1. The document describes the surgical repair of a large palatal fistula in a 7-year-old girl using an anteriorly based tongue flap.
2. An anteriorly based tongue flap was designed to match the size of the roughly quadrangular shaped palatal fistula measuring approximately 3 cm on each side.
3. The tongue flap was sutured to the edges of the defect and the donor site was closed. Follow up revealed no nasal regurgitation and mild speech improvement without complications.
This case report describes the use of tongue flaps to close anterior palatal fistulas in several patients with a history of cleft lip and palate surgery. Anteriorly based tongue flaps were used to close fistulas ranging in size. The tongue flap procedure involves elevating a portion of the dorsal tongue and closing the donor site, then using the tongue flap to cover the palatal defect. Patients recovered well with no speech or swallowing issues. The report concludes that the tongue flap is a reliable option for closing complicated palatal fistulas due to the tongue's good blood supply and ability to provide ample tissue.
This case report describes the successful closure of a recurrent giant palatal fistula measuring 2.5 cm x 2.5 cm in a 4-year old child using a posteriorly based tongue flap. The fistula had previously been unsuccessfully repaired three times at other centers using local flaps. The surgical technique involved raising a posteriorly based tongue flap of adequate size and carefully suturing it into the defect. The pedicle was divided three weeks later. The fistula was successfully closed with this technique and the child was put on speech therapy. Tongue flaps are an excellent option for closing large or recurrent palatal fistulas when other techniques have failed.
This document discusses pulpectomy procedures for primary teeth. It begins with an overview of pulp treatment modalities and definitions of pulpectomy. It then covers the brief history of pulpectomy, case selection criteria, indications and contraindications. The document discusses access cavity preparation, working length determination, cleaning and shaping of root canals, and obturation materials and techniques. It also addresses special considerations for pulpectomy in patients with medical conditions like hemophilia and leukemia.
This document discusses young permanent teeth and their characteristics compared to mature teeth. It notes that young permanent teeth are those that have recently erupted and have not completed root development and closure of the apical foramen. The root development process can take 2-3 years after eruption. These young teeth are still developing and possess stem cells that can aid in continued root development. Factors like deep caries or trauma can lead to pulp necrosis in an immature tooth and result in an open apex. The document also discusses various classifications and stages of root development in young permanent teeth.
This document discusses the acoustic characteristics of speech for individuals who have undergone a glossectomy or partial removal of the tongue. It notes that a glossectomy is commonly performed to treat tongue cancer. For a patient who underwent a right hemiglossectomy, an articulation test in Hindi revealed distortions of affricates, fricatives, and dental/retroflex stops, with poor intelligibility. Acoustic analysis found deviated pitch, intensity, and noise parameters in the voice, as well as deviated average formant values, due to changes in oral cavity volume from the surgery. Rehabilitation of swallowing and speech therapy are important for socialization following a glossectomy.
Endodontics deals with diseases of the dental pulp, which is made of loose connective tissue inside the root canals. The number of canals correlates to the number of tooth roots. The pulp provides nutrients, sensation, and forms secondary dentin for protection. Accessory canals can branch off from the main canal. Proper access cavity preparation is important to allow straight-line access to the canals and apical foramen. Irrigation serves to lubricate, dissolve pulp, wash out debris, and disinfect canals using solutions like sodium hypochlorite and EDTA. New technologies like EndoVac and EndoActivator improve irrigation.
Hi, I am Dr Komal Ghiya, pediatric dentist, I am here to upload my own presentations for educational purposes. I hope this presentation will help you in knowing more about pulpectomy in primary teeth
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 case report describes the use of tongue flaps to close anterior palatal fistulas in several patients with a history of cleft lip and palate surgery. Anteriorly based tongue flaps were used to close fistulas ranging in size. The tongue flap procedure involves elevating a portion of the dorsal tongue and closing the donor site, then using the tongue flap to cover the palatal defect. Patients recovered well with no speech or swallowing issues. The report concludes that the tongue flap is a reliable option for closing complicated palatal fistulas due to the tongue's good blood supply and ability to provide ample tissue.
This case report describes the successful closure of a recurrent giant palatal fistula measuring 2.5 cm x 2.5 cm in a 4-year old child using a posteriorly based tongue flap. The fistula had previously been unsuccessfully repaired three times at other centers using local flaps. The surgical technique involved raising a posteriorly based tongue flap of adequate size and carefully suturing it into the defect. The pedicle was divided three weeks later. The fistula was successfully closed with this technique and the child was put on speech therapy. Tongue flaps are an excellent option for closing large or recurrent palatal fistulas when other techniques have failed.
This document discusses pulpectomy procedures for primary teeth. It begins with an overview of pulp treatment modalities and definitions of pulpectomy. It then covers the brief history of pulpectomy, case selection criteria, indications and contraindications. The document discusses access cavity preparation, working length determination, cleaning and shaping of root canals, and obturation materials and techniques. It also addresses special considerations for pulpectomy in patients with medical conditions like hemophilia and leukemia.
This document discusses young permanent teeth and their characteristics compared to mature teeth. It notes that young permanent teeth are those that have recently erupted and have not completed root development and closure of the apical foramen. The root development process can take 2-3 years after eruption. These young teeth are still developing and possess stem cells that can aid in continued root development. Factors like deep caries or trauma can lead to pulp necrosis in an immature tooth and result in an open apex. The document also discusses various classifications and stages of root development in young permanent teeth.
This document discusses the acoustic characteristics of speech for individuals who have undergone a glossectomy or partial removal of the tongue. It notes that a glossectomy is commonly performed to treat tongue cancer. For a patient who underwent a right hemiglossectomy, an articulation test in Hindi revealed distortions of affricates, fricatives, and dental/retroflex stops, with poor intelligibility. Acoustic analysis found deviated pitch, intensity, and noise parameters in the voice, as well as deviated average formant values, due to changes in oral cavity volume from the surgery. Rehabilitation of swallowing and speech therapy are important for socialization following a glossectomy.
Endodontics deals with diseases of the dental pulp, which is made of loose connective tissue inside the root canals. The number of canals correlates to the number of tooth roots. The pulp provides nutrients, sensation, and forms secondary dentin for protection. Accessory canals can branch off from the main canal. Proper access cavity preparation is important to allow straight-line access to the canals and apical foramen. Irrigation serves to lubricate, dissolve pulp, wash out debris, and disinfect canals using solutions like sodium hypochlorite and EDTA. New technologies like EndoVac and EndoActivator improve irrigation.
Hi, I am Dr Komal Ghiya, pediatric dentist, I am here to upload my own presentations for educational purposes. I hope this presentation will help you in knowing more about pulpectomy in primary teeth
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 discusses the management of deep carious lesions. It begins by defining deep carious lesions as those that penetrate deeply into the dentin, potentially involving over half of the dentin thickness. It then covers the response of the pulpo-dentinal complex at different stages of carious lesion progression. This includes the cellular changes that occur as caries advances through enamel and into dentin. The document also discusses arrested caries, histopathology of carious dentin, effective depth of remaining dentin and its impact on pulpal response, prognosis of deep lesions, reparability of the pulpo-dentinal complex, and various treatment modalities including indirect pulp capping and stepwise excavation.
The document summarizes the anatomy and structures of the gingiva. It describes the marginal gingiva, gingival sulcus, attached gingiva, interdental gingiva, and mucogingival junction. It discusses the functions of the gingiva in protecting tissues, obtaining shape with tooth eruption, and resisting forces. The document also examines age-related changes to the gingiva and studies on the width of attached gingiva needed for periodontal health.
This document outlines the management of incomplete root formation in vital teeth. It discusses the embryology of tooth development, factors that can influence root development, and the goal of apexogenesis to promote continued root development and closure of the apex. Three techniques for apexogenesis are described: indirect pulp capping, direct pulp capping, and pulpotomy. For each technique, the definition, goals, indications, contraindications, materials used, and procedure are explained. Calcium hydroxide and MTA are highlighted as common medicaments used. Successful outcomes of apexogenesis include continued root development, a calcified barrier over the radicular pulp, and maintenance of pulp vitality and normal responses to testing.
This document reviews periodontic-endodontic lesions that originate from infections of the periodontium or dental pulp. Pulpal infections can spread to the periodontium through lateral and accessory canals, causing retrograde peri-odontitis. Conversely, periodontal disease can spread to the pulp through these same pathways. The diagnosis of whether a lesion originated from the periodontium or pulp can be difficult, as the clinical and radiographic features may be similar. Determining pulp vitality is important for differential diagnosis and treatment planning.
Non-vital pulp therapy in primary teeth involves removing infected or necrotic pulp tissue from the root canal through a procedure called pulpectomy. Pulpectomy can be partial, removing pulp from the crown only, or complete, removing all pulp tissue. It can be done in one or multiple visits. Sodium hypochlorite and chlorhexidine are common irrigants used to disinfect canals, along with EDTA or other chelators. The goal of pulpectomy is to eliminate infection while retaining the tooth until natural exfoliation, without harming the permanent successor tooth.
This document discusses presurgical nasoalveolar molding (PNAM) for treating cleft lip and palate. PNAM involves using custom acrylic plates to gently reshape the gums, lips, and nostrils before surgery. This lessens the severity of the cleft and reduces the need for multiple follow-up surgeries. The document provides a brief history of PNAM and reviews several studies showing benefits such as improved nasal symmetry and reduced need for bone grafting. PNAM takes advantage of cartilage flexibility in newborns to externally reshape nasal structures through controlled forces on plates over time.
Apexogenesis apexification and revascularizationsanakhalid52
This document discusses apexogenesis, apexification, and revascularization procedures for immature permanent teeth. Apexogenesis aims to encourage continued root development by maintaining pulp vitality. It is used for teeth with damaged coronal pulp but healthy root pulp. Apexification induces a calcific barrier at an open apex in pulpless immature teeth using calcium hydroxide or MTA. Revascularization aims to regenerate pulp-like tissue by inducing bleeding into the root canal and using a blood clot and scaffold. It is used for teeth with necrotic pulp and an immature apex. The procedures involve disinfection, medication placement, and temporary fillings, with calcium hydroxide or MTA used to encourage apex closure
Lecture 8 management of patients with orofacial cleftsLama K Banna
Maxillofacial Surgery
Dental Students Fifth Year First semester
Lecture Name management of patients with orofacial clefts
Lecture 8
Al Azhar University Gaza Palestine
Dr. Lama El Banna
Non-Surgical Repair of A Perforation Defect-A Case ReportQUESTJOURNAL
ABSTRACT: Iatrogenic root perforations, which may have serious implications, occur in approximately 2- 12% of endodontically treated teeth. Root perforation repair has historically been an unpredictable treatment modality, with an unacceptably high rate of clinical failure. Successful management of root perforations is dependent on early diagnosis of the defect, location of the perforation, choice of treatment, materials used, host response, and the experience of the practitioner. This case report presents the successful management of a nonsurgical iatrogenic perforation repair
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.
MAZEN DOUMANI Access cavity and morphologymazen doumani
This document discusses tooth morphology and root canal anatomy. It describes the components of the root canal system and various pulp canal configurations that can occur. It provides guidelines for access cavity preparation, including objectives, evaluation of tooth anatomy, use of magnification and burs, orifice location and flaring. Morphology and specific preparation techniques are outlined for individual tooth types from anterior to posterior in both arches. Care must be taken during access preparation to locate all canals and avoid perforations.
management of non vital open apex roots/ orthodontic course by indian dental...Indian dental academy
This document discusses the management of non-vital teeth with open or incomplete root development. It defines various terms like apexogenesis, apexification, and maturogenesis. It describes the stages of root development and causes of open apices. For diagnosis and treatment, apexogenesis aims to encourage continued root development by removing inflamed pulp and placing calcium hydroxide. Apexification induces a calcified barrier in a tooth with a non-vital open apex. Maturogenesis allows continued deposition of dentin throughout the root for increased strength.
Young permanent teeth have incompletely formed roots and differ from permanent teeth in their pulp chamber anatomy, pulp size, and dentin thickness. Their roots are longer and more slender compared to primary teeth. Indirect pulp capping involves applying a medicament over remaining dentin after deep caries removal without exposure. Direct pulp capping places a biocompatible material over an inadvertent exposure to seal the pulp. Pulpotomy removes coronal pulp tissue to preserve radicular vitality, while pulpectomy removes necrotic pulp and obturates canals to maintain an infection-free tooth.
This document summarizes a seminar on non-vital pulp therapy procedures presented by Ram Kumar Sharma and guided by Dr. Meghna Singh. It defines a non-vital tooth as one with a completely necrosed pulp containing no living cells. Key non-vital pulp therapy procedures discussed include pulpectomy (root canal therapy), apexogenesis to encourage continued root development, and apexification to induce root-end closure in an incompletely formed tooth. Various root canal filling materials are also summarized such as zinc oxide eugenol, Vitapex, and KRI paste.
This document provides information about ill-fitting denture induced lesions. It discusses the purpose of the presentation which is to describe the etiology, clinical features, management, and differential diagnosis of various denture induced lesions. It then covers various specific lesions in detail, including traumatic ulcer, cheek bite, inflammatory hyperplasia, fibrous papillary hyperplasia, chronic atrophic candidiasis (denture stomatitis), contact allergy, malignancy, angular cheilitis, and palatal perforation. For each lesion, it discusses causes, clinical features, and management.
This document discusses the frenum attachment in the oral cavity, its development and variations. It describes different types of frenum attachments and associated syndromes like Ehlers-Danlos syndrome. Complications of an abnormal frenum like gingival recession and difficulty brushing are mentioned. Treatment techniques for abnormal frenum like frenectomy and frenotomy using conventional, Z-plasty, and laser methods are summarized. Post-operative instructions are provided.
1) The document reports on a case study examining the effects of a third ventricle lesion with obstructive hydrocephalus on cognitive, linguistic, and speech skills both before and after surgery.
2) Pre-surgery assessments found deficits in memory, fluency, reading, writing and speech intelligibility. Post-surgery, oro-motor skills and cranial nerve function improved, but cognitive and memory skills did not, though some language tasks did relatively.
3) The study concludes that while surgery improved some speech and language abilities, deviations remained, demonstrating the need for further therapy and rehabilitation to fully address impairments from third ventricle lesions.
Non Surgical Root Canal Treatment of Calcified CanalZiad Abdul Majid
This case report is presented to illustrate the successful non - surgical management of canal calcification in a maxillary first premolar in a 17 years old female.
Published By the International Journal of Health and Dental Sciences, Second Volume 2015.
This case report describes the frenectomy procedure performed on a 16-year-old female patient with posterior ankyloglossia (tongue-tie). The patient complained of difficulty with speech articulation since birth. Examination revealed a short, thick fibrous cord posterior to the tongue, limiting its movement. The patient underwent frenectomy with muscle dissection under local anesthesia. The frenulum was excised, leaving a diamond-shaped wound. Post-procedure, the patient's speech improved and she was referred to speech therapy. The report discusses ankyloglossia assessment tools and management, noting frenectomy can improve speech in many patients.
1. The document discusses frenal attachments, which are vertical bands of oral mucosa that attach the lips and cheeks to the alveolar ridges. Abnormal frenal attachments can cause issues like diastemas between teeth or limit toothbrush access.
2. There are different classifications of frenal attachments based on their location of insertion. Treatment of abnormal attachments may involve frenectomy or frenotomy procedures to remove or relocate the frenal tissue.
3. Surgical techniques for treating abnormal frenal attachments include conventional frenectomy, Miller's technique, Z-plasty, and V-Y plasty. Nonsurgical options like electrosurgery or laser frenectomy are also discussed
This document discusses the management of deep carious lesions. It begins by defining deep carious lesions as those that penetrate deeply into the dentin, potentially involving over half of the dentin thickness. It then covers the response of the pulpo-dentinal complex at different stages of carious lesion progression. This includes the cellular changes that occur as caries advances through enamel and into dentin. The document also discusses arrested caries, histopathology of carious dentin, effective depth of remaining dentin and its impact on pulpal response, prognosis of deep lesions, reparability of the pulpo-dentinal complex, and various treatment modalities including indirect pulp capping and stepwise excavation.
The document summarizes the anatomy and structures of the gingiva. It describes the marginal gingiva, gingival sulcus, attached gingiva, interdental gingiva, and mucogingival junction. It discusses the functions of the gingiva in protecting tissues, obtaining shape with tooth eruption, and resisting forces. The document also examines age-related changes to the gingiva and studies on the width of attached gingiva needed for periodontal health.
This document outlines the management of incomplete root formation in vital teeth. It discusses the embryology of tooth development, factors that can influence root development, and the goal of apexogenesis to promote continued root development and closure of the apex. Three techniques for apexogenesis are described: indirect pulp capping, direct pulp capping, and pulpotomy. For each technique, the definition, goals, indications, contraindications, materials used, and procedure are explained. Calcium hydroxide and MTA are highlighted as common medicaments used. Successful outcomes of apexogenesis include continued root development, a calcified barrier over the radicular pulp, and maintenance of pulp vitality and normal responses to testing.
This document reviews periodontic-endodontic lesions that originate from infections of the periodontium or dental pulp. Pulpal infections can spread to the periodontium through lateral and accessory canals, causing retrograde peri-odontitis. Conversely, periodontal disease can spread to the pulp through these same pathways. The diagnosis of whether a lesion originated from the periodontium or pulp can be difficult, as the clinical and radiographic features may be similar. Determining pulp vitality is important for differential diagnosis and treatment planning.
Non-vital pulp therapy in primary teeth involves removing infected or necrotic pulp tissue from the root canal through a procedure called pulpectomy. Pulpectomy can be partial, removing pulp from the crown only, or complete, removing all pulp tissue. It can be done in one or multiple visits. Sodium hypochlorite and chlorhexidine are common irrigants used to disinfect canals, along with EDTA or other chelators. The goal of pulpectomy is to eliminate infection while retaining the tooth until natural exfoliation, without harming the permanent successor tooth.
This document discusses presurgical nasoalveolar molding (PNAM) for treating cleft lip and palate. PNAM involves using custom acrylic plates to gently reshape the gums, lips, and nostrils before surgery. This lessens the severity of the cleft and reduces the need for multiple follow-up surgeries. The document provides a brief history of PNAM and reviews several studies showing benefits such as improved nasal symmetry and reduced need for bone grafting. PNAM takes advantage of cartilage flexibility in newborns to externally reshape nasal structures through controlled forces on plates over time.
Apexogenesis apexification and revascularizationsanakhalid52
This document discusses apexogenesis, apexification, and revascularization procedures for immature permanent teeth. Apexogenesis aims to encourage continued root development by maintaining pulp vitality. It is used for teeth with damaged coronal pulp but healthy root pulp. Apexification induces a calcific barrier at an open apex in pulpless immature teeth using calcium hydroxide or MTA. Revascularization aims to regenerate pulp-like tissue by inducing bleeding into the root canal and using a blood clot and scaffold. It is used for teeth with necrotic pulp and an immature apex. The procedures involve disinfection, medication placement, and temporary fillings, with calcium hydroxide or MTA used to encourage apex closure
Lecture 8 management of patients with orofacial cleftsLama K Banna
Maxillofacial Surgery
Dental Students Fifth Year First semester
Lecture Name management of patients with orofacial clefts
Lecture 8
Al Azhar University Gaza Palestine
Dr. Lama El Banna
Non-Surgical Repair of A Perforation Defect-A Case ReportQUESTJOURNAL
ABSTRACT: Iatrogenic root perforations, which may have serious implications, occur in approximately 2- 12% of endodontically treated teeth. Root perforation repair has historically been an unpredictable treatment modality, with an unacceptably high rate of clinical failure. Successful management of root perforations is dependent on early diagnosis of the defect, location of the perforation, choice of treatment, materials used, host response, and the experience of the practitioner. This case report presents the successful management of a nonsurgical iatrogenic perforation repair
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.
MAZEN DOUMANI Access cavity and morphologymazen doumani
This document discusses tooth morphology and root canal anatomy. It describes the components of the root canal system and various pulp canal configurations that can occur. It provides guidelines for access cavity preparation, including objectives, evaluation of tooth anatomy, use of magnification and burs, orifice location and flaring. Morphology and specific preparation techniques are outlined for individual tooth types from anterior to posterior in both arches. Care must be taken during access preparation to locate all canals and avoid perforations.
management of non vital open apex roots/ orthodontic course by indian dental...Indian dental academy
This document discusses the management of non-vital teeth with open or incomplete root development. It defines various terms like apexogenesis, apexification, and maturogenesis. It describes the stages of root development and causes of open apices. For diagnosis and treatment, apexogenesis aims to encourage continued root development by removing inflamed pulp and placing calcium hydroxide. Apexification induces a calcified barrier in a tooth with a non-vital open apex. Maturogenesis allows continued deposition of dentin throughout the root for increased strength.
Young permanent teeth have incompletely formed roots and differ from permanent teeth in their pulp chamber anatomy, pulp size, and dentin thickness. Their roots are longer and more slender compared to primary teeth. Indirect pulp capping involves applying a medicament over remaining dentin after deep caries removal without exposure. Direct pulp capping places a biocompatible material over an inadvertent exposure to seal the pulp. Pulpotomy removes coronal pulp tissue to preserve radicular vitality, while pulpectomy removes necrotic pulp and obturates canals to maintain an infection-free tooth.
This document summarizes a seminar on non-vital pulp therapy procedures presented by Ram Kumar Sharma and guided by Dr. Meghna Singh. It defines a non-vital tooth as one with a completely necrosed pulp containing no living cells. Key non-vital pulp therapy procedures discussed include pulpectomy (root canal therapy), apexogenesis to encourage continued root development, and apexification to induce root-end closure in an incompletely formed tooth. Various root canal filling materials are also summarized such as zinc oxide eugenol, Vitapex, and KRI paste.
This document provides information about ill-fitting denture induced lesions. It discusses the purpose of the presentation which is to describe the etiology, clinical features, management, and differential diagnosis of various denture induced lesions. It then covers various specific lesions in detail, including traumatic ulcer, cheek bite, inflammatory hyperplasia, fibrous papillary hyperplasia, chronic atrophic candidiasis (denture stomatitis), contact allergy, malignancy, angular cheilitis, and palatal perforation. For each lesion, it discusses causes, clinical features, and management.
This document discusses the frenum attachment in the oral cavity, its development and variations. It describes different types of frenum attachments and associated syndromes like Ehlers-Danlos syndrome. Complications of an abnormal frenum like gingival recession and difficulty brushing are mentioned. Treatment techniques for abnormal frenum like frenectomy and frenotomy using conventional, Z-plasty, and laser methods are summarized. Post-operative instructions are provided.
1) The document reports on a case study examining the effects of a third ventricle lesion with obstructive hydrocephalus on cognitive, linguistic, and speech skills both before and after surgery.
2) Pre-surgery assessments found deficits in memory, fluency, reading, writing and speech intelligibility. Post-surgery, oro-motor skills and cranial nerve function improved, but cognitive and memory skills did not, though some language tasks did relatively.
3) The study concludes that while surgery improved some speech and language abilities, deviations remained, demonstrating the need for further therapy and rehabilitation to fully address impairments from third ventricle lesions.
Non Surgical Root Canal Treatment of Calcified CanalZiad Abdul Majid
This case report is presented to illustrate the successful non - surgical management of canal calcification in a maxillary first premolar in a 17 years old female.
Published By the International Journal of Health and Dental Sciences, Second Volume 2015.
This case report describes the frenectomy procedure performed on a 16-year-old female patient with posterior ankyloglossia (tongue-tie). The patient complained of difficulty with speech articulation since birth. Examination revealed a short, thick fibrous cord posterior to the tongue, limiting its movement. The patient underwent frenectomy with muscle dissection under local anesthesia. The frenulum was excised, leaving a diamond-shaped wound. Post-procedure, the patient's speech improved and she was referred to speech therapy. The report discusses ankyloglossia assessment tools and management, noting frenectomy can improve speech in many patients.
1. The document discusses frenal attachments, which are vertical bands of oral mucosa that attach the lips and cheeks to the alveolar ridges. Abnormal frenal attachments can cause issues like diastemas between teeth or limit toothbrush access.
2. There are different classifications of frenal attachments based on their location of insertion. Treatment of abnormal attachments may involve frenectomy or frenotomy procedures to remove or relocate the frenal tissue.
3. Surgical techniques for treating abnormal frenal attachments include conventional frenectomy, Miller's technique, Z-plasty, and V-Y plasty. Nonsurgical options like electrosurgery or laser frenectomy are also discussed
This document discusses the comprehensive management of cleft lip and palate. It covers the embryology, anatomy, classification, rationale and various techniques for cleft palate repair including Von Langenbeck, Bardach, Furlow and Delaire techniques. It also discusses velopharyngeal insufficiency, its assessment and various surgical techniques for correction including palatal lengthening and pharyngeal flaps. The complications of cleft lip and palate surgeries are discussed along with their management. The document provides a detailed overview of cleft palate and its multidisciplinary management.
This document summarizes guidelines for the management of cleft lip and palate, including neonatal care and feeding, naso-alveolar molding techniques, and primary repair of unilateral cleft lip. It discusses the challenges of feeding in cleft lip and palate patients, guidelines to address these challenges, and the use of various feeding appliances. It also provides details on Grayson's technique for naso-alveolar molding to reduce the cleft deformity, including the objectives, procedure, and potential complications. Finally, it covers considerations and techniques for primary repair of unilateral cleft lip, including the goals and timing of repair.
Tongue & its prosthetic coniderations seminaradifay wan
This document provides an overview of the anatomy of the tongue. It begins with an introduction and then covers the gross anatomy, muscles, blood supply, innervation, taste buds, and histological features of the tongue. It also discusses age-related changes and the applied anatomy of the tongue in relation to prosthodontics. Specifically, it explores how the tongue influences the stability of dentures and the neutral zone. The document concludes with a section on prosthetic considerations for the tongue.
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.
- Cleft lip and palate is a birth defect where the lip and/or palate do not fully form during development in utero.
- The incidence of cleft lip and palate varies by race, with Asians having the highest rate at 1 in 500 live births. Males are more likely than females to be affected.
- Treatment involves a multidisciplinary approach including surgery to repair the cleft, orthodontics, speech therapy and psychological support. The goal is to achieve normal appearance, speech and dental function.
This document discusses the management of vertical maxillary excess. It begins by outlining treatment approaches for mixed and permanent dentition, including habit breaking appliances, myotherapy, functional appliances, and orthodontic appliances. It then discusses specific treatment options in more detail, such as altering breathing mode, myotherapy exercises and appliances, habit breaking appliances like tongue cribs and vestibular screens, and functional appliances like activators. The document emphasizes the importance of proper diagnosis and treatment planning for managing vertical malocclusions.
This document discusses cleft lip and palate, including the embryology, causes, problems individuals may experience, and treatment approaches. It notes that clefts occur due to failure of fusion during embryonic development. Individuals with clefts often experience dental issues, malocclusion, speech difficulties, and ear problems. Treatment is multi-disciplinary and involves surgical procedures like cheilorrhaphy to repair the lip and palatorrhaphy to repair the hard and soft palate, as well as alveolar bone grafts and dental treatments throughout development. The goal is to correct anatomical issues and produce normal function and appearance.
This document discusses various aspects of treating young permanent teeth with immature roots, including their development, characteristics, and treatment considerations. It begins by defining young permanent teeth as those recently erupted where root development is incomplete. It notes the importance of preserving these teeth due to their role in alveolar growth. The document then covers evaluation methods that are more accurate for immature teeth compared to typical pulp testing. It discusses various treatment options for both vital and non-vital pulp therapy aimed at maintaining the tooth. A brief history of pulp capping techniques is also provided.
My soft palate / dental implant courses by Indian dental academy 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
This document discusses the anatomy and pathology of the maxillary sinus and oroantral communications. It describes the location and drainage of the maxillary sinus and causes of sinusitis. Oroantral communications are defined as pathological connections between the oral cavity and maxillary sinus that can form due to dental procedures or trauma. Signs, testing methods, prevention, and management strategies are outlined for both acute communications and oroantral fistulas. Surgical techniques for repair include local soft tissue flaps, grafts, and use of the buccal fat pad flap. Immediate closure of communications less than 3 weeks old has a high success rate, while delayed or recurrent fistulas require surgical intervention.
This document discusses alveolar cleft bone grafting. It begins with an introduction to cleft lip and palate treatment and the importance of alveolar bone grafting. It then covers the history, timing, rationale, and techniques of alveolar bone grafting. Key points include that secondary bone grafting between ages 6-13 is most common, with the goal of providing stability for dental arch development and closure of oronasal fistula. The document discusses various graft materials and surgical techniques to achieve tension-free closure of the alveolar cleft.
This document describes techniques for customizing the palatal contours of maxillary complete dentures to improve speech, specifically production of the sibilant sounds /s/ and /sh/. It discusses evaluating palatal contact during speech using a palatogram, and modifying the palatal contour with tissue conditioner if the denture is under-or over-contoured in the anterior region. Duplicating the patient's palatal rugae using impression materials or wax can further enhance speech and reduce adaptation time. The conclusion recommends keeping the posterior ridge thin and contouring mainly in the anterior palate for best phonetics.
This document summarizes a presentation on a retrospective study comparing surgical treatment modalities for 100 patients with oral submucous fibrosis. The study compared outcomes of excising fibrous bands and using different grafting techniques, including buccal fat pad graft (group I), tongue flap (group II), nasolabial fold flap (group III), and split skin graft (group IV). The results found that buccal fat pad grafting had the highest mean mouth opening at 1 week post-op, highest post-op pain/function scores at 1 month, and offered ease of surgery and low morbidity. Tongue flap had the lowest post-op mouth opening and caused discomfort due to difficulty with tongue movement.
management of vertical maxillary excess /certified fixed orthodontic courses ...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
This document provides an overview of the multidisciplinary management of cleft lip and palate. It discusses prenatal diagnosis, protocols for dental care from infancy through adolescence, surgical techniques for cleft lip and nasal repair, timing of cleft palate repair, and the roles of various specialists including pediatric dentists, orthodontists, plastic surgeons, speech pathologists and others in a cleft team. The goal is comprehensive treatment from prenatal counseling through adulthood to address dental, orthodontic, surgical, speech and psychosocial needs.
The document discusses ankyloglossia (tongue-tie), including its incidence, potential complications, clinical assessment, and treatment options. Ankyloglossia is a congenital condition where the lingual frenulum limits tongue mobility and can impair functions like speech, swallowing, and breastfeeding. Surgical techniques like frenotomy and frenectomy aim to release the frenulum and improve tongue function. Assessment considers factors like a patient's ability to protrude and elevate their tongue tip.
This document reviews the role of speech in orthognathic surgery. It discusses how malocclusions like Class II and III can cause errors in sounds requiring specific lip and tongue positioning. Orthognathic surgery aims to correct the underlying skeletal deformities and restore normal occlusion, which has the potential to improve speech errors by realigning the lips and teeth. The document summarizes several studies that found speech generally improved or did not change after orthognathic surgery, though a small number of patients saw deterioration. The type and timing of post-surgical speech changes differed depending on the specific jaw surgery and pre-existing malocclusion. Overall, orthognathic surgery can help speech by creating a better oral environment
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Mathew P, Kattimani VS, Tiwari RV, Iqbal MS, Tabassum A, Syed KG. New Classification System for Cleft Alveolus: A Computed Tomography-based Appraisal. J Contemp Dent Pract. 2020 Aug 1;21(8):942-948. PubMed PMID: 33568619
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1. Rahul Tiwari1,*
, Philip Mathew2
, Yasmin Jose3
, Bhaskar Roy4
, Kritika Sehrawat5
1
Fellow, 2
HOD, 3
Clinical Observer, 4,5
PG Student, 1-3
Jubilee Mission Medical College Hospital and Research Center,
Thrissur, Kerala, 4
KVG Dental College and Hospital, Sullia, D.K, Karnataka, 5
Sudha Rustagi Dental College and Research
Centre, Faridabad, Haryana, India
*Corresponding Author:
Email: drrahulvctiwari@gmail.com
The most widely recognized difficulty of a repaired congenital fissure is palatal fistula which can be seen from narrow to wide
forms as derived in the published literature. Small fistulas are usually asymptomatic, but the larger ones create regurgitation of
fluids in the nasal cavity and interferes the normal speech. Various options are present for the surgical management to close
fistulas. Local flaps are usually used for small fistulas comparatively large fistulas are difficult to manage. Tongue flaps due to its
high vascularity are region is the treatment of choice for most of the surgeons. The anteriorly based tongue fold is a sheltered and
compelling strategy for conclusion of moderately extensive repetitive palatal fistula with no practical impedance of the giver site.
This article portrays remaking of one such wide palatal fistula by anteriorly based tongue fold performing single layer
conclusion.
Keywords: Palatal fistula, Tongue flap, Cleft palate, Local flap.
0 – 77.8% worldwide prevalence is proven as the
commonest complication occurring after cleft palate is
palatal fistula.1
Palatal fistulas can involve both primary
and secondary palate in which involvement of
secondary palate ranges from 8.9 – 34%.2
Transposition
of adjacent tissues can be used for closing small fistulas
comparatively it is extremely difficult to close large
fistulas.3-8
The junction premaxilla and secondary palate
or hard and soft palate is the common location of
palatal fistula. Size, position and degree of
velopharyngeal incompetence are major factors for
deciding the treatment plan. The incidence of fistulas is
not necessarily of genetic origin but the etiologic
factors can also vary like trauma, tumour, infection,
granuloma, leprosy, Noma, syphilitic gumma,
leishmaniasis.2
Main objectives of ideal reconstruction
are replacement of the lost tissue with similar tissue.
Tongue flap is a versatile flap which can be anteriorly
or posteriorly based with axial or random pattern of
blood supply and can be harvested from ventral, dorsal
or lateral portion of tongue.9-12
In the event of tongue
folds there are numerous specialized focuses that
specialists need to consider as the essential to diminish
the odds of repeat. One of these is the accentuation on
great nasal layer conclusion in two-layer system.13-16
Seven-year-old girl operated for cleft lip and palate
at childhood presented with huge palatal fistula on
primary palate extending mildly to secondary palate
presented to us for closure (Fig. 1). An anteriorly based
tongue fold was made arrangements for the conclusion
of palatal fistula. Choice was made to play out a
solitary layer conclusion. The palatal fistula was
roughly quadrangular in shape each side measuring
around 3 cm crossing alveolus between the incisors.
Orthopantomogram and 3-D CT confirmed the bony
defect. Routine blood investigations were done which
were unremarkable. Under general anaesthesia,
according to the size of defect (Fig. 2) an anteriorly
based tongue flap was taken which was sutured with
vicryl (non-absorbable) (Fig. 3). Length and width of
tongue flap was determined by using a template as a
guide. The depth of flap was about 5 to 8 mm thick,
which included thin muscular layer, for the protection
of sub-mucosal plexus, which is the major source of
blood supply to the flap. The flap was then rotated
forward and sutured to raw edges of palatal defect
anteriorly and laterally using 4-0 vicryl. Donor site was
also closed using interrupted 4-0 vicryl sutures. We
used a thin needle prick after an hour of procedure then
every 4 hourly for a period of 24 hours to check the
viability of flap. The flap was tested with vascular loop
tourniquet for adequate vascularity before separation.
Patient was given nasal feed post operatively for two
weeks. Following fourteen long periods of medical
procedure the pedicle was separated under general
anaesthesia (Fig. 4). Palatable recuperating of the site
was watched. Follow up revealed no nasal regurgitation
and mild improvement of speech and the patient was
sent to speech pathologist.
2. Fig. 1: Pre-Clinical Picture showing Cleft
Fig. 2: Measurement of defect
Fig. 3: Anterior tongue flap
Fig. 4: Post-operative picture
Guerrero-Santos and Altamirano (1966) were first
to describe the use of a tongue flap to close palatal
fistulas secondary to cleft palate repair. The tongue
flap, with its muscular bulk and excellent vascularity,
has proved to be effective in occluding even large
palatal fistulas that were previously felt to be
inoperable. Tongue fold have been utilized as a part of
abundant in our field of oral and maxillofacial medical
procedure to close innate deformities like palatal fistula
or obtained absconds which happen after delicate tissue
tumor resection, injury, diseases or oro-antral fistulas.
They have been additionally utilized for conclusion of
imperfections happening after radiotherapy absconds.
There is posteriorly based fold too which are shown for
recreation of delicate sense of taste, back oral mucosa
and retromolar region. Anteriorly based folds are
utilized to close hard sense of taste, essential sense of
taste, intra oral mucosa, lips and floor of the mouth
absconds. They are adaptable decision of treatment
because of their vascularity, portability and versatility.
Tongue folds are shown in instances of palatal fistulas,
its repeat, disappointment of congenital fissure, sense of
taste with extreme scarring and places here lingering
palatal tissue does not permit reasonable conclusion.
They are likewise utilized as a part of deformities
which are bigger than 1 cm. in width. Achievement has
been accounted for in nearby folds in fistulas estimating
under 1.5 cm. in breadth.17
Ranina supply routes
navigate profoundly before ventral mucosa, creating
branches which rise to the dorsum of tongue, this ranina
branches inundate front based tongue fold.18
Several
creators have announced occurrence of enormous
palatal fistula after palatoplasties, and additionally
trouble of their treatment. Occurrence have extended
from 0-30% which relies upon kind of parted, patients
age, palatoplasty procedure and specialists encounter.19
Tongue flap closure for end stage palatal defect id
associated with relative lack of complication and high
success rate in children and adults.20
The specialist
must not delay to raise a vast fold to guarantee its
vascular practicality and permit impressive tongue
development without undue strain on the pedicle.21
This
allows water tight closure and increased area for
ingrowth of new blood vessels before flap division.
Some hesitate to alter the tongue anatomy for fear of
changing speech and deglutination. There are no
significant adverse effect on articulation, lingual
mobility, or swallowing following the use of a tongue
flap procedure to close palatal defects. The mobility of
the remaining tongue may be more important in
preserving speech intelligibility than the relative mass
of the tongue that remains. Although lingual mobility
and articulation are reported to be unaffected by
removal of tongue tissue, Steinhauser (1982) cautioned
that the tongue flap itself may interfere with lingual
mobility and articulation if it is too thick. In this case,
partial excision or debulking may be required as a
secondary procedure. The tongue flap has been found to
be an effective method of closing large palatal fistulas
to reduce nasal emission and hypernasality. However,
there is a lack of sufficient clinical research that
specifically evaluates changes in resonance and nasal
3. emission as a result of fistula repair. Protruding tissue
can interfere with normal tongue movement, with
tongue placement, and with the anterior f ow of air
during articulation. This can result in a lateral distortion
of speech. Therefore, the surgeon should attempt to
shape the tongue flap so that it conforms to the contour
of the palatal vault as much as possible. Occluding a
palatal fistula is often done for the purpose of reducing
or eliminating hypernasality and nasal emission. The
nasal emission that remains is more audible and,
therefore, the patient's speech may be perceived to be
worse. If this occurs, parents should be counseled that
this is not a sign that the surgery was unsuccessful.19
Few authors have used flap from lateral border of
tongue. Different alterations have been done in these
folds in which one adjusted fold strategy shows that the
edges of fistula are swung to the nasal side without
coordinate conclusion, leaving the nasal layer free of
strain. In the wake of resecting the fold, the all around
vascularized crude territory of tongue will be in contact
with the crude region of fistula and nasal hole. This
crude to crude contact coordinates the tongue fold and
prompts firm recuperating of the encompassing region.
The nasal layer hole will then begin to epithelialize
until the total conclusion of this hole which is
demonstrated by nasoscope development.22
Single layer
conclusion of fistula by pedicle foremost based tongue
fold can hence be demonstrated for repair of extensive
palatal fistulas that can't be effectively treated by other
nearby and removed folds as a result of the size and
position of the imperfections.
Tongue folds are amazing option for wide or
intermittent palatal fistulas as they are adaptable and
can be intended for every fistula closure. They are
normally shown for fistulas that are in excess of 1 cm.
The pedicle anteriorly based tongue flap in our case has
given excellent result which has improved the quality of
life of the patient.
1. Hardwicke JT, Landini G, Richard BM. Fistula incidence
after primary cleft palate repair: a systematic review of
the literature. Plast Reconstr Surg 2014;134:618e–627e.
2. Posnick JC, Getz SB Jr. Surgical closure of end-stage
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J Oral Maxillofac Surg 1987;45:907-12.
3. Campbell R. Fistula in the hard palate following
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tongue flap. Int J Oral Maxillofac Surg. 1986;15:581-4.
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13. Sadhu P. Oronasal fistula in cleft palate surgery. Ind J
Plast Surg 2009;42 Suppl:S123–8.
14. Vasishta SM, Krishnan G, Rai YS, et al. The versatility of
the tongue flap in the closure of palatal fistula.
Craniomaxillofac Trauma Reconstr 2012;5:145–60.
15. Sodhi SP, Kapoor P, Kapoor D. Closure of anterior
palatal fistula by tongue flap: A prospective study. J
Maxillofac Oral Surg 2014;13:546–9.
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review of treatment results and a surgical management
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17. Zeidman A, Lockshin A et al. Repair of a chronic
oronasal defect with an anterior based tongue flap: report
of a case. J Oral Maxillofac Surg 1988;46:412-5.
18. Whetzel TP, Saunders CJ. Arterial anatomy of the oral
cavity: An analysis of vascular territories. Plast Reconstr
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palate fistulas: a multivariate statistical analysis of a
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Reconstr Surg 1991;87 (6):1041-7.
20. Posnick JC, Getz SB Jr (1987) Surgical closure of end
stage palatal fistulas using anteriorly based dorsal tongue
flaps. J Oral Maxillofac Surg 45(11):907–12
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Fistula Classification System: a standardized scheme for
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J 2007;44:590–4.
22. Alsalman AK, Algadiem EA, Alwabari MS, Almugarrab
FJ. Single-layer Closure with Tongue Flap for Palatal
Fistula in Cleft Palate Patients. Plastic and
Reconstructive Surg 2016;4(8):e852.