secondary impression / final impression in complete denture.
#prosthodontics
#prostho
BDS 4th year
Nischala Chaulagain
Nobel Medical College , Biratnagar
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
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.
The treatment of maxillary transverse deficiency in post-pubertal patients has been an area of disagreement among orthodontists. Much of the controversy is over the timing of when it is appropriate for these patients to be referred to an oral and maxillofacial surgeon for an adjunctive surgical procedure or whether traditional orthodontic mechanics should be attempted. The decision, therefore, by an orthodontist of when to refer a patient for surgery
appears to be an individual one. The question then becomes which of the three basic surgical procedures would be most appropriate for the patient. Specifically, consideration must be given to surgically assisted rapid palatal expansion, segmental LeFort I osteotomy, or mandibular midline osteotomy with constriction.
A brief presentation about the maxillofacial extra-oral defects, and the prosthesis used for the rehabilitation, as well as steps of fabrication.
Hossam Faisal - TA of Prosthodontics, Future University Egypt
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.
Rhinoplasty by Dr. Amit T. Suryawanshi, Oral Surgeon, Pune All Good Things
Hi. This is Dr. Amit T. Suryawanshi. Oral & Maxillofacial surgeon from Pune, India. I am here on slideshare.com to share some of my own presentations presented at various levels in the field of OMFS. Hope this would somehow be helpful to you making your presentations. All the best.
Impression for distal extension bases /certified fixed orthodontic courses b...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
00919248678078
secondary impression / final impression in complete denture.
#prosthodontics
#prostho
BDS 4th year
Nischala Chaulagain
Nobel Medical College , Biratnagar
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
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.
The treatment of maxillary transverse deficiency in post-pubertal patients has been an area of disagreement among orthodontists. Much of the controversy is over the timing of when it is appropriate for these patients to be referred to an oral and maxillofacial surgeon for an adjunctive surgical procedure or whether traditional orthodontic mechanics should be attempted. The decision, therefore, by an orthodontist of when to refer a patient for surgery
appears to be an individual one. The question then becomes which of the three basic surgical procedures would be most appropriate for the patient. Specifically, consideration must be given to surgically assisted rapid palatal expansion, segmental LeFort I osteotomy, or mandibular midline osteotomy with constriction.
A brief presentation about the maxillofacial extra-oral defects, and the prosthesis used for the rehabilitation, as well as steps of fabrication.
Hossam Faisal - TA of Prosthodontics, Future University Egypt
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.
Rhinoplasty by Dr. Amit T. Suryawanshi, Oral Surgeon, Pune All Good Things
Hi. This is Dr. Amit T. Suryawanshi. Oral & Maxillofacial surgeon from Pune, India. I am here on slideshare.com to share some of my own presentations presented at various levels in the field of OMFS. Hope this would somehow be helpful to you making your presentations. All the best.
Impression for distal extension bases /certified fixed orthodontic courses b...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
00919248678078
PREPROSTHETIC SURGERY: ROLE IN PREPARATION OF AN IDEAL FOUNDATION FOR COMPLET...Dr ARATI HOSKHANDE
The goal of preposthetic surgery is to modify the oral environment to render it free of disease and to make its form and possibly it’s function more compatible with the requirements of prosthesis.
what is kyphosis? what is thoracic kyphosis?
what is criteria to diagnose? what are differential diagnosis? what are types of kyphosis? what is management? what is physical therapy management of kyphosis?
Prevention and Treatment of Abused Tissue /cosmetic dentistry 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
www.indiandentalacademy.com
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
11. PHILOSOPHICAL
• WELL MOTIVATED
• REALIZE THEIR ROLE IN TREATMENT SUCCESS
• COOPERATIVE AND LEARNS TO ADJUST
• RATIONAL, SENSIBLE, CALM AND COMPOSED
12. EXACTING
• METHODICAL AND PRECISE
• REQUIRES DETAILED EXPLANATION
• MAY PROPOSE TREATMENT ALTERNATIVES
• MANAGEMENT:
• REQUIRE EXTRA CARE AND PATIENCE
• CAN BE GOOD PATIENT IF INTELLIGENT AND UNDERSTANDING
• LISTEN TO DEMANDS BUT NEVER GIVE IN
13. INDIFFERENT
• QUESTIONABLE PROGNOSIS
• LACKS MOTIVATION AND INTEREST
• TRIES TO FIND FAULTS IN TREATMENT AND BLAME THE DENTIST
• NEVER COOPERATE OR FOLLOW INSTRUCTIONS
• MANAGEMENT:
• DIFFICULT
• IDENTIFY BEFORE STARTING TREATMENT AND EDUCATE AND IMPROVE PATIENT INTEREST
• BEST TO POSTPONE TREATMENT
14. HYSTERICAL
• EASILY EXCITED
• HIGHLY APPREHENSIVE AND EMOTIONALLY UNSTABLE
• RARELY COOPERATIVE
• UNREALISTIC EXPECTATIONS
• MANAGEMENT:
• NEED A LOT OF TIME AND EFFORT
• PROFESSIONAL HELP MAYBE REQUIRED
• PROBLEMS ARE MAINLY SYSTEMIC
15. SKEPTICAL
• BAD EXPERIENCE FROM PREVIOUS TREATMENT
• OFTEN HAVE UNFAVOURABLE CONDITIONS LIKE SEVERELY RESORBED RIDGES AND POOR HEALTH
• MAY HAVE PSYCHOLOGICAL PROBLEMS
• MANAGEMENT:
• PSYCHOLOGICAL MANAGEMENT
• KINDNESS, CARE AND SYMPATHY SHOULD BE OFFERED
• REQUIRE MORE TIME AND ATTENTION
16. FACTORS FOR FAVORABLE ADAPTIVE RESPONSE
• TRUST AND CONFIDENCE IN DENTIST
• PREVIOUS FAVORABLE EXPERIENCE
• POSITIVE ATTITUDE
• REALISTIC EXPECTATIONS
• YOUTH AND GOOD GENERAL HEALTH
• WILLINGNESS TO COOPERATE
• GOOD LEARNING CAPACITY
17. FACTORS PRODUCING MALADAPTIVE RESPONSE
• LACK OF TRUST
• POOR COMMUNICATION
• PREVIOUS NEGATIVE EXPERIENCE
• UNREALISTIC EXPECTATION
• ANXIETY AND LOW TOLERANCE
• POOR HEALTH
• POOR MUSCLE COORDINATION
• POOR LEARNING ABILITY
• PSYCHOLOGICAL DISORDERS
21. INTRA ORAL EXAMINATION
• MUCOSA
• FRENAL ATTACHMENT AND VESTIBULAR DEPTH
• INFECTION
• Based on thickness
• Thin
• Thick
• Based of function
• Keratinized
• Lining
• Specialized
22. INTRA ORAL EXAMINATION
• RIDGE
• FORM
• SHAPE
• ANTERIOR RIDGE RELATIONSHIP
• POSTERIOR RIDGE RELATIONSHIP
• RIDGE PARALLELISM
• TUBEROSITY
• TORI
24. INTRA ORAL EXAMINATION
• TONGUE
• SIZE AND SHAPE
• POSITION
• MOBILITY
• MUCOSA
• SALIVA
• QUALITY
• QUANTITY
• Class I:
Normal size, development and function with enough teeth present
to maintain form
• Class II:
Teeth absent long enough to permit change in form and function
• Class III:
excessively large tongue due absence of teeth for extended period
of time
• Class i:
Tongue lies in the floor of mouth with tip forward and slightly below the
incisal edge
• Class ii:
Flat and broadened tongue with tip in the normal position
• Class III:
Tongue is retracted and depressed into the floor of the mouth with the tip
curled upward, downward or assimilated into the body
27. EXISTING TEETH
• INDICATIONS FOR RETENTION OF TEETH:
• USING TRADITIONAL DENTAL INTERVENTIONS—PERIODONTAL, RESTORATIVE, PROSTHODONTIC, AND
SURGICAL—THE HEALTH OF THE DENTITION MAY BE RESTORED
• THOSE TEETH THAT ARE REGARDED AS HAVING POOR OR DUBIOUS PROGNOSES MAY BE EXTRACTED WHILE
RETAINING OTHERS THAT OFFER A GOOD PROGNOSTIC OUTCOME
• SPECIFIC TEETH CAN BE SELECTED AS POTENTIAL ABUTMENTS FOR OVERDENTURE TREATMENT WITH OR
WITHOUT ADJUNCTIVE IMPLANT SUPPORT
28. EXISTING TEETH
• INDICATIONS FOR EXTRACTION OF TEETH:
• ADVANCED PERIODONTAL DISEASE WITH SEVERE BONE LOSS AROUND THE TEETH
• SEVERELY BROKEN-DOWN CROWNS WITH SUBGINGIVAL RESIDUAL TOOTH TISSUE THAT CANNOT BE
ADEQUATELY RESTORED
• FRACTURED ROOTS
• PERIAPICAL OR PERIODONTAL ABSCESSES THAT CANNOT BE SUCCESSFULLY TREATED
• UNFAVORABLY TIPPED OR INCLINED TEETH THAT POSE PROBLEMS FOR THEIR USE AS ABUTMENTS FOR FIXED OR
REMOVABLE PROSTHESES
• EXTRUDED OR TIPPED TEETH THAT INTERFERE WITH THE PROPER LOCATION OF THE OCCLUSAL PLANE AND ARE
NOT AMENABLE TO PROSTHODONTIC MODIFICATION.
34. MANAGING TRAUMATIZED TISSUES
• REST FOR THE DENTURE-SUPPORTING TISSUES CAN BE ACHIEVED BY REMOVAL OF THE DENTURES FROM
THE MOUTH FOR AN EXTENDED PERIOD
• ALLOW DEFORMED TISSUE OF THE RESIDUAL RIDGES TO RETURN TO NORMAL
35. MANAGING TRAUMATIZED TISSUES
• TISSUE ABUSE CAUSED BY IMPROPER OCCLUSION CAN BE CORRECTED BY
• WITHHOLDING THE FAULTY DENTURES FROM THE PATIENT
• ADJUSTING/CORRECTING THE OCCLUSION AND REFITTING THE DENTURE BY MEANS OF A TISSUE CONDITIONER
• SUBSTITUTING PROPERLY MADE DENTURES ONCE THE DENTURE-BEARING TISSUES HAVE RECOVERED
• DENTURE-BEARING TISSUES DEMONSTRATE MICROSCOPIC EVIDENCE OF INFLAMMATION, EVEN IF THEY APPEAR
CLINICALLY NORMAL
36. PRE-PROSTHETIC SURGICAL METHODS
OBJECTIVES
• CORRECTING CONDITIONS THAT PRECLUDE OPTIMAL PROSTHETIC FUNCTION
• LOCALIZED OR GENERALIZED HYPERPLASTIC REPLACEMENT OF RESORBED RIDGES
• EPULIS FISSURATUM
• PAPILLOMATOSIS
• UNFAVORABLY LOCATED FRENULAR ATTACHMENTS
• PENDULOUS MAXILLARY TUBEROSITIES
• BONY PROMINENCES, UNDERCUTS, AND RIDGES
• DISCREPANCIES IN JAW SIZE RELATIONSHIPS
• PRESSURE ON MENTAL FORAMEN
37. PRE-PROSTHETIC SURGICAL METHODS
OBJECTIVES
• ENLARGEMENT OF DENTURE-BEARING AREA
• VESTIBULOPLASTY
• RIDGE AUGMENTATION
• PROVISION FOR PLACING TOOTH ROOT ANALOGUES BY MEANS OF OSSEO-INTEGRATED DENTAL IMPLANTS
39. HYPERPLASTIC RIDGE, EPULIS FISSURATUM, AND PAPILLOMATOSIS
• MOBILE TISSUES THAT INTERFERE WITH OPTIMAL SEATING OF THE DENTURE, LOCALIZED ENLARGEMENT OF
PERIPHERAL TISSUES OR TISSUES THAT READILY HARBOR MICROORGANISMS ARE NOT CONDUCIVE TO FIRM,
HEALTHY FOUNDATIONS FOR COMPLETE DENTURES
• THESE TISSUES SHOULD BE RESTED, MASSAGED, OR TREATED WITH AN ANTIFUNGAL AGENT BEFORE THEIR
SURGICAL EXCISION
• CONSIDERABLE REDUCTION IN THE EDEMA, MAKING THE SURGICAL PROCEDURE SIMPLER AND LESS EXTENSIVE
40. FRENULAR ATTACHMENTS
• CLOSE TO THE CREST OF THE BONY RIDGE IT MAY BE DIFFICULT TO OBTAIN THE IDEAL EXTENSION
• UPPER LABIAL FRENUM IN PARTICULAR MAY BE COMPOSED OF A STRONG BAND OF FIBROUS CONNECTIVE
TISSUE
• FRENA OFTEN BECOME PROMINENT AS A RESULT OF REDUCTION OF THE RESIDUAL RIDGES
• FRENECTOMY CAN BE CARRIED OUT EITHER BEFORE PROSTHETIC TREATMENT IS BEGUN OR AT THE TIME OF
DENTURE INSERTION WHEN THE NEW PROSTHESIS CAN ACT AS A SURGICAL TEMPLATE
41. PENDULOUS MAXILLARY TUBEROSITIES
• OCCUR UNILATERALLY OR BILATERALLY
• MAY INTERFERE WITH DENTURE CONSTRUCTION
• SURGICAL EXCISION IS THE TREATMENT OF CHOICE
• CARE MUST BE USED TO AVOID OPENING INTO THE MAXILLARY SINUS
42. BONY PROMINENCES, UNDERCUTS, SPINY RIDGES, AND TORI
• MAY HAVE TO BE REMOVED TO AVOID PAINFUL DENTURE FLANGE IMPINGEMENT AND TO ACHIEVE A
BORDER SEAL
• MAXILLARY TORI ARE RARELY REMOVED BECAUSE SATISFACTORY DENTURES CAN BE MADE OVER MOST
OF THEM BY CAREFUL RELIEF
43. BONY PROMINENCES, UNDERCUTS, SPINY RIDGES, AND TORI
• INDICATIONS FOR THE REMOVAL OF MAXILLARY TORI
• AN EXTREMELY LARGE TORUS THAT FILLS THE PALATAL VAULT AND PREVENTS THE FORMATION OF AN
ADEQUATELY EXTENDED AND STABLE MAXILLARY DENTURE
• AN UNDERCUT TORUS THAT TRAPS FOOD DEBRIS, CAUSING A CHRONIC INFLAMMATORY CONDITION; SURGICAL
EXCISION IS NECESSARY TO CREATE OPTIMAL ORAL HYGIENE
• A TORUS THAT EXTENDS PAST THE JUNCTION OF THE HARD AND SOFT PALATES AND PREVENTS THE
DEVELOPMENT OF AN ADEQUATE POSTERIOR PALATAL SEAL
• A TORUS THAT CAUSES THE PATIENT CONCERN
44. BONY PROMINENCES, UNDERCUTS, SPINY RIDGES, AND TORI
• EXOSTOSES MAY OCCUR ON BOTH JAWS BUT ARE MORE FREQUENT ON THE BUCCAL SIDES OF THE
POSTERIOR MAXILLARY SEGMENTS
• GENIAL TUBERCLES ARE EXTREMELY PROMINENT AS A RESULT OF ADVANCED RIDGE REDUCTION
• GENIOGLOSSUS MUSCLE HAS A TENDENCY TO DISPLACE THE LOWER DENTURE
• IF THE MUCOSA OVER THE TUBERCLE CANNOT TOLERATE THE PRESSURE OR CONTACT OF THE DENTURE
FLANGE IN THIS AREA, THEN IT MAY HAVE TO BE REMOVED AND THE GENIOGLOSSUS MUSCLE DETACHED
45. PRESSURE ON MENTAL FORAMEN
• EXTREME BONE RESORPTION LEADING TO OPENING OF MENTAL FORAMEN NEAR OR DIRECTLY AT THE
CREST OF RIDGE
• MARGINS OF MENTAL FORAMEN EXTEND AND HAVE VERY SHARP EDGES, 2 TO 3 MM HIGHER THAN THE
SURROUNDING MANDIBULAR BONE
• PRESSURE FROM THE DENTURE ON THE MENTAL NERVE EXITING THE FORAMEN AND OVER THIS SHARP
BONY EDGE WILL CAUSE PAIN AND PARESTHESIA
• THE MOST SUITABLE WAY OF MANAGING THIS IS TO ADJUST THE DENTURE TO RELIEVE THE PRESSURE
46. RIDGE PARALLELISM
• LACK OF PARALLELISM MAY BE CAUSED BY FAILURE TO TRIM THE TUBEROSITY, JAW DEFECTS, UNEQUAL
RIDGE REDUCTION, OR ABNORMALITIES OF GROWTH AND DEVELOPMENT
• PARALLEL RIDGES DIRECT FORCES IN A WAY THAT TENDS TO SEAT THE DENTURES
48. VESTIBULOPLASTY AND RIDGE AUGMENTATION
• THE ANTERIOR PART OF THE BODY OF THE MANDIBLE IS THE SITE MOST FREQUENTLY INVOLVED WITH THE
LABIAL SULCUS VIRTUALLY OBLITERATED, AND THE MENTALIS MUSCLE ATTACHMENTS APPEARING TO
“MIGRATE” TO THE CREST OF THE RESIDUAL RIDGE
• RESULTS IN THE SETUP OF TEETH IN A MORE LINGUAL POSITION
• MYOPLASTY ACCOMPANIED BY SULCUS DEEPENING
49. CLASSIFICATIONS OF RESIDUAL RIDGE MORPHOLOGY
CLASS I: THIS CLASSIFICATION LEVEL DESCRIBES THE STAGE OF EDENTULISM THAT IS MOST APT TO BE
SUCCESSFULLY TREATED BY CONVENTIONAL PROSTHODONTIC TECHNIQUES WITH COMPLETE DENTURE
PROSTHESIS
• DEFINED BY:
• RESIDUAL BONE HEIGHT OF 21 MM OR GREATER MEASURED AT THE LEAST VERTICAL HEIGHT OF THE MANDIBLE
• CLASS I MAXILLOMANDIBULAR RELATIONSHIP
50. CLASSIFICATIONS OF RESIDUAL RIDGE MORPHOLOGY
CLASS II: THIS CLASSIFICATION LEVEL DISTINGUISHES ITSELF WITH THE NOTED CONTINUATION OF THE
PHYSICAL DEGRADATION OF THE DENTURE-SUPPORTING STRUCTURES AND IN ADDITION IS
CHARACTERIZED BY LOCALIZED SOFT TISSUE FACTORS AND PATIENT MANAGEMENT/LIFESTYLE
CONSIDERATIONS
• DEFINED BY:
• RESIDUAL BONE HEIGHT OF 16 TO 20 MM MEASURED AT THE LEAST VERTICAL HEIGHT OF THE MANDIBLE
• CLASS I MAXILLOMANDIBULAR RELATIONSHIP
• RESIDUAL RIDGE MORPHOLOGY THAT RESISTS HORIZONTAL AND VERTICAL MOVEMENT OF THE DENTURE BASE
51. CLASSIFICATIONS OF RESIDUAL RIDGE MORPHOLOGY
CLASS III: THIS CLASSIFICATION LEVEL IS CHARACTERIZED BY THE NEED FOR SURGICAL INTERVENTION
(IMPLANT THERAPY OR PRE-PROSTHETIC SURGERY) TO ALLOW FOR ADEQUATE PROSTHODONTIC FUNCTION
• DEFINED BY:
• RESIDUAL BONE HEIGHT OF 11 TO 15 MM MEASURED AT THE LEAST VERTICAL HEIGHT OF THE MANDIBLE
• CLASS I, II, AND III MAXILLOMANDIBULAR RELATIONSHIP
• RESIDUAL RIDGE MORPHOLOGY HAS MINIMUM INFLUENCE TO RESIST HORIZONTAL OR VERTICAL MOVEMENT OF
THE DENTURE BASE
• LOCATION OF MUSCLE ATTACHMENTS WITH MODERATE INFLUENCE ON DENTURE-BASE STABILITY AND
RETENTION
52. CLASSIFICATIONS OF RESIDUAL RIDGE MORPHOLOGY
CLASS IV: THIS CLASSIFICATION LEVEL DEPICTS THE MOST DEBILITATED EDENTULOUS CONDITION.
SURGICAL RECONSTRUCTION IS ALMOST ALWAYS INDICATED BUT CANNOT ALWAYS BE ACCOMPLISHED
BECAUSE OF THE PATIENT’S HEALTH, DESIRES, PAST DENTAL HISTORY, AND FINANCIAL CONSIDERATIONS
• DEFINED BY:
• RESIDUAL BONE HEIGHT OF LEAST VERTICAL HEIGHT OF THE MANDIBLE
• CLASS I, II, AND III MAXILLOMANDIBULAR RELATIONSHIPS
• RESIDUAL RIDGE OFFERS NO RESISTANCE TO HORIZONTAL OR VERTICAL MOVEMENT
• LOCATION OF MUSCLE ATTACHMENTS WITH SIGNIFICANT INFLUENCE ON DENTURE-BASE STABILITY AND
RETENTION
53. DISCREPANCIES IN JAW SIZE
• PATIENT WITH PROGNATHISM FREQUENTLY PLACES CONSIDERABLE STRESS AND UNFAVORABLE
LEVERAGES ON THE MAXILLARY BASAL SEAT UNDER A COMPLETE DENTURE
• MANDIBULAR OSTEOTOMY IN VERY CAREFULLY SELECTED CASES CAN CREATE A MORE FAVORABLE ARCH
ALIGNMENT AND ALSO IMPROVE THE APPEARANCE
54. REPLACEMENT OF TOOTH ROOTS WITH OSSEOINTEGRATED DENTAL
IMPLANTS
• DISSATISFACTION WITH TOOTH LOSS AND THE PROSTHESES USED TO
MANAGE EDENTULISM IS AS OLD AS DENTISTRY
• IMPLANT APPROACH IS FAR MORE PRACTICAL
• OUTCOME IS DETERMINED BY HOST BONE SITE AND ESTHETIC
CONSIDERATIONS AND ABOVE ALL A PROSTHODONTICALLY DRIVEN TEAM
APPROACH
History
Attitude
Systemic health
Cause of tooth loss
tmj
House classification of frenal attachment
Atwood classification of residual alveolar ridge
House classification of tongue size
Wright classification of tongue position
Unstimulated 0.2ml/min
Stimulated 1-2ml/min
Dentures can apply excessive forces to the supporting tissues because of poor fit or occlusal errors. These loads may be localized or generalized and can cause accelerated bone resorption, inflammation, and hyperplasia
can be readily achieved by removing the dentures for 48 to 72 hours before the impressions are made for the construction of new dentures