The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document provides an overview of cleft lip and palate, including:
- The incidence is approximately 1 in 700 live births. Males are more commonly affected by cleft lip while females are more commonly affected by cleft palate.
- Clefts occur due to both genetic and environmental factors like certain viruses, medications, and smoking. They may also be associated with other syndromes.
- Clefts are classified based on their location and severity, with unilateral cleft lip and palate (UCLP) being one of the most common types.
- Individuals with cleft lip and palate can experience problems with feeding, speech, hearing, and psychosocial issues. Timely management including
Cleft lip and palate are congenital anomalies that require a multidisciplinary team for treatment. They can involve the lip, alveolus, hard and soft palates. Treatment involves a coordinated approach between multiple specialties and begins with surgery to repair the cleft, followed by ongoing dental, orthodontic and reconstructive procedures over many years.
The document provides information on cleft lip and cleft palate including definitions, incidence rates, development, classifications, problems associated, and treatment protocols. It defines cleft lip as an opening in the upper lip and cleft palate as an opening in the roof of the mouth. Treatment is a multidisciplinary approach involving surgery to repair the cleft, orthodontics to align teeth and jaws, and speech therapy. Management occurs over many years from infancy through adulthood to address dental, esthetic, speech and other issues.
Craniofacial anomalies are a diverse group of deformities in the growth of the head and facial bones that result from abnormalities in embryonic development. They can be classified into four main categories: cerebrocranial dysplasia, cerebrofacial dysplasia, craniofacial dysplasia, and craniofacial dysplasias with other origins. Common examples discussed include cleft lip and palate, craniosynostosis syndromes like Crouzon syndrome, and conditions involving dysplasia of specific bones or regions like the nose, premaxilla, or mandible. The causes of craniofacial anomalies are multifactorial, including genetic factors and environmental influences.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document summarizes a seminar on cleft lip and palate. It discusses the development, etiology, classification, incidence, clinical features, and associated syndromes of cleft lip and cleft palate. Various theories for the development are provided. Genetic and environmental factors that may cause clefts are described. Different classification systems for clefts are outlined, including those based on morphology and embryology.
This document discusses various types of facial bone fractures including the nasal bones, maxilla, zygomatic bones, and mandible. It describes the common causes of facial fractures such as road traffic accidents, falls, assaults, and sports injuries. The key aspects of managing facial trauma are controlling airway, hemorrhage, and treating associated injuries. Examination involves checking specific areas of the face. Treatment options depend on the type and severity of the fracture and may include closed or open reduction as well as splinting or internal fixation with plates or screws.
This document summarizes a seminar on cleft lip presented by Dr. Cathrine Diana. It discusses the history, embryology, etiology, epidemiology, classifications, parent counseling, feeding, surgical procedures, post-operative care, and recent advances related to cleft lip. The key topics covered include the causes of cleft lip being multifactorial including genetic and environmental factors, classifications according to location and severity, importance of pre-surgical orthodontics and nutrition management, and surgical techniques for lip repair and reconstruction.
This document provides an overview of cleft lip and palate, including:
- The incidence is approximately 1 in 700 live births. Males are more commonly affected by cleft lip while females are more commonly affected by cleft palate.
- Clefts occur due to both genetic and environmental factors like certain viruses, medications, and smoking. They may also be associated with other syndromes.
- Clefts are classified based on their location and severity, with unilateral cleft lip and palate (UCLP) being one of the most common types.
- Individuals with cleft lip and palate can experience problems with feeding, speech, hearing, and psychosocial issues. Timely management including
Cleft lip and palate are congenital anomalies that require a multidisciplinary team for treatment. They can involve the lip, alveolus, hard and soft palates. Treatment involves a coordinated approach between multiple specialties and begins with surgery to repair the cleft, followed by ongoing dental, orthodontic and reconstructive procedures over many years.
The document provides information on cleft lip and cleft palate including definitions, incidence rates, development, classifications, problems associated, and treatment protocols. It defines cleft lip as an opening in the upper lip and cleft palate as an opening in the roof of the mouth. Treatment is a multidisciplinary approach involving surgery to repair the cleft, orthodontics to align teeth and jaws, and speech therapy. Management occurs over many years from infancy through adulthood to address dental, esthetic, speech and other issues.
Craniofacial anomalies are a diverse group of deformities in the growth of the head and facial bones that result from abnormalities in embryonic development. They can be classified into four main categories: cerebrocranial dysplasia, cerebrofacial dysplasia, craniofacial dysplasia, and craniofacial dysplasias with other origins. Common examples discussed include cleft lip and palate, craniosynostosis syndromes like Crouzon syndrome, and conditions involving dysplasia of specific bones or regions like the nose, premaxilla, or mandible. The causes of craniofacial anomalies are multifactorial, including genetic factors and environmental influences.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document summarizes a seminar on cleft lip and palate. It discusses the development, etiology, classification, incidence, clinical features, and associated syndromes of cleft lip and cleft palate. Various theories for the development are provided. Genetic and environmental factors that may cause clefts are described. Different classification systems for clefts are outlined, including those based on morphology and embryology.
This document discusses various types of facial bone fractures including the nasal bones, maxilla, zygomatic bones, and mandible. It describes the common causes of facial fractures such as road traffic accidents, falls, assaults, and sports injuries. The key aspects of managing facial trauma are controlling airway, hemorrhage, and treating associated injuries. Examination involves checking specific areas of the face. Treatment options depend on the type and severity of the fracture and may include closed or open reduction as well as splinting or internal fixation with plates or screws.
This document summarizes a seminar on cleft lip presented by Dr. Cathrine Diana. It discusses the history, embryology, etiology, epidemiology, classifications, parent counseling, feeding, surgical procedures, post-operative care, and recent advances related to cleft lip. The key topics covered include the causes of cleft lip being multifactorial including genetic and environmental factors, classifications according to location and severity, importance of pre-surgical orthodontics and nutrition management, and surgical techniques for lip repair and reconstruction.
The document discusses several craniofacial anomalies including craniosynostosis. Craniosynostosis occurs when one or more of the fibrous sutures in the skull fuse prematurely, restricting skull growth. It can be primary, due to a defect in ossification, or secondary, due to inadequate brain growth. Primary craniosynostosis affects a single suture and causes specific head shapes like scaphocephaly or brachycephaly, while secondary craniosynostosis involves multiple sutures fusing. Treatment involves surgery to reshape the skull if increased intracranial pressure develops by age 2-4 months.
Cleft lip and palate are common birth defects that affect speech, hearing, breathing, and appearance. They require a team-based approach involving multiple specialists like otolaryngologists. The document discusses the management of cleft lip and palate, including the roles of different specialists in examining, diagnosing, and treating issues related to feeding, airway, speech, hearing, and surgery. Surgical techniques aim to restore normal anatomy and function through procedures on the lip and palate.
Treacher Collins Syndrome is a rare genetic disorder that affects the development of the facial structures. It is caused by mutations in genes that play roles in facial development. The syndrome is characterized by hypoplasia of the zygomatic bones, mandible, and other facial structures derived from the first and second branchial arches. Treatment involves a series of reconstructive surgeries throughout childhood to correct functional issues and reconstruct the facial structures. Surgical techniques discussed include mandibular distraction, zygomaticomaxillary bone grafting and distraction, and coloboma repair. Later orthognathic procedures may also be considered in selected adult patients.
Micrognathia is a condition where the jaw, most commonly the mandible, is severely deficient. There are two types - apparent micrognathia which is an illusion and true micrognathia where the jaw is actually small. True micrognathia can be congenital or acquired and is associated with other birth defects or injuries from forceps delivery or ankylosis. Clinical features include a retracted middle face, retruded chin, and steep mandibular angle with the jaw being too small to feed properly in infants. Management may involve orthognathic surgery.
This document discusses infections that can occur in the five masticatory spaces. It describes the boundaries, contents, causes, clinical features, and treatment for infections of the pterygomandibular space, submasseteric space, and the three temporal spaces (superficial, infratemporal, and deep). Infections in these spaces can spread between adjacent spaces and present with symptoms like trismus, swelling, and pain. Treatment involves incision and drainage through intraoral, extraoral, or combined approaches depending on the specific infected space.
1) The document summarizes dental management considerations for patients with Down syndrome, fetal alcohol syndrome, and cerebral palsy. It describes the characteristic oral findings, clinical features, and etiology of each condition.
2) It provides guidance for treating such patients in dental offices, including moving at a slower pace, using sedation if needed, and prescribing adequate analgesia since patients may not express pain clearly.
3) The document also outlines specific oral health challenges faced by patients with each condition and suggestions for home care, such as using the smallest toothbrush for those with misaligned teeth.
This document provides an overview of cleft lip and palate, including:
- The incidence of cleft lip and palate is approximately 1 in 600 births worldwide. It is the second most common birth defect.
- The embryology of facial development and how failures in processes like fusion of the medial nasal processes can result in clefting.
- Cleft lip and palate have multifactorial etiology involving both genetic and environmental factors. Risk is increased with positive family history or exposure to teratogens.
- Classification systems have evolved over time but still categorize clefts as involving the lip, palate, or both, and as unilateral or bilateral. The Victor Veau system from 1931 remains influential
This document discusses Le Fort fractures and their management. It begins by describing the three areas that make up the facial skeleton: upper third, lower third, and middle third. It then provides detailed descriptions and classifications of Le Fort I, II, and III fractures based on the location and direction of the fracture lines. For each type of fracture, it outlines the characteristic signs, symptoms, and clinical features both externally and internally. It also discusses other midface fractures and dentoalveolar fractures. In summary, the document provides an in-depth overview of Le Fort fractures, including their anatomical basis, classification, and clinical presentation.
Natal and neonatal teeth refer to teeth that are present at birth or erupt within 30 days of birth. The incidence is estimated to be 1 in 1000 for natal teeth and 1 in 30,000 for neonatal teeth, with the majority being mandibular incisors. These premature teeth can cause issues with breastfeeding and tongue laceration. Radiographs are needed to assess root development and mobility. Teeth that are excessively mobile or interfering with breastfeeding should be removed to prevent aspiration risk and further trauma.
This document provides information on midfacial fractures, including the LeFort classifications. It describes:
1) The LeFort I, II, and III fracture patterns involving the maxilla and midface bones. LeFort I involves the maxilla, LeFort II separates the midface, and LeFort III separates the entire midface from the skull.
2) Clinical signs of each type include swelling, mobility of teeth, and malocclusion for LeFort I; moon face and raccoon eyes for LeFort II; and severe edema and flattening of the cheeks for LeFort III.
3) Treatment involves reducing and fixing the fractures, usually through closed or open reduction using manual manipulation or specialized instruments to re
Ectodermal dysplasias (EDs) are a group of inherited disorders that affect two or more ectodermal structures such as hair, teeth, nails, and sweat glands. They are caused by genetic defects that may be inherited or occur spontaneously. EDs are classified based on clinical phenotypes and affected structures. The most common types are hypohidrotic ED (affecting hair, teeth, nails and sweat glands) and hidrotic ED (affecting hair, teeth, and nails). Without proper care, ED patients can experience life-threatening hyperthermia, infections, and failure to thrive. Treatment focuses on managing symptoms and may involve dentures, skin care, eye protection, and environmental thermal
Crouzon Syndrome.
Primarily characterized by premature closure of the fibrous joints (cranial sutures) between certain bones in the skull (craniosynostosis) and distinctive facial abnormalities
Ankyloglossia a congenital oral anomaly Dr Medical
https://userupload.net/h9ig9byum706
Ankyloglossia, also known as tongue-tie, is a congenital oral anomaly that may decrease mobility of the tongue tip and is caused by an unusually short, thick lingual frenulum, a membrane connecting the underside of the tongue to the floor of the mouth. Ankyloglossia or tongue-tie is the result of a short, tight, lingual frenulum causing difficulty in speech articulation due to limitation in tongue movement. Ankyloglossia is a congenital condition in which a neonate is born with an abnormally short, thickened, or tight lingual frenulum that restricts mobility of the tongue. Ankyloglossia may be associated with other craniofacial abnormalities, but is also often an isolated anomaly.
Cleft Lip and Palate - Presentation.
Cleft Lip and Palate is the 2nd most common Congenital Anomaly after Clubfoot. This presentation goes in depth about the Presentation, eitiology, Genetics, Medical management, Nasoalveolar Moulding, Surgical management of Cleft Lip & Palate
This document discusses mandibular fractures, including:
- The anatomy and common sites of fracture in the mandible.
- Various classification systems used to describe fracture location and complexity.
- Clinical signs seen with mandibular fractures like swelling, step deformities, and malocclusion.
- Radiographic tools like panoramic x-rays, CT scans, and occlusal views used to diagnose and characterize fractures.
- Principles of managing mandibular fractures through techniques like open reduction and internal fixation.
Ludwig's angina is a serious neck infection that can compromise the airway. It involves the sublingual and submandibular spaces and spreads through connective tissue planes. The infection is usually polymicrobial, involving bacteria like Streptococcus and Staphylococcus. It commonly originates from an odontogenic infection. Symptoms include neck swelling, difficulty swallowing and breathing. Immediate priorities in treatment are airway protection through intubation or tracheostomy and IV antibiotics.
This document provides information on fractures of the maxilla bone. It begins with an introduction to the maxilla's anatomy and location. It then describes the different types of Le Fort fractures classified by Rene Le Fort in 1901, including Le Fort I (low maxillary), Le Fort II (pyramidal), and Le Fort III (craniofacial disjunction) fractures. For each type, it outlines the fracture pattern and key clinical features such as deformities, symptoms, and appropriate management approaches involving open reduction and fixation.
Mucoceles are benign cysts caused by mucus extravasation or retention from minor salivary glands. When located in the floor of the mouth, they are called ranulas. Ranulas present as smooth, blue, dome-shaped swellings that can enlarge and elevate the tongue. Treatment involves complete surgical excision of the cyst wall and sublingual gland to prevent recurrence, while preserving nearby nerves like the lingual nerve. Plunging ranulas extend behind the mylohyoid muscle into the neck.
This document discusses natal and neonatal teeth. Natal teeth are present at birth, while neonatal teeth erupt within the first month of life. They are uncommon anomalies that can lead to complications like feeding difficulties, trauma to the tongue, and premature eruption of other teeth. Management may involve smoothing sharp edges, protective dressings, or extraction if the tooth is loose or interfering with feeding. The exact causes are unknown but may involve genetic and environmental factors.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
This document discusses various craniofacial syndromes and deformities, their causes and characteristics. It describes Pierre Robin sequence, featuring micrognathia, glossoptosis and cleft palate. It also discusses Treacher Collins syndrome, characterized by mandibulofacial dysostosis due to defects of the first and second branchial arches. Several craniosynostosis syndromes are outlined, including Crouzon syndrome, Apert syndrome, Pfeiffer syndrome, and cloverleaf skull syndrome. Surgical treatments aim to decompress the brain, reshape the skull, and reconstruct midface and jaw deformities.
The document discusses several craniofacial anomalies including craniosynostosis. Craniosynostosis occurs when one or more of the fibrous sutures in the skull fuse prematurely, restricting skull growth. It can be primary, due to a defect in ossification, or secondary, due to inadequate brain growth. Primary craniosynostosis affects a single suture and causes specific head shapes like scaphocephaly or brachycephaly, while secondary craniosynostosis involves multiple sutures fusing. Treatment involves surgery to reshape the skull if increased intracranial pressure develops by age 2-4 months.
Cleft lip and palate are common birth defects that affect speech, hearing, breathing, and appearance. They require a team-based approach involving multiple specialists like otolaryngologists. The document discusses the management of cleft lip and palate, including the roles of different specialists in examining, diagnosing, and treating issues related to feeding, airway, speech, hearing, and surgery. Surgical techniques aim to restore normal anatomy and function through procedures on the lip and palate.
Treacher Collins Syndrome is a rare genetic disorder that affects the development of the facial structures. It is caused by mutations in genes that play roles in facial development. The syndrome is characterized by hypoplasia of the zygomatic bones, mandible, and other facial structures derived from the first and second branchial arches. Treatment involves a series of reconstructive surgeries throughout childhood to correct functional issues and reconstruct the facial structures. Surgical techniques discussed include mandibular distraction, zygomaticomaxillary bone grafting and distraction, and coloboma repair. Later orthognathic procedures may also be considered in selected adult patients.
Micrognathia is a condition where the jaw, most commonly the mandible, is severely deficient. There are two types - apparent micrognathia which is an illusion and true micrognathia where the jaw is actually small. True micrognathia can be congenital or acquired and is associated with other birth defects or injuries from forceps delivery or ankylosis. Clinical features include a retracted middle face, retruded chin, and steep mandibular angle with the jaw being too small to feed properly in infants. Management may involve orthognathic surgery.
This document discusses infections that can occur in the five masticatory spaces. It describes the boundaries, contents, causes, clinical features, and treatment for infections of the pterygomandibular space, submasseteric space, and the three temporal spaces (superficial, infratemporal, and deep). Infections in these spaces can spread between adjacent spaces and present with symptoms like trismus, swelling, and pain. Treatment involves incision and drainage through intraoral, extraoral, or combined approaches depending on the specific infected space.
1) The document summarizes dental management considerations for patients with Down syndrome, fetal alcohol syndrome, and cerebral palsy. It describes the characteristic oral findings, clinical features, and etiology of each condition.
2) It provides guidance for treating such patients in dental offices, including moving at a slower pace, using sedation if needed, and prescribing adequate analgesia since patients may not express pain clearly.
3) The document also outlines specific oral health challenges faced by patients with each condition and suggestions for home care, such as using the smallest toothbrush for those with misaligned teeth.
This document provides an overview of cleft lip and palate, including:
- The incidence of cleft lip and palate is approximately 1 in 600 births worldwide. It is the second most common birth defect.
- The embryology of facial development and how failures in processes like fusion of the medial nasal processes can result in clefting.
- Cleft lip and palate have multifactorial etiology involving both genetic and environmental factors. Risk is increased with positive family history or exposure to teratogens.
- Classification systems have evolved over time but still categorize clefts as involving the lip, palate, or both, and as unilateral or bilateral. The Victor Veau system from 1931 remains influential
This document discusses Le Fort fractures and their management. It begins by describing the three areas that make up the facial skeleton: upper third, lower third, and middle third. It then provides detailed descriptions and classifications of Le Fort I, II, and III fractures based on the location and direction of the fracture lines. For each type of fracture, it outlines the characteristic signs, symptoms, and clinical features both externally and internally. It also discusses other midface fractures and dentoalveolar fractures. In summary, the document provides an in-depth overview of Le Fort fractures, including their anatomical basis, classification, and clinical presentation.
Natal and neonatal teeth refer to teeth that are present at birth or erupt within 30 days of birth. The incidence is estimated to be 1 in 1000 for natal teeth and 1 in 30,000 for neonatal teeth, with the majority being mandibular incisors. These premature teeth can cause issues with breastfeeding and tongue laceration. Radiographs are needed to assess root development and mobility. Teeth that are excessively mobile or interfering with breastfeeding should be removed to prevent aspiration risk and further trauma.
This document provides information on midfacial fractures, including the LeFort classifications. It describes:
1) The LeFort I, II, and III fracture patterns involving the maxilla and midface bones. LeFort I involves the maxilla, LeFort II separates the midface, and LeFort III separates the entire midface from the skull.
2) Clinical signs of each type include swelling, mobility of teeth, and malocclusion for LeFort I; moon face and raccoon eyes for LeFort II; and severe edema and flattening of the cheeks for LeFort III.
3) Treatment involves reducing and fixing the fractures, usually through closed or open reduction using manual manipulation or specialized instruments to re
Ectodermal dysplasias (EDs) are a group of inherited disorders that affect two or more ectodermal structures such as hair, teeth, nails, and sweat glands. They are caused by genetic defects that may be inherited or occur spontaneously. EDs are classified based on clinical phenotypes and affected structures. The most common types are hypohidrotic ED (affecting hair, teeth, nails and sweat glands) and hidrotic ED (affecting hair, teeth, and nails). Without proper care, ED patients can experience life-threatening hyperthermia, infections, and failure to thrive. Treatment focuses on managing symptoms and may involve dentures, skin care, eye protection, and environmental thermal
Crouzon Syndrome.
Primarily characterized by premature closure of the fibrous joints (cranial sutures) between certain bones in the skull (craniosynostosis) and distinctive facial abnormalities
Ankyloglossia a congenital oral anomaly Dr Medical
https://userupload.net/h9ig9byum706
Ankyloglossia, also known as tongue-tie, is a congenital oral anomaly that may decrease mobility of the tongue tip and is caused by an unusually short, thick lingual frenulum, a membrane connecting the underside of the tongue to the floor of the mouth. Ankyloglossia or tongue-tie is the result of a short, tight, lingual frenulum causing difficulty in speech articulation due to limitation in tongue movement. Ankyloglossia is a congenital condition in which a neonate is born with an abnormally short, thickened, or tight lingual frenulum that restricts mobility of the tongue. Ankyloglossia may be associated with other craniofacial abnormalities, but is also often an isolated anomaly.
Cleft Lip and Palate - Presentation.
Cleft Lip and Palate is the 2nd most common Congenital Anomaly after Clubfoot. This presentation goes in depth about the Presentation, eitiology, Genetics, Medical management, Nasoalveolar Moulding, Surgical management of Cleft Lip & Palate
This document discusses mandibular fractures, including:
- The anatomy and common sites of fracture in the mandible.
- Various classification systems used to describe fracture location and complexity.
- Clinical signs seen with mandibular fractures like swelling, step deformities, and malocclusion.
- Radiographic tools like panoramic x-rays, CT scans, and occlusal views used to diagnose and characterize fractures.
- Principles of managing mandibular fractures through techniques like open reduction and internal fixation.
Ludwig's angina is a serious neck infection that can compromise the airway. It involves the sublingual and submandibular spaces and spreads through connective tissue planes. The infection is usually polymicrobial, involving bacteria like Streptococcus and Staphylococcus. It commonly originates from an odontogenic infection. Symptoms include neck swelling, difficulty swallowing and breathing. Immediate priorities in treatment are airway protection through intubation or tracheostomy and IV antibiotics.
This document provides information on fractures of the maxilla bone. It begins with an introduction to the maxilla's anatomy and location. It then describes the different types of Le Fort fractures classified by Rene Le Fort in 1901, including Le Fort I (low maxillary), Le Fort II (pyramidal), and Le Fort III (craniofacial disjunction) fractures. For each type, it outlines the fracture pattern and key clinical features such as deformities, symptoms, and appropriate management approaches involving open reduction and fixation.
Mucoceles are benign cysts caused by mucus extravasation or retention from minor salivary glands. When located in the floor of the mouth, they are called ranulas. Ranulas present as smooth, blue, dome-shaped swellings that can enlarge and elevate the tongue. Treatment involves complete surgical excision of the cyst wall and sublingual gland to prevent recurrence, while preserving nearby nerves like the lingual nerve. Plunging ranulas extend behind the mylohyoid muscle into the neck.
This document discusses natal and neonatal teeth. Natal teeth are present at birth, while neonatal teeth erupt within the first month of life. They are uncommon anomalies that can lead to complications like feeding difficulties, trauma to the tongue, and premature eruption of other teeth. Management may involve smoothing sharp edges, protective dressings, or extraction if the tooth is loose or interfering with feeding. The exact causes are unknown but may involve genetic and environmental factors.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
This document discusses various craniofacial syndromes and deformities, their causes and characteristics. It describes Pierre Robin sequence, featuring micrognathia, glossoptosis and cleft palate. It also discusses Treacher Collins syndrome, characterized by mandibulofacial dysostosis due to defects of the first and second branchial arches. Several craniosynostosis syndromes are outlined, including Crouzon syndrome, Apert syndrome, Pfeiffer syndrome, and cloverleaf skull syndrome. Surgical treatments aim to decompress the brain, reshape the skull, and reconstruct midface and jaw deformities.
Craniofacial syndromes /certified fixed orthodontic courses by Indian dental ...Indian dental academy
The document discusses various craniofacial syndromes and anomalies. It begins by introducing craniofacial anomalies and their significance. It then defines key terms like syndrome, anomaly, sequence, and association. It describes the four types of congenital anomalies: malformation, disruption, deformation, and dysplasia. It also discusses classifications of craniofacial syndromes and some specific syndromes associated with midfacial deficiencies like Apert syndrome, Crouzon syndrome, and Pfeiffer syndrome. It provides details on the etiology, clinical features, dental anomalies, and treatment of these conditions.
Preterm care involves respiratory management to maintain oxygen levels, thermoregulation through wrapping and warming, and careful skin care to prevent injury. Fluid and electrolyte needs require close monitoring due to immature renal function. Kangaroo mother care provides skin-to-skin contact and bonding. Consultations address neurodevelopment. Initial nutrition is colostrum or breast milk, adding fortifiers for preemies, and formula may be needed to meet caloric needs for growth.
This document provides information about cerebral palsy (CP), including:
1) CP is defined as a non-progressive disorder of movement, muscle tone, and posture due to a brain injury before age 5. It is often associated with developmental disabilities like intellectual disability, epilepsy, and sensory or speech problems.
2) CP is classified based on affected body parts (topographic), muscle tone physiology), and functional ability. Assessment involves evaluating health, neurological function, movement, cognition, vision/hearing, feeding, speech, orthopedic issues, and home situation.
3) Management is multidisciplinary, involving medical evaluation, physiotherapy to improve movement and prevent deformities, occupational therapy, play
National Guidelines and RecommendationsTim Smitley
This document discusses recommendations from various national organizations for the use of kangaroo care. It begins by reviewing the origins of kangaroo care and discusses how evidence of its benefits has led professional organizations to publish guidelines supporting its use. Some key recommendations mentioned include the WHO, AAP, CDC, and ACOG guidelines supporting kangaroo care for benefits like improved breastfeeding rates, decreased infant mortality and morbidity, and pain and stress reduction. The document then reviews studies demonstrating these benefits. It concludes by discussing how following kangaroo care guidelines can help institutions support parents and improve infant outcomes.
This document summarizes common infectious diseases among pediatric patients from a public health perspective using evidence-based methodology. It discusses major causes of childhood morbidity and mortality historically and currently in Saudi Arabia such as rotavirus, adenovirus, respiratory syncytial virus, influenza, and healthcare-associated infections. It also covers recent updates on management including vaccines, antibiotic practices, emerging pathogens like MERS, and infection control measures.
Fibroosseous lesions 8/certified fixed orthodontic courses by Indian dental a...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The document discusses maternal and child health, noting that maternal health refers to women ages 15-45, child health is for those under 15, and health encompasses physical, mental, and social well-being. It outlines the importance of antenatal care in detecting high-risk mothers, preventing complications, and educating on child care and family planning. The document also covers intra natal care which aims for asepsis during birth, minimal injury to mother and infant, and readiness to address complications while caring for the newborn.
Origin of malformations /certified fixed orthodontic courses by Indian dental...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
This presentation is done by Prof. Ahmed M. Adawy, Professor Emeritus, Dep. Oral & Maxillofacial Surg., Former Dean, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt.
The presentation is about the chapter of Temoromandibular Joint in Oral Surgery which includes definition, anatomy, diseases and its surgical treatment.
The document discusses internal derangement and temporomandibular joint (TMJ) disorders. Some key points:
1. Internal derangement describes a structural abnormality within the TMJ, specifically an abnormal positional relationship between the disc and articulating surfaces. Common symptoms include joint pain, clicking, and limited jaw movement.
2. Internal derangement is one of the most common TMJ pathologies. Studies show disc displacement in 30-50% of adolescents and adults.
3. Disc displacement can be with or without reduction, referring to whether the disc can reduce back to its normal position during opening.
4. Factors like trauma, overloading, laxity and muscle
This document discusses electrocardiograms (ECGs), including how to properly record and evaluate them and how to diagnose cardiac conditions with the help of ECGs along with clinical findings. It provides guidance on evaluating features of ECGs like rates, intervals, axes, and rhythms. It emphasizes that ECGs should not be used alone for diagnosis and must be considered together with a patient's clinical presentation and history. It also presents several case studies of pediatric cardiac patients and asks the reader to make a diagnosis based on the ECG and clinical findings provided.
El síndrome de Treacher Collins es una enfermedad genética rara causada por mutaciones en el gen TCOF1 que afecta el desarrollo de la cresta neural durante la embriogénesis y causa defectos en la mandíbula, pómulos y ojos, así como sordera. Se caracteriza principalmente por hipoplasia de los huesos cigomáticos y mandibulares, colobomas, pérdida de pestañas, paladar hendido y microtía.
This document discusses the anatomy and reduction techniques for temporomandibular joint (TMJ) dislocations. It begins with an overview of the anatomy of the TMJ, noting that it allows movement in multiple planes unlike a simple hinge joint. It then describes traditional techniques for reducing TMJ dislocations that involve manually manipulating the jaw from inside the mouth. The document goes on to describe a new "syringe technique" where a syringe is placed between the teeth and used as a rolling fulcrum by the patient to self-reduce the dislocation, which has been shown to be effective in over 30 patients without complications. This hands-free approach provides advantages over traditional techniques such as avoiding procedural sedation, analgesia
Treacher Collins Syndrome (TCS) is a rare genetic disorder characterized by deformities of the face, especially the jaws and cheeks. It is caused by mutations in the TCOF1 gene and is inherited in an autosomal dominant pattern. People with TCS often experience hearing loss, cleft palate, and psychological effects from the visible facial differences. While not fatal, it requires multiple corrective surgeries that can improve hearing and facial appearance but not provide a cure. Prenatal detection is possible in severe cases using ultrasound.
This document discusses the care of preterm babies. Key points include:
- Preterm babies are born before 37 weeks gestation and have low birth weight, immature organ systems, and are susceptible to complications.
- Care involves temperature regulation, appropriate feeding, monitoring for complications like respiratory distress and infections.
- Feeding may begin with intravenous fluids or a nasogastric tube and progress to breastfeeding. Nutritional needs for protein, carbohydrates, fats, vitamins and minerals must be met.
- Ongoing monitoring of vital signs and development is needed to detect any issues and provide appropriate treatment and care. Immunizations should also be given according to schedule.
The document discusses craniofacial anomalies such as clefts. It describes different types of craniofacial clefts including Tessier cleft classifications 0 through 11. For each classification, it provides details on the anatomical location of the cleft and associated soft tissue deformities. The document also discusses mechanisms, genetics, teratogens, and management considerations for various craniofacial anomalies.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Choanal atresia is a congenital condition where the posterior nasal openings are blocked or narrowed. It occurs due to a failure of rupture of the membrane separating the nasal cavity from the oral cavity during embryonic development. Clinically, it presents with nasal obstruction and discharge or cyclic cyanosis in infants. Diagnosis is confirmed with CT scan showing narrowing of the posterior nasal airway. Treatment involves surgical repair through a transnasal or transpalatal approach to reopen the nasal passage, with stenting sometimes needed. Recurrence of narrowing can occur.
This document discusses ultrasound evaluation of the fetal face and neck. It outlines normal sonographic anatomy and various craniofacial anomalies that can be detected prenatally, including facial clefts, orbital defects, micrognathia, macroglossia, tumors, and ear abnormalities. It also mentions craniosynostosis and neck anomalies like nuchal cystic hygroma that can be identified. The conclusion emphasizes that identifying facial or neck anomalies indicates the need for a full fetal exam to check for associated conditions, and that prognosis depends on severity and presence of syndromes or neurological defects. Advanced ultrasound is improving detection and preparation for neonatal care.
This document provides information on craniosynostosis, including:
1. It is a premature fusion of one or more cranial sutures, restricting skull growth.
2. Brain growth is rapid in early childhood, requiring open sutures for proper skull expansion.
3. Diagnosis involves clinical exam, imaging like CT/MRI to identify fused sutures.
4. Treatment is early surgery to release fused sutures and reconstruct the skull to allow for brain growth.
This document discusses the management of craniofacial syndromes and developmental anomalies. It begins by defining syndromes and anomalies, and describes how Ibn Sina pioneered the idea of classifying syndromes. It then discusses various craniofacial development stages and factors that can affect them, including teratogens, radiation, genes, and more. Finally, it outlines different syndromes and anomalies that occur at each development stage, and how orthodontists are involved in managing craniofacial disorders through diagnostic considerations, various treatment approaches, and understanding surgical correction methods.
chromosomal disorders of the human body.pptanyaloreto813
1. Chromosomal disorders are caused by structural or numerical abnormalities in human chromosomes that can result in genetic conditions.
2. Some examples of chromosomal disorders discussed in the document include Down syndrome, Turner syndrome, Klinefelter syndrome, and Cri-du-chat syndrome.
3. Chromosomal disorders are associated with intellectual disabilities and physical abnormalities that vary depending on which chromosome is involved in the abnormality.
This document discusses genetics and genetic disorders relevant to ENT. It begins with definitions of genetics terms and an overview of heredity and variation. The main types of genetic inheritance patterns - autosomal dominant, autosomal recessive, X-linked - are explained. Many genetic disorders that can cause hearing loss are described, including their inheritance patterns and characteristic features. The document also covers cytogenetic disorders involving extra or missing chromosomes, as well as newer areas of genetics research like gene therapy.
The document discusses congenital malformations, including:
- Types of congenital anomalies like major anomalies that interfere with normal functioning and minor anomalies that have only cosmetic significance.
- Causes of congenital anomalies which can be genetic like chromosomal or single gene defects, or non-genetic like drugs, infections, or maternal illness.
- Stages of normal morphogenesis and how abnormalities can occur if stages are incomplete, take an aberrant form, or functional defects develop. Timing of different malformations is outlined.
- Specific genetic syndromes are mentioned as causes for different malformation patterns. Deletion 22q11 syndrome is discussed in detail as a common microdeletion syndrome.
This document defines microcephaly and discusses its classification, etiology, pathogenesis, and diagnosis. Microcephaly is defined as an occipitofrontal circumference more than 3 standard deviations below the mean for age and gender. It can be classified as congenital or postnatal, genetic or environmental, symmetric or asymmetric, and isolated or syndromic. Causes include genetic conditions like primary microcephaly and chromosomal abnormalities, as well as congenital infections, metabolic disorders, and environmental factors. Neuroimaging can aid diagnosis by identifying brain abnormalities and calcifications.
Gorlin Goltz syndrome, also known as basal cell nevus syndrome, is a rare genetic disorder caused by a mutation in the PTCH gene. It is characterized by multiple basal cell carcinomas, odontogenic keratocysts of the jaws, skeletal abnormalities such as bifid ribs and calcification of the falx cerebri. The incidence varies from 1 in 57,000 to 1 in 256,000. Management requires a multidisciplinary team and focuses on complete surgical removal of odontogenic keratocysts, orthodontic treatment to preserve dental and facial structure, and genetic counseling due to its autosomal dominant inheritance.
Neural tube defects (NTDs) are birth defects of the brain and spinal cord that occur early in pregnancy. The most severe forms are anencephaly and rachischisis where the brain and spinal cord are exposed or absent. NTDs result from the failure of the neural tube to close properly during embryonic development. Risk factors include genetic factors and folic acid deficiency. Prenatal screening and ultrasound can detect NTDs. Treatment depends on the specific defect but may involve surgery after birth and lifelong management of complications such as hydrocephalus.
The document discusses various chromosomal abnormalities including numerical defects like Trisomy 21 which causes Down Syndrome, and structural defects. It provides details on several chromosomal disorders including Down Syndrome, Edwards Syndrome (Trisomy 18), Patau Syndrome (Trisomy 13), Turner Syndrome, and Klinefelter Syndrome. These disorders are caused by errors in chromosome number or structure and can result in physical and mental birth defects as well as developmental issues. The document outlines characteristics, symptoms, and prognosis of each condition.
This document discusses ultrasound evaluation of the fetal face and neck. It outlines normal fetal facial anatomy and various craniofacial anomalies that can be detected prenatally, including cleft lip and palate, orbital defects, micrognathia, and neck masses. It provides detailed descriptions of embryonic development and ultrasound images of normal and abnormal features. It emphasizes the importance of a complete fetal exam when abnormalities are found, as this may reveal associated anomalies or genetic syndromes. The prognosis depends on the severity and presence of other issues; advances in prenatal imaging aid neonatal care planning.
This document discusses congenital anomalies (structural abnormalities present at birth) including their causes, types, and examples. It notes that around 3% of liveborn infants have major anomalies, which can be genetic, environmental, or multifactorial in origin. During the first two weeks after conception, teratogens usually have no effect, but between weeks 3-8 (organogenesis period) they can cause major anomalies, and after week 9 functional abnormalities. Causes discussed include genetic factors, infections like rubella and toxoplasmosis, radiation, chemicals/drugs, maternal diseases, and nutritional deficiencies. The document provides examples of syndromes and specific anomalies affecting various body systems. Prevention emphasizes good prenatal care, iod
Sagittal craniosynostosis is the most common type, affecting 1 in 5000 live births. It results in an elongated, narrow skull shape called scaphocephaly. Bilateral coronal craniosynostosis causes brachycephaly, or an abnormally short and wide skull, while unilateral coronal craniosynostosis results in anterior plagiocephaly. Metopic craniosynostosis results in trigonocephaly, seen as a triangular skull shape from above. Common craniosynostosis syndromes include Crouzon syndrome, Apert syndrome, Pfeiffer syndrome, and Saethre-Chotzen syndrome. Anesthesia management focuses on potential airway issues and
Down syndrome, also known as Trisomy 21, is the most common chromosomal disorder and cause of intellectual disability. It occurs in approximately 1 in 700 live births. Clinically, it manifests as characteristic facial features, organ malformations, and mental disability. The majority of cases are caused by trisomy of chromosome 21, though some are due to translocations. Features include upward slanting eyes, a flat nasal bridge, small mouth, and single palm crease. Associated conditions include heart defects, gastrointestinal abnormalities, thyroid issues, and Alzheimer's disease. Diagnosis involves prenatal screening and testing as well as postnatal evaluation and treatment of conditions.
This document discusses several chromosomal abnormalities including Down syndrome, Turner syndrome, Patau syndrome, and Edwards syndrome. It provides details on the characteristics, causes, diagnosis and management of each condition. Down syndrome results from trisomy 21 and is associated with developmental delays, congenital heart defects, increased risk of leukemia and thyroid disorders. Turner syndrome occurs when one X chromosome is missing and affects growth and fertility in girls. Patau and Edwards syndromes are trisomies of chromosomes 13 and 18 respectively, often causing multiple physical abnormalities and intellectual disability. Prenatal screening and testing can help identify these conditions.
Radiographic Features of Developmental Anomalies in the Face and JawsHadi Munib
This document discusses several developmental anomalies of the face and jaws, including cleft lip and palate, Crouzon syndrome, hemifacial microsomia, and Treacher Collins syndrome. Cleft lip and palate are the most common craniofacial anomalies, resulting from a failure of fusion during fetal development. Crouzon syndrome is characterized by premature fusion of cranial sutures, resulting in a short skull and facial abnormalities. Hemifacial microsomia displays reduced growth on half of the face, while Treacher Collins syndrome involves underdevelopment of the zygomatic bones and mandible.
Opportunity for Dentists (BDS/MDS )to relocate to United kingdom -Register as a DENTAL HYGIENIST/ DENTAL THERAPIST without Board exams and after approval you can register in GDC as a DH/DT and start working as a DH/DT Immediately and get paid.
You can complete the whole process in 3-4 months.Salary range for DH/DT is around 2500-3500 Pounds per month.
Eligibility / requirements-
1. An International English Language Testing System (IELTS) certificate
at the appropriate level.(Within 2 yrs of application date )
2: A recent primary dental qualification that has been taught and examined in English..(Within 2 yrs of application date )
3: A recent pass in a language test for registration with a regulatory authority in a country where the first language is English.
If you are interested Please contact us for more details.
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...Indian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals
who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry,
Periodontics and General Dentistry.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
I –Aligners are made with FDA approved transparent thermoplastic materials using 3D scanning, 3D Printing and finally Trays with Pressure vacuum formers.
Dear Doctor,
Indian Dental Academy Now offers comprehensive online Orthodontics course.
Course includes:
1.whiteboard lecture presentations
2.Case Discussions
3.with hundreds of pictures.
4.Demo on Models
5.Demo on Patients
6. subtitles in your own language
12 months unlimited access and support @350 USD only.
For Demo please visit :www.idalectures.com/preview/
For more details visit: www.idalectures.com
Please contact us for any clarifications:
idalectures@gmail.com
indiandentalacademy@gmail.com
Thanks & Regards
Indian Dental Academy
--
Indian Dental Academy
Leader in continuing dental education
www.indiandentalacademy.com
skype:indiandentalacademy
+919248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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Diagnosis and treatment planning in completely endntulous arches/dental coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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Properties of Denture base materials /rotary endodontic coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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Use of modified tooth forms in complete denture occlusion / dental implant...Indian dental academy
This document discusses dental occlusion concepts and philosophies for complete dentures. It introduces key terms like physiologic occlusion and defines different occlusion schemes like balanced articulation and monoplane articulation. The document discusses advantages and disadvantages of using anatomic versus non-anatomic teeth for complete dentures. It also outlines requirements for maintaining denture stability, such as balanced occlusal contacts and control of horizontal forces. The goal of occlusion for complete dentures is to re-establish the homeostasis of the masticatory system disrupted by edentulism.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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This document discusses dental casting investment materials. It describes the three main types of investments - gypsum bonded, phosphate bonded, and ethyl silicate bonded investments. For gypsum bonded investments specifically, it details their classification, composition including the roles of gypsum, silica, and modifiers, setting time, normal and hygroscopic setting expansion, and thermal expansion. It provides information on how the properties of gypsum bonded investments are affected by their composition. The document serves as a comprehensive overview of dental casting investment materials.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Temple of Asclepius in Thrace. Excavation resultsKrassimira Luka
The temple and the sanctuary around were dedicated to Asklepios Zmidrenus. This name has been known since 1875 when an inscription dedicated to him was discovered in Rome. The inscription is dated in 227 AD and was left by soldiers originating from the city of Philippopolis (modern Plovdiv).
Strategies for Effective Upskilling is a presentation by Chinwendu Peace in a Your Skill Boost Masterclass organisation by the Excellence Foundation for South Sudan on 08th and 09th June 2024 from 1 PM to 3 PM on each day.
How to Make a Field Mandatory in Odoo 17Celine George
In Odoo, making a field required can be done through both Python code and XML views. When you set the required attribute to True in Python code, it makes the field required across all views where it's used. Conversely, when you set the required attribute in XML views, it makes the field required only in the context of that particular view.
Communicating effectively and consistently with students can help them feel at ease during their learning experience and provide the instructor with a communication trail to track the course's progress. This workshop will take you through constructing an engaging course container to facilitate effective communication.
Beyond Degrees - Empowering the Workforce in the Context of Skills-First.pptxEduSkills OECD
Iván Bornacelly, Policy Analyst at the OECD Centre for Skills, OECD, presents at the webinar 'Tackling job market gaps with a skills-first approach' on 12 June 2024
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
2. • More than 3,000 syndromes classified
• Optimal growth, development, and learning
requires early recognition and intervention
• Team Approach:
– Parents
– Pediatrician
– Otolaryngologist
– Cardiologist
– Nephrologist
– Geneticist
– Speech Therapist
– Teachers
– Others
The Sydromal
Child
www.indiandentalacademy.com
3. The Sydromal
Child
• History
– Parental factors (age)
– Consanguinity
– Abortions
– Teratogen exposure
– Medical Pedigree
www.indiandentalacademy.com
4. • Physical Exam
– Major and Minor Anomalies
• Airway
• Skull
• Ears
• Facial skeleton
– Comparison to Family Members
– Reference Material
The Sydromal
Child
www.indiandentalacademy.com
7. • Described by John Landon Down in
1866
• Etiology: nondisjuction mutation
resulting in Trisomy 21
• Prevalence 1:700
– Most common chromosomal anomaly
• Associated with Maternal age > 35
Down
Syndrome
www.indiandentalacademy.com
9. Down
Syndrome
Picture From: Kanamori G: Otolaryngologic Manifestations of Down Syndrome. Otolaryngol Clin
North Am 33(6), 2000.
www.indiandentalacademy.com
10. • Airway Concerns
– Due to midface hypoplasia, the
nasopharynx and oropharynx dimensions
are smaller
• Slight adenoid hypertrophy can cause upper
airway obstruction
– Congenital mild-moderate subglottic
narrowing not uncommon
• Post-extubation stridor
Down
Syndrome
www.indiandentalacademy.com
11. • Obstructive Sleep Apnea
– Prevalence 54-100% in DS patients
– Combination of anatomic and functional
mechanisms
• Midface hypoplasia, macroglossia, etc
• Hypotonia of pharyngeal muscles
Down
Syndrome
www.indiandentalacademy.com
12. • Obstructive Sleep Apnea
– Management:
• Polysomnography to confirm
• Medical interventions:
– CPAP
– Weight Loss
– Medications to stimulate respiratory drive
Down
Syndrome
www.indiandentalacademy.com
17. • First described by Shprintzen et al. in 1978
• Not uncommon
– Prevalence 1 in every 4,000 newborns
– 8% of all cleft palate patients
• Autosomal Dominant inheritance
– Hemizygous microdeletion shared with DiGeorge Sequence at
22q11.2 locus
• Features
– Cleft palate
– Congenital heart disease
– Characteristic facies
– Hypernasal speech
– Learning disablities
VCFS
www.indiandentalacademy.com
18. • Oropharyngeal Findings:
– Apparent cleft palate (10-35%)
– Submucous cleft (33%)
– Submucous cleft and velar paresis (33%)
– Tonsils small or aplastic (50%)
– Adenoids small or aplastic (85%)
– Malocclusion
– Hypernasal speech
VCFS
www.indiandentalacademy.com
19. • Airway Obstruction is common
– 50% of neonates with VCFS have OSA
– Adenotonsillectomy should be avoided if
not indicated
– Oral airway needed in urgent setting
– Cleft palate repair required
VCFS
www.indiandentalacademy.com
21. Nasal Findings:
• Prominent nasal root
• Large tip
• Pinched, hypoplastic alar
base
VCFS
Pictures From: Shprintzen RJ: Velocardiofacial Syndrome. Otolaryngol Clin North Am 33(6), 2000.
www.indiandentalacademy.com
22. • Ear findings
– Small auricles (48%)
– CHL secondary to serous effusions and
ETD (75%)
• PE tubes effective
– SNHL (8%)
• Amplification devices
VCFS
www.indiandentalacademy.com
23. • Cardiovascular Findings
– 75-80% with cardiac anomalies
– 10% of patients with VCFS die in early
infancy due to these anomalies
– VSD (65%)
– Right sided aortic arch (35%)
– Tetralogy of Fallot (20%)
– Aberrant subclavian artery (20%)
VCFS
www.indiandentalacademy.com
25. • Growth and mental retardation
• Flat affect and poor social interaction
with impulsive behavior
• Renal anomalies in 35%
• T cell dysfuction in 10% with
hypocalcemia
VCFS
www.indiandentalacademy.com
27. BORS
• First termed by Melnick et al in 1975
• 1 in every 40,000 births
• Autosomal dominant inheritance
– Isolated to 8q13.3 locus
• Characteristics:
– Branchial cleft cysts or fistulas
– Preauricular pits
– Malformed auricles
– Hearing loss
– Renal anomalies
www.indiandentalacademy.com
28. BORS
• Branchial cleft cysts and fistulas
– Present in 50-60% of cases
– Usually bilateral
– Found in lower third of neck
– Fistulas may connect to tonsillar fossa
• Facial nerve paralysis (10%)
• Aplasia or stenosis of lacrimal duct
(25%)
www.indiandentalacademy.com
29. BORS
• External ear anomalies
– Auricular malformation (30-60%) or
abnormal position
• Minor aberration of anatomy to severe microtia
– Helical or preauricular pits (70-80%)
• Middle ear anomalies
– Malformation and/or fixation of ossicles
– Abnormal size/structure of the tympanic
cavity
www.indiandentalacademy.com
30. BORS
Picture From: Gorlin et al: Syndromes of the Head and Neck. New York, Oxford University Press, 1990
www.indiandentalacademy.com
31. BORS
• Inner ear anomalies
(rare)
– Dilated vestibule and/or
endolymphatic duct/sac
– Bulbous internal auditory
canal
– Small semicircular canals
– Hypoplastic cochlea
• Mondini
Images From: Ceruti, S et al: Temporal Bone Anomalies in the Branchio-Oto-Renal Syndrome: Detailed ComputedTomographic
and Magnetic Resonance Imaging Findings. Otology & Neurotology 23, 2002.www.indiandentalacademy.com
33. BORS
• Renal anomalies (12-20%)
– Likely underreported when a disease
process not involved
– Renal agenesis or hypoplasia
– Structural anomalies of renal pelvis or
ureters
www.indiandentalacademy.com
34. BORS
• Diagnosis and Treatment
– History and Physical Examination
– Audiogram, CT temporal bones
– CT neck
– Renal Ultrasound, IVP
www.indiandentalacademy.com
35. BORS
• Diagnosis and Treatment
– Surgical excision of branchial cleft cyst,
sinus, or fistula
– Otoplasty
– Excision of pits
– Possible ossicular chain reconstruction
– Hearing aids
– Urology consultation for renal anomalies
www.indiandentalacademy.com
37. TCS
• First described by Thomson and Toynbee in
1846-7
– Later, essential components described by
Treacher Collins in 1960
• Autosomal dominant inheritance
– TCOF1, mapped to 5q32-33.1
• 60% are from new mutation
– Associated with increased paternal age
• Prevalence of 1 in 50,000
• a.k.a. Mandibulofacial dysostosis
www.indiandentalacademy.com
38. TCS
• Characteristics
– Likely due to abnormal migration of neural crest cells into
first and second branchial arch structures
– Usually bilateral and symmetric
– Malar and supraorbital hypoplasia
– Non-fused zygomatic arches
– Cleft palate in 35%
– Hypoplastic paranasal sinuses
– Downward slanting palpebral fissures
– Mandibular hypoplasia with increased angulation
– Coloboma of lower eyelid with absent cilia
– Malformed pinna
– Normal intelligence
www.indiandentalacademy.com
39. TCS
Picture From: Cummings, CW: Otolaryngology: Head and Neck Surgery. St Louis, Mosby, 1998
www.indiandentalacademy.com
40. TCS
• OP/Airway concerns
– Cleft palate
– Choanal atresia may be present
• Respiratory distress in newborn
• Oral airway, McGovern nipple
– Obstructive sleep apnea is the most common
airway dysfunction
• Mandibular hypoplasia results in retrodisplacement of
tongue into oropharynx
• Oral airway, tracheotomy
• Distraction osteogenesis vs. free fibular transfer
www.indiandentalacademy.com
41. TCS
• Otologic concerns
– Malpositioned auricles
– Malformed pinna
– EAC atresia
– Ossicular abnormalities
– Conductive hearing loss is common
• Hearing aids are effective
– Normal intelligence
www.indiandentalacademy.com
42. TCS
Picture From: Acosta, HL et al: Vertical Mesenchymal Distraction and Bilateral Free Fibula Transfer for Severe Treacher
Collins Syndrome. Plastic & Reconstructive Surgery, 113(4), 2004.www.indiandentalacademy.com
43. TCS
Picture From: Acosta, HL et al: Vertical Mesenchymal Distraction and Bilateral Free Fibula Transfer for Severe Treacher
Collins Syndrome. Plastic & Reconstructive Surgery, 113(4), 2004.www.indiandentalacademy.com
45. Apert and
Crouzon
• Belong to family of Craniosynostoses
• Apert Syndrome (Acrocephalosyndactyly)
– First described by Wheaton in 1894
– Apert further expanded in 1906
• Crouzon Syndrome (Craniofacial
Dysostosis)
– Described by Crouzon in 1912
• Autosomal dominant inheritance
– Most are sporadic in Apert Syndrome
– 1/3 are sporadic in Crouzon Sydrome
• Prevalence: 15 - 16 per 1,000,000
www.indiandentalacademy.com
46. Apert and
Crouzon
• Typical characteristics
– Craniosynostosis
• Coronal sutures fused at birth
• Larger than average head circumference at
birth
– Midfacial malformation and hypoplasia
– Shallow orbits with exophthalmos
– Apert Syndrome: symmetric syndactyly of
hands and feet
www.indiandentalacademy.com
47. Apert and
Crouzon
• Crouzon and Apert Syndromes facial
features
– Shallow orbits with exophthalmos
– Retruded midface with relative
prognathism
– Beaked nose
– Hypertelorism
– Downward slanting palpebral fissures
www.indiandentalacademy.com
48. Apert and
Crouzon
Wong, GB et al: Analysis of Fronto-orbital Advancement for Apert, Crouzon, Pfeiffer, and Saethre-Chotzen Syndromes.
Plast. Reconstr. Surg. 105: 2314-2323, 2000.www.indiandentalacademy.com
50. Apert and
Crouzon
• Otologic concerns
– CHL resulting from ETD
– Congenital fixation of stapes footplate in Apert syndrome
• Treatment
– Ventilation tubes
– Stapedectomy or OCR
• Fronto-Orbital advancement
– Brain growth and expansion of cranial vault, orbital depth
• Orthodontics
– Maxillary teeth abnormalities
– Crossbite
www.indiandentalacademy.com
51. Apert and
Crouzon
Picture From: Wong, GB et al: Analysis of Fronto-orbital Advancement for Apert, Crouzon, Pfeiffer, and Saethre-
Chotzen Syndromes. Plast. Reconstr. Surg. 105, 2000.
Fronto-Orbital Advancement Surgery
www.indiandentalacademy.com
52. Apert and
Crouzon
Picture From: Chang, J: Reconstruction of the Hand in Apert Syndrome: A Simplified Approach. Plast. Reconstr. Surg.
109: 465, 2002.
Syndactyly
reconstruction in
Apert Syndrome
www.indiandentalacademy.com
54. PRS
• Triad of micrognathia, glossoptosis and cleft
palate
– First described by St. Hilaire in 1822
– Pierre Robin first recognized the association of
micrognathia and glossoptosis in 1923
• Prevalence: 1 of every 8,500 newborns
– Syndromic 80%
• Treacher Collins Syndrome
• Velocardiofacial Syndrome
• Fetal Alcohol Syndrome
– Nonsyndromic 20%
www.indiandentalacademy.com
64. • Proposed by Pagon et al in 1981
• Incidence unknown
• Associated with paternal age > 34
• Head and Neck anomalies:
CHARGECHARGE
- ColobomaColoboma
- Choanal AtresiaChoanal Atresia
- External Ear AbnormalitiesExternal Ear Abnormalities
- Facial Nerve PalsyFacial Nerve Palsy
- LaryngomalaciaLaryngomalacia
- OSAOSA
- GERDGERD
- Mondini MalformationMondini Malformation
- Semicircular Canal HypoplasiaSemicircular Canal Hypoplasia
- Vocal Cord ParesisVocal Cord Paresis
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65. Coloboma
• Failure of fusion of
embryonic (choroidal)
fissure
– Optic nerve, inferior
nasal fundus, or
inferior iris may be
involved
• Redundant tissue of
upper or lower eyelid
lacking skin
appendages
CA
Picture from: Levin AV: Congenital Eye Abnormalities. Pediatr Clin North Am 50(1), 2003.
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66. Choanal Atresia
• Prevalence: 1/5000
to 1/8000
• Females/Males: 2/1
• Unilateral 65-75%
• 75% with Bilateral
have CHARGE, or
other syndromes
Picture from: Keller JL: Choanal Atresia, CHARGE association, and Congenital Nasal
Stenosis. Otolaryngol Clin North Am 33(6), 2000.
CHARGE
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67. • Neonates are obligate nasal breathers
• Mouth breathing is a learned
response, developed at 4-6 weeks
• Bilateral CA presents at birth with
respiratory distress and cyanosis,
relieved with crying
• Unilateral CA usually presents later in
life with chronic nasal discharge
CA
Choanal Atresia
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68. • Diagnosis:
– 6 French catheter
– Nasal endoscopy
– Bell of Stethoscope
– Mirror
• Radiology
– CT (preferred method)
CA
Choanal Atresia
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69. • Treatment:
– Unilateral CA does not require immediate
correction
• May be delayed until starting school
– Bilateral CA requires immediate interventions:
• Oral Airway
• McGovern Nipple
• Intubation
• Tracheostomy
CA
Choanal Atresia
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71. Bibliography
• Gorlin, RJ et al: Syndromes of the Head and Neck. New York, Oxford
University Press, 1990.
• Bluestone CD et al. Pediatric Otolaryngology. Philadelphia, Saunders, 2003.
• Chang, J: Reconstruction of the Hand in Apert Syndrome: A Simplified
Approach. Plast. Reconstr. Surg. 109, 2002.
• Wong, GB et al: Analysis of Fronto-orbital Advancement for Apert, Crouzon,
Pfeiffer, and Saethre-Chotzen Syndromes. Plast. Reconstr. Surg. 105, 2000.
• Acosta, HL et al: Vertical Mesenchymal Distraction and Bilateral Free Fibula
Transfer for Severe Treacher Collins Syndrome. Plastic & Reconstructive
Surgery, 113(4), 2004.
• Levin AV: Congenital Eye Abnormalities. Pediatr Clin North Am 50(1), 2003.
• Ceruti, S et al: Temporal Bone Anomalies in the Branchio-Oto-Renal
Syndrome: Detailed ComputedTomographic and Magnetic Resonance
Imaging Findings. Otology & Neurotology 23, 2002.
• Keller JL: Choanal Atresia, CHARGE association, and Congenital Nasal
Stenosis. Otolaryngol Clin North Am 33(6), 2000.
• Kanamori G: Otolaryngologic Manifestations of Down Syndrome. Otolaryngol
Clin North Am 33(6), 2000.
Shprintzen RJ. Velocardiofacial Syndrome. Otolaryngol Clin North Am 33(6),
2000.
• Weintraub AS: Neonatal Care of Infants with Head and Neck Anomalies.
Otolaryngol Clin North Am 33(6), 2000.www.indiandentalacademy.com