend conducting studies to answer why most students are not aware of the mission and vision of YES-O.

How Poverty Causes The Greatest Suffering On Humans

ORDERS PROFILEBALANCE $0.00 $240.00 SUPPORT NEW ORDERYour time zone : UTC-06:00 †¹ Back Results of Plagiarism check for order #47358605 No plagiarism detected Abstract The World Health Organization described that poverty causes the greatest suffering on humans. Poverty leads to people living in a state of financial instability that causes both physical and emotional stress. The problem of poverty has continued to be a problem to both the developing and the developed countries all over the world. The main focus in this paper is on poverty in America and how it affects the American economy. The paper will also find ways to reduce poverty, the new faces of poverty and how it affects the citizens Introduction Poverty is a where an individual or a particular community does not have sufficient amount of resources or income to cater for their needs (Dollar). The key factors that may lead to such economic situation may be overpopulation, unequal distribution of resources, the increasing and high standards or cost of living. The other factors that may result to poverty are a lack of adequate employment and education opportunities, degrading the environmental, and economic and demographic trends in the society. Poverty is caused by deprivation or lack of the essentials needs that are required for an individual to have the minimum standard of well-being and life(Dieterlen). The overall effect of poverty has grievous consequences on human life and the society. In many developed andShow MoreRelatedEssay on The Dalai Lama: A Path to Greater Happiness1601 Words   |  7 Pagesindividuals, and for humanity. The first noble truth is The Truth of Suffering. Dalai Lama says that we face three different types of sufferings: the suffering of suffering, the suffering of change, and all pervasive suffering. 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