Adhesives in maxillofacial prosthesis /orthodontics courses in india


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Adhesives in maxillofacial prosthesis /orthodontics courses in india

  1. 1. ADHESIVES IN MAXILLOFACIAL PROSTHESIS INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.comn
  3. 3. TERMINOLOGIES:TERMINOLOGIES: www.indiandentalacademy.comn
  4. 4. Maxillofacial prosthetic adhesive:: A material used to adhere external prosthesis to skin and associated structures around the periphery of an external anatomic defect.(GPT-8) www.indiandentalacademy.comn
  5. 5. Adhesion: 1) The property of remaining in close proximity, as that resulting from the physical attraction of molecules to a molecular attraction existing between the surfaces of bodies in contact.(GPT-8) 2) The stable joining of parts to each other, which may occur abnormally. (GPT-8) www.indiandentalacademy.comn
  6. 6. www.indiandentalacademy.comn
  7. 7. Sensory RootSensory Root:: • from the cells of the semi lunar ganglion • which lies in the apex of the petrous part of the temporal bone. • On entering the pons, divide into upper and lower roots. • This lower root is sometimes named the spinal root of the nerve. www.indiandentalacademy.comn
  8. 8. BRANCHES OF TRIGEMINAL NERVEBRANCHES OF TRIGEMINAL NERVE • In Latin, tress means three,geminus means twins i.e.; three born together. •Trigeminal nerve has three main branches Ophthalmic Maxillary Mandibular www.indiandentalacademy.comn
  9. 9. The Ophthalmic Nerve:The Ophthalmic Nerve: • It is first division of the trigeminal. • It is a sensory nerve. • It is the smallest of the three divisions of the trigeminal. • It supplies branches to the cornea, ciliary body, iris,lacrimal gland ,conjunctiva, mucous membrane of the nasal cavity, skin of the eyelids, eyebrow, forehead, and nose. www.indiandentalacademy.comn
  10. 10. OriginOrigin:: •upper part of the semilunar ganglion. •a short, flattened band, about 2.5 cm. long. •passes below the oculomotor and trochlear nerves. •enters the orbit. www.indiandentalacademy.comn
  11. 11. Branches:Branches: • just before entering the orbit, through the superior orbital fissure, it divides into three branches Lacrimal Frontal Nasociliary www.indiandentalacademy.comn
  12. 12. TheThe Lacrimal NerveLacrimal Nerve •It is the smallest of the three branches •It passes forward in a separate tube of dura mater, and enters the orbit through the narrowest part of the superior orbital fissure •In the orbit it runs along the upper border of the Rectus lateralis •It enters the lacrimal gland and gives several filaments, which supply the gland and the conjunctiva. •Finally it pierces the orbital septum, and ends in the skin of the upper eyelidwww.indiandentalacademy.comn
  13. 13. TheThe Frontal NerveFrontal Nerve:: •It is the largest branch of the ophthalmic •It enters the orbit through the superior orbital fissure •Midway between the apex and base of the orbit it divides into two branches, Supratrochlear Supraorbital www.indiandentalacademy.comn
  14. 14. TheThe supratrochlear nervesupratrochlear nerve:: • The smallest branch of frontal nerve. • It escapes from the orbit through the supraorbital foramen. • It supplies the skin of the lower part of the forehead close to the middle line and sends filaments to the conjunctiva and skin of the upper eyelid. www.indiandentalacademy.comn
  15. 15. TheThe supraorbital nervesupraorbital nerve:: • Passes through the supraorbital foramen. • It then ascends upon the forehead, and ends in two branches, a medial and lateral. • supply the scalp till the lamdoid suture. www.indiandentalacademy.comn
  16. 16. TheThe Nasociliary NerveNasociliary Nerve:: • It is intermediate in size • It enters the orbit • It passes through the anterior ethmoidal foramen • Entering the cavity of the cranium, traverses a shallow groove on the lateral margin of the front part of the cribriform plate of the ethmoid bone, and runs down, through a slit at the side of the crista galli, into the nasal cavity • It supplies internal nasal branches and external nasal branch.www.indiandentalacademy.comn
  17. 17. BranchesBranches:: The nasociliary nerve gives off the following branches, viz.: long root of the ciliary ganglion. long ciliary nerves. ethmoidal nerves. www.indiandentalacademy.comn
  18. 18. The Maxillary NerveThe Maxillary Nerve:: •It is second division of the trigeminal •is a sensory nerve •It is intermediate, both in position and size, between the ophthalmic and mandibular www.indiandentalacademy.comn
  19. 19. OriginOrigin:: •It begins at the middle of the semilunar ganglion •As a flattened plexiform band •It leaves the skull through the foramen rotundum •Where it becomes more cylindrical in form, and firmer in texture www.indiandentalacademy.comn
  20. 20. CourseCourse:: • It then crosses the pterygopalatine fossa • enters the orbit through the inferior orbital fissure • it traverses the infraorbital groove and floor of the orbit • appears upon the face at the infraorbital foramenwww.indiandentalacademy.comn
  21. 21. BranchesBranches:: Cranium- Middle meningeal Pterygopalatine Fossa- Zygomatic. Sphenopalatine. Posterior superior alveolar. Infraorbital Canal- Anterior superior alveolar. Middle superior alveolar. Face- Inferior palpebral. External nasal. Superior labial. www.indiandentalacademy.comn
  22. 22. TheThe Middle Meningeal NerveMiddle Meningeal Nerve:: •Is given off from the maxillary nerve directly after its origin from the semilunar ganglion •supplies the dura mater www.indiandentalacademy.comn
  23. 23. TheThe Zygomatic NerveZygomatic Nerve:: Arises in the pterygopalatine fossa, enters the orbit by the inferior orbital fissure It divides into two branches, zygomaticotemporal zygomaticofacial. www.indiandentalacademy.comn
  24. 24. •passes along the inferolateral angle of the orbit. • It pierces the temporal fascia about 2cm above the zygomatic arch, to supply the skin of the temple. • It communicates with facial and auriculotemporal nerve. The zygomaticotemporal branch: www.indiandentalacademy.comn
  25. 25. The zygomaticofacial branch: •This nerve also traverses the inferolateral angle of the orbit and emerging on the face through a foramen in the zygomatic bone, perforating orbicularis occuli muscle. •It supplies the skin on the prominence of the cheek. www.indiandentalacademy.comn
  26. 26. The Sphenopalatine BranchesThe Sphenopalatine Branches:: •Two in number, descend to the sphenopalatine ganglion. •They also serve as important functional communication between the ganglion and maxillary nerve. •The branches of distribution of pterygopalatine nerves are divided into three groups • orbital, nasal and palatine www.indiandentalacademy.comn
  27. 27. TheThe Posterior Superior AlveolarPosterior Superior Alveolar BranchesBranches:: • Arise from the trunk of the nerve just before it enters the infraorbital groove. • They descend on the tuberosity of the maxilla. • Give off branches to the lining membrane of the maxillary sinus and three twigs to each molar tooth. www.indiandentalacademy.comn
  28. 28. TheThe Anterior Superior AlveolarAnterior Superior Alveolar BranchBranch:: •Is given off from the nerve just before its exit from the infraorbital foramen. •supply the incisor and canine teeth www.indiandentalacademy.comn
  29. 29. TheThe Middle Superior AlveolarMiddle Superior Alveolar BranchBranch:: • It is given off from the nerve in the posterior part of the infraorbital canal. • supply the two premolar teeth. www.indiandentalacademy.comn
  30. 30. TheThe External Nasal BranchesExternal Nasal Branches:: •Supply the skin of the side of the nose and the septum. www.indiandentalacademy.comn
  31. 31. TheThe Superior Labial BranchesSuperior Labial Branches:: •The largest and most numerous. •They are distributed to the skin of the upper lip, the mucous membrane of the mouth, and labial glands. www.indiandentalacademy.comn
  32. 32. The Mandibular NerveThe Mandibular Nerve:: •It is the largest of the three divisions •is made up of two roots a large, sensory root a small, motor root •motor root:unites with the sensory root, just after its exit through the foramen ovale. www.indiandentalacademy.comn
  33. 33. •Immediately beneath the base of the skull, the nerve gives off from its medial side a recurrent branch nervus spinosus and the nerve to the Pterygoideus internus. •It then divides into two trunks The anterior division The posterior division www.indiandentalacademy.comn
  34. 34. TheThe Nervus SpinosusNervus Spinosus •It enters the skull through the foramen spinosum. •It supplies the dura mater www.indiandentalacademy.comn
  35. 35. The Internal Pterygoid Nerve:The Internal Pterygoid Nerve: •The nerve to the Pterygoideus internus is a slender branch, which enters the deep surface of the muscle www.indiandentalacademy.comn
  36. 36. The anterior division:The anterior division: •branches are the Masseteric Deep temporal Buccinator and External pterygoid. www.indiandentalacademy.comn
  37. 37. The posterior division:The posterior division: branches are the Auriculotemporal Lingual and Inferior alveolar nerves. www.indiandentalacademy.comn
  38. 38. TheThe Auriculotemporal NerveAuriculotemporal Nerve:: •Orign: by two roots between which the middle meningeal artery ascends. •It runs backward beneath the Pterygoideus externus to the medial side of the neck of the mandible. •It then turns upward with the superficial temporal artery. •It ascends over the zygomatic arch, and divides into superficial temporal branches.www.indiandentalacademy.comn
  39. 39. BranchesBranches branches of distribution are: • Anterior auricular • External acoustic meatus • Articular branches • Parotid branches • Superficial temporal www.indiandentalacademy.comn
  40. 40. TheThe Lingual NerveLingual Nerve:: •It supplies the mucous membrane of the anterior two-thirds of the tongue. •It lies medial to and in front of the inferior alveolar nerve. •The lingual nerve along with chorda tympani crosses obliquely to the side of the tongue. •It finally runs across the duct of the submaxillary gland, and along the tongue to its tip, lying immediately beneath the mucous membrane. www.indiandentalacademy.comn
  41. 41. BranchesBranches supply the sublingual gland mucous membrane of The mouth The gums Anterior 2/3’rdof the tongue www.indiandentalacademy.comn
  42. 42. TheThe Inferior Alveolar Nerve:Inferior Alveolar Nerve: •It is the largest branch of the mandibular nerve •It then passes into mandibular foramen •It then passes forward as far as the mental foramen •It divides into two terminal branches incisive mental www.indiandentalacademy.comn
  43. 43. BranchesBranches · Mylohyoid · Dental · Incisive and · Mental. www.indiandentalacademy.comn
  44. 44. GanglionGanglion •Associated with the three divisions of the trigeminal nerve are four small ganglia. •The ciliary ganglion is connected with the ophthalmic nerve •sphenopalatine ganglion with the maxillary nerve •the otic and submaxillary ganglia with the mandibular nervewww.indiandentalacademy.comn
  45. 45. Testing of trigeminal nerve:Testing of trigeminal nerve: •Trigeminal nerve is tested for both motor and sensory functions •Motor branch supplies the muscles of mastication. www.indiandentalacademy.comn
  46. 46. www.indiandentalacademy.comn
  47. 47. Motor:Motor: •Another useful test of motor power is to carry out voluntary displacement of the jaw against the imposed resistance of the examiners hand •Like, place the thumb on the lower molar table with fingers externally about the body and ramus. •The patient is asked to move the jaw Forward Sideways Upward • His head is steadied by the other handwww.indiandentalacademy.comn
  48. 48. Sensory:Sensory: •Maxillary: •These tests are conducted with the patients eye closed. •Test tube filled with warm and cold fluid are pressed alternatively against the cheek. •Differences in response on the opposite sides of the face indicate increased or decreased sensitivity to temperature. •Differences in response to pinpricks on the opposite sides of the face indicate increased or decreased sensitivity to pain.www.indiandentalacademy.comn
  49. 49. •A variety of instruments are available as aids in sensory evaluation. •Graded von Frey hairs. •Two point esthesiometers •Calibrated thermal devices •Disc of sand paper •Stereognostic forms •Taste testing. www.indiandentalacademy.comn
  50. 50. Prosthodontic viewProsthodontic view www.indiandentalacademy.comn
  51. 51. MasseterMasseter •At the time of preliminary impression is made, while the compound on the borders of the impression tray in this region is still soft, considerable downward force should be exerted on the lower jaw by dentist. •Now the patient is attempting to counteract this downward pressure which will cause the masseter muscle to contract. •This forces the softened compound away from impingement in this region. www.indiandentalacademy.comn
  52. 52. •Thus the denture border can also be contoured to accommodate this action. If this is not done the muscle interaction will displace the mandibular denture and force it in an anterior direction www.indiandentalacademy.comn
  53. 53. Temporalis muscleTemporalis muscle  The action of this muscle is sometimes used as a test to determine whether the patient is closing in centric relation. www.indiandentalacademy.comn
  54. 54. The Facial NerveThe Facial Nerve (N. Facialis; Seventh Nerve)(N. Facialis; Seventh Nerve) www.indiandentalacademy.comn
  55. 55. Type:Type: The facial nerve mixed motor and sensory root www.indiandentalacademy.comn
  56. 56. Origin:Origin: motor root arises from a nucleus in lower pons. The sensory root arises from the genicular ganglion, in the facial canal. www.indiandentalacademy.comn
  57. 57. coursecourse •Entering the brain at the lower border of the pons. •sensory root pass into the substance of the medulla oblongata and end in the upper part of the terminal nucleus. •From the superficial attachments to the brain, the two roots of the facial nerve pass lateralward and forward to the internal acoustic meatus. www.indiandentalacademy.comn
  58. 58. •In the meatus the motor root lies in a groove on the upper and anterior surface of the acoustic nerve, the sensory root being placed between them. •At the bottom of the meatus, the facial nerve enters the facial canal, termination at the stylomastoid foramen •On emerging from the stylomastoid foramen, the facial nerve runs forward in the substance of the parotid gland, and divides behind the ramus of the mandible into branches www.indiandentalacademy.comn
  59. 59. Branches of Communication:Branches of Communication: •In the internal acoustic meatus- With the acoustic nerve •At the genicular ganglion- With the sphenopalatine ganglion by the greater petrosal nerve. - With the otic ganglion by a branch which joins the lesser petrosal. -With the sympathetic on the middle meningeal artery. •In the facial canal- With the auricular branch of the vagus. •At its exit from the stylomastoid foramen- With the glossopharyngeal, With the vagus, With the great auricular, With the auriculotemporal.www.indiandentalacademy.comn
  60. 60. • Behind the ear- With the lesser occipital. • On the face- With the trigeminal. • In the neck- With the cutaneous cervical. www.indiandentalacademy.comn
  61. 61. Branches of Distribution:Branches of Distribution: •The branches of distribution of the facial nerve may be thus arranged •With the facial canal- Nerve to the Stapedius muscle. Chorda tympani. •At its exit from the stylomastoid foramen- Posterior auricular. Digastric. Stylohyoid. •On the face- Temporal Zygomatic. Buccal. Mandibular. Cervicalwww.indiandentalacademy.comn
  62. 62. Testing of facial nerve:Testing of facial nerve: Affections of chorda tympani may be associated with failure of salivary flow to increase following application of lemon juice or citric acid to the affected side of mouth. www.indiandentalacademy.comn
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  64. 64. www.indiandentalacademy.comn
  65. 65. • Ask the patient to ‘mimic’ the muscles of facial expression. like  wrinkle the forehead  Frown  Close the eyelids tightly  Wink  Open the mouth  Retract the mouth  Blow out the cheeks  Pucker the lips  Screw up the nose  Whistle  Speakwww.indiandentalacademy.comn
  66. 66. www.indiandentalacademy.comn
  67. 67. Thank you For more details please visit www.indiandentalacademy.comn