Journal of Odontology
Open Access

Seong Lee^{* *}Correspondence: Seong Lee, Department of Odontology, Taxila Institute of Asian Civilization, Quaid-i-Azam University , Islamaba, Pakistan, Email:

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Introduction

Fluorosis is extensively prevalent in India and is a core problem of public health concern. Around six million Indian population is poorly affected because of fluorosis. At Several places in our country, groundwater is richly supplemented with fluoride and large numbers of Indian population depends on groundwater for various purposes.

Ingestion of very high levels of fluoride over a longer period of time fallouts in dental as well as skeletal fluorosis depending on years he stayed in particular endemic area. Initial symptoms of exposure to high quantity of fluoride include, burning sensation and aches in hand and feet, stiff joints, weak muscles, decreased appetite, gastrointestinal problems and weight loss. In the later stages, long bones usually affected with osteoporosis and calcification of the bones also occur. In further stages, bones and joints become weak making movement of person difficult and tender. Fusion of vertebrae is a common finding in several areas of spine particularly in the cervical areas of spine.

In more severe cases spinal canal becomes narrow with calcification of the neural arch and intervertebral foramina. Late manifestation of skeletal fluorosis results in â??Poker backâ? spine where the whole spine seems as one continuous column of backbone. In the last stage, the patient is crippled. In a routine orthopedics outpatient department majority of patients complain about pain in joints, chronic fatigue and stiffness of joints etc. and quite often for these complaints consultant prescribe opioids, NSAID and other anti-inflammatory and analgesics drugs as management. These patients also comprise those patients who are also suffering from skeletal fluorosis. So, these patients are getting symptomatic treatment. There are many clinical symptoms of skeletal fluorosis that mimic to arthritis and other skeletal disorder hence skeletal fluorosis could be easily misdiagnosed.

Fluoride level estimation in urine can be estimated easily that gives an idea of patient affected with skeletal fluorosis. Dental fluorosis can be an indicator for skeletal and non-skeletal fluorosis.

Treatment/Retreatment in endodontics has changed fundamentally in the last few years following the introduction of the surgical operating microscope. Cases that once seemed impossible became easy and exciting to operate. Although initial root canal therapy has been shown to be a predictable procedure with a high degree of success, failures can occur after treatment. As fewer teeth are extracted, an increasing number of retreatment cases have been recorded in the past 15 years.

Utilization of the enhanced magnification devices in endodontic retreatment has brought significant advantages and has expanded the scope of indications using a non-surgical approach. Procedures such as bypassing a ledge, removing broken instrument or repair a perforation have become considerably more reliable. Also, there has been advances in terms of dental materials used in endodontics and one such advancement is in the field of root canal sealers. Lately new root canal sealers have been introduced by the name of â??Bioceramicsâ?. Bioceramic sealers are an attempt to develop a biocompatible sealer with ideal physical, chemical, mechanical, and biological properties. Bioceramic is a term introduced for an important subset of biomaterials that can be classified as bioinert, bioactive or biodegradable according to the interaction with surrounding tissues.

However, apart from materials the root canal system itself plays an important role in the success of the endodontic therapy. This system is not as simple as it looks to be. The knowledge of the normal and its frequent variations can greatly enhance the success rate of endodontic practice. Curved root canals exhibit great difficulty in cleaning, shaping & obturation of the root canal system, therefore determining the degree of curvature of root canal before starting the endodontic treatment is mandatory.