Ideas on continuing education

Ideas on continuing education

S ta te o f t h e p u l p , c h r o n i c in f l a m m a t i o n r e s o r p t i v e p r o c e s s .” is o f t e n p r e s e n t , a n d u p o n th ...

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S ta te o f t h e p u l p , c h r o n i c in f l a m m a t i o n

r e s o r p t i v e p r o c e s s .”

is o f t e n p r e s e n t , a n d u p o n th is s t a t e , t h e a c u t e s ta g e is e n g r a f t e d . I n o t h e r

s ta te

w o r d s , p r e c e d in g t h e a c u t e s ta g e w a s

and

o f a n in v o lv e d a lr e a d y

has

r e a s o n , t h e h i s t o lo g ic p i c t u r e is m o s t

la r abscess as a n

o fte n

and m ay

and

c h r o n ic

in ­

p u lp

been

T h is s e rv e s a d u a l p u rp o s e :

m e n t io n e d .

“ in fr e q u e n t e n tity

n o t n e c e s s a r i ly

b e r e la te d

t o m i c r o b i a l i n v a s io n f r o m a n e c r o t ic

fla m m a t io n .”

n a te d tim e e a c h y e a r .

is a g r e e d

T h e a u t h o r s r e g a r d a n a c u t e a lv e o ­

a s y m p t o m l e s s c h r o n i c s ta g e . F o r th is

th a t o f a c u te

t h e i r l o c a l h o s p it a l s t a f f f o r a d e s ig ­

T h a t c h r o n i c p u lp i t is is a c o m m o n

— it w o u ld and

e s t a b l is h

p r a c tic a l

a m e a n in g fu l

c o n tin u in g

e d u c a t io n

p r o g r a m , a v a i l a b l e t o t h e lo c a l d e n ­ t is t s ,

fr e e in g

th e m

of

expense

and

tr a v e l, a n d — it

w o u ld

a id

th e

in d ig e n t ,

who

a c u t e p u lp i t is is

p u lp .” C lin ic ia n s a p p a r e n tly see m o re

u s e d t o d i f f e r e n t i a t e t h is t y p e o f p u lp ­

cases o f a c u te a lv e o la r ab s c es s th a n

it is f r o m

u l c e r a t i v e a n d h y p e r p la s t ic

h i s t o p a t h o lo g is t s b e c a u s e i t is n o t a n

g ra m , v ia g o v e rn m e n t-s p o n s o re d p ro ­

p u lp i t is , a n d is a c o m m o n l y a c c e p t e d

u n c o m m o n o c c u rre n c e to o p e n a ro o t

g ra m s .

F in a lly , th e te rm

w i l l b e t h e b e n e f ic ia r ie s o f t h is p r o ­

t e r m u s e d b y a lm o s t e v e r y a u t h o r o f

c a n a l o r t o la n c e a n a b s c e s s a n d s e e

I b e lie v e th is a p p r o a c h t o b e s o u n d

a t e x t b o o k o n e n d o d o n t ic s ( C o o l id g e

fra n k pus escap e. F u rth e rm o re , even

a n d p r a c t ic a l, a n d its c o n c e p t d e s e rv e s

a n d K e s e l; C r o w le y , O s tr a n d e r , S o m ­

in

f u r t h e r c o n s id e r a t io n .

m e r; M u m f o r d ; N ic h o lls ; A b r a m s o n

m ic r o o r g a n is m s

a n d N o r r i s ; W e in e ; a n d H a r t y ) .

(B ro w n

W i t h r e g a r d t o p u lp h y p e r e m i a , i t w o u ld

o th e r w is e

p la in

th o s e

be

d iffic u lt to

c ir c u la to r y

and

o f tra u m a

and

ex­

F u lg h u m , S u n q u is t ) .

a s t h o s e a c c o m p a n y i n g m e n s t r u a t io n

A

new

o f sound

have

K a n tz

W ittg o w

te e th ,

is o la t e d

ARNOLD HO N IG M A N , DDS

M a c D o n a ld

GREAT NECK, NY

been

R u d o lp h ,

a s s o c ia t e s ,

d is t u r b a n c e s

w h i c h a r e r e f l e c t e d i n t h e p u lp s u c h

an d p re g n a n c y ,

cases

and

and

H e n ry ,

S a b is t a n , ■

te rm

f o r g r a n u l o m a is n o t

n e e d e d d e s p it e t h e f a c t t h a t e t y m o l -

o r v a s c u la r c o n g e s ­

o g ic a l ly i t is i n c o r r e c t , b u t t o c a l l a ll

t i o n i n t h e p u lp s o f t e e t h a s s o c ia te d

a re a s o f p e r ia p ic a l r a r e fa c tio n a g ra n ­

w i t h t h e c o m m o n c o ld o f s in u s d is ­

u l o m a p lu s s o m e t h in g e ls e f r o m a h is ­

ease.

t o l o g i c s t a n d p o in t d o e s n o t a p p e a r t o

A

p h o t o m ic r o g r a p h

o f p u lp a l

h y p e r e m i a a s s o c ia t e d w i t h m i l d t r a n ­

b e r e a s o n a b le .

s ie n t p a i n is s h o w n i n f i g u r e 2 1 o f m y

v a tio n w e k n o w

book.

t o l o g y is q u i t e d i f f e r e n t b e t w e e n a n

M o rs e w ith

my

and

a s s o c ia t e s

fin d

fa u lt

s ta te m e n t th a t in te r n a l r e ­

s o r p t io n is a d e g e n e r a t iv e s t a t e o f t h e p u lp a n d o f f e r S te d m a n ’ s d e fin itio n o f d e g e n e r a t io n

and

a

c l i n ic a l o b s e r ­

th a t th e s y m p to m a ­

c h r o n ic

a b s c e s s , c y s t,

c o n d e n s in g o s t e it is , p e r i a p i c a l s c a r , o s t e o m y e l it is ,

and

c e l lu l it is

a ll

of

w h i c h a r e s t a t e d t o b e b a s ic a lly g r a n ­

“ a re tro g re s ­

u lo m a s b y t h e a u t h o r s . A t t e m p t s t o

s iv e p a t h o lo g ic c h a n g e i n c e lls o r t is ­

s im p li f y a r e l a u d a b l e , b u t in d o in g so

sues

o n e lo s e s t h e p e r s p e c t i v e o f t h e c l i n ­

in

w h i c h is

a c u te

F ro m

consequence

fu n c tio n s

m ay

be

of

w h ic h

in h ib it e d

th e

and

de­

s t r o y e d a n d t h e p r o t o p la s m is a lt e r e d

LOUIS I . GROSSMAN, DDS

i n s u c h a m a n n e r t h a t n e c r o s is r e s u lt s ;

PROFESSOR, UNIVERSITY O F PENNSYLVANIA

and,

w h ile

m ay

occur

by

am

k e p t m e fro m

t in u e s a n d , o f c o u r s e , m y p r o d u c t i o n s to p s w h e n I a m g o n e . The

t o t a l e x p e n s e is s iz a b le a s i t

in c l u d e s c o s t o f c o u r s e , t r a v e l , f o o d , a n d lo d g i n g w h i c h c a n b e d e d u c t e d , h o w e v e r.

If

c o n tin u in g

d r e s s e d i t s e l f t o t h e q u e s t io n o f c o n ­

in

m o s t c a s e s w e a r e s t ill d e a lin g w i t h a v ita l p u lp , o th e r w is e r e p a ir c o u ld n o t o c c u r. W a r n e r a n d a s s o c ia te s h a v e s h o w n

e d u c a t io n

c o u rs e s a re m a d e m a n d a to r y , th e n I f e e l t h e d e n t i s t s h o u ld r e c e i v e a $ 2 0 0 to $ 3 0 0 p e r c o u rs e t a x c r e d it to c o v e r and

o ffic e

o v e rh e a d ,

as

w e ll as a c tu a l e x p e n s e d e d u c tio n s . A l i m i t c o u l d b e im p o s e d s o t h a t t h e t a x c r e d it id e a w o u ld n o t b e a b u s e d .

L EE H . OSBORN, DDS

h a s p r o p e r ly a d ­

t in u in g e d u c a t io n i n a m o s t c o m p r e ­

th a t

d e n tis t

U N IO N LAKE, MICH m T h e June J A D A

in fla m m a tio n

is

younger

a t t e n d in g c o u r s e s f a r

Id e a s o n c o n t in u in g e d u c a tio n

b e lo n g s u n d e r t h e h e a d in g o f p u lp a l answ er

a

fr o m h o m e . M y o ffic e o v e rh e a d c o n ­

o s te o d e n tin e ,

b o n e , o r c e m e n tu m . A s to w h e th e r it

th e

I

p r o p e r s t a t e o r n a t io n a l a u t h o r i t ie s .

not

c o m p le te ly r e v e r s ib le , a n a tte m p t a t r e p a ir

y e a r ly .

a n d th e e x p e n s e d o es a d d u p a n d has

t i o n a n d p o s s ib le p r e s e n t a t i o n t o t h e

i n t e r n a l r e s o r p t i o n t o a t e e . I t is a d e ­ p ro c e s s

es

I f e e l t h i s i d e a d e s e r v e s c o n s id e r a ­

e s s is r e v e r s i b l e . ” T h e d e f i n i t i o n f it s

g e n e r a tiv e

t in u in g e d u c a t io n c o u r s e s . I t r y t o t a k e tw o to f o u r , o n e -d a y o r tw o -d a y c o u rs ­

lo s t w a g e s

ic a l c o n d it io n .

a t s o m e s ta g e s t h e d e g e n e r a t iv e p r o c ­

I a m f u l l y in a g r e e m e n t t h a t a ll d e n ­

t is t s s h o u ld b e r e q u i r e d t o t a k e c o n ­

h e n s iv e m a n n e r .

C P R f o r d e n t is t &

a u x ilia r ie s

A d m i t t e d l y , w e a r e s t ill in a q u a g ­ m ir e o n t h is is s u e b e c a u s e o f c o u r s e

m I w o u ld li k e to a d d a fo o tn o te to th e

a v a ila b ility , s tru c tu re ,

e x c e lle n t, c lin ic a lly u s e fu l a r tic le o n

expense, and

s e v e r a l h i s t o lo g ic e x a m p l e s o f i n t e r ­

a ll t h e o t h e r r e a s o n s m e n t io n e d . B u t

c a r d i o v a s c u l a r p r o b le m s i n d e n t i s t r y

nal

th e re

b y o u r m e d ic a l c o ll e a g u e , D r . S . P .

r e s o r p tio n

b e le d

w ith

illu s tr a tio n s

“ s lig h t i n f l a m m a t o r y

in p u l p , ”

“ a c u te p u lp itis ,”

la ­

is o n e p r a c t i c a l r e s o u r c e t h a t

r e a c t io n

h a s y e t t o b e d is c u s s e d , a n d t h a t is o u r

“ in fla m ­

lo c a l h o s p it a l.

m a tio n in r e m a in d e r o f p u lp .”

G l a s s e r ( J u n e J A D A , p a g e 1 1 5 8 ). I n h is c lo s in g r e m a r k s , t h e a u t h o r a llu d e d

to

th e

p r e c i p it o u s

c a rd ia c

And

I b e li e v e t h e b e s t m e t h o d o f f u l f i l l ­

T h o m a h a s s t a t e d “ i n f l a m m a t o r y c e lls

in g c o n t i n u i n g e d u c a t io n is t o r e q u ir e

e m e r g e n c y . I n t h a t s e t t in g i t m ig h t b e

w e r e u s u a l l y p r e s e n t a t t h e s it e o f t h e

a ll d e n t is t s t o b e a c t i v e m e m b e r s o f

w e ll t o a d d th a t e v e r y d e n tis t, d e n ta l

184 ■ LETTERS TO THE EDITOR / JADA, Vol. 95, A ugust 1977