Presentacion Ortodoncia
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Presentacion Ortodoncia

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Presentacion Ortodoncia Presentacion Ortodoncia Presentation Transcript

  • Oral Biology 5670
    • Bone growth and development
    • Bone biology
    • Educational objectives
      • Exposure to basic concepts of bone biology
      • Correlation of basic bone biology to clinical treatment
      • Special considerations / implications of bone biology to dentistry
  • Clinical Correlates of Bone Growth and Development
    • Facial skeletal development
    • Maxillary development
    • Mandibular development
  • Clinical Correlates of Bone Growth and Development
    • Effect of congenital anonalies on facial growth and development
    • Effect of surgical correction of congenital anomalies on facial growth and development
    • Tooth development and retention influence on alveolar bone levels
  • Clincal Correlates of Bone Growth and Development
    • Orthodontic tooth movement
    • Bone healing following tooth extraction
    • Bone response to alloplastic materials
    • Bone healing in approximation of dental implants
  • Clinical Correlates of Bone Growth and Development
    • Bone grafting to treat dentoalveolar defects
    • Bone grafting to treat discontinuity defects
    • Fracture healing
  • Cellular Growth
    • Hypertrophy
    • Hyperplasia
    • Secretion of extracellular material
    • Interstitial growth
  • Embryologic Type of Bone
    • Endochondral
    • Intramembranous
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  • Functional Matrix Theory of Growth
    • “ Growth of the face occurs as a response to the functional need and is mediated by the soft tissue in which the bone is embedded”
    • Soft tissues grow, bone and cartilage react
  • Growth Control
    • Bone is the determinant of its own growth
    • Cartilage is the determinant of bone growth
    • Soft tissue matrix is the determinant of growth
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  • Orthodontic Tooth Movement
    • Bone apposition and resorption
    • Effects on the pulp
    • Effects on the PDL
    • Effects on the tooth root
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  • Effects of Periosteum
    • Provision of undifferentiated mesechymal cells
    • Envelope to limit/regulate bone apposition
  • Introduction 10 y.o. female 12/98
    • CC:
      • Noticed swelling in face on left side for two weeks
    • HPI:
      • Facial swelling
      • Left lower lip “tingles”
      • No pain or change in bite
  • Examination
    • Left lower facial swelling, without thrill/bruit
    • Lower vestibular swelling, L>R
    • No abnormal tooth mobility
    • Teeth 19-28 vital with EPT
    • CN II-XII grossly intact
  • Assessment
    • Problem list:
      • Multilocular radiolucent lesion
      • Teeth vital without resorption, displacement, or mobility
      • Apparent cortical expansion
    • Diff. Dx:
      • Central Giant Cell Lesion
      • Ameloblastomic Fibroodontoma
      • Ameloblastoma
  • Treatment Plan
    • Impressions for splint fabrication
    • Screening labs Ca, alk phos, PTH
      • All WNL
    • CT of mandible:
      • Multilocular radiolucents, from infer border to encompass tooth roots superiorly
      • Buccal and lingual cortices intact, although expansion present
    • Incisional bx