Diagnosis and treatment planning is the foremost protocol in the fabrication of complete denture.
The steps involved in the diag and treat planning are mentioned in the same
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.
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 Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
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 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
Diagnosis and treatment planning in completely edentulous patientsDr ARYA SUDARSANAN
If you like to view in my youtube channel Dr Aaryas Vlogs please click on these links for parts 1 to 4
https://youtu.be/jBT4UloMqoM
https://youtu.be/cBwQpjW0yD0
https://youtu.be/EO_MSE2wle4
https://youtu.be/1UXMNQ0gPho
Thanks for watching..........
Please do like, share and subscribe my channel for more videos..........
INTRODUCTION
DEFINITIONS
CLASSIFICATIONS
COMMUNICATION WITH GERIATRIC PATIENT
Dr.MM HOUSE CLASSIFICATION
AGE & NUTRITION
FACTORS AFFECTING NUTRITION
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
different classification of complete denture patients, includes house classification
for more
https://youtu.be/aaJ6gpQohcs
https://youtu.be/REMKSUty0cE
https://youtu.be/fv3_tWZPJIU
https://youtu.be/GeZIbCwqKYU
if you want me to make ppt on some topic do let me know on the comment section of my youtube channel
diagnostic aids part 1 diagnosis, examination, BMR, EMG.docxDr.Mohammed Alruby
Introduction:
Proper treatment plane depends on prompt diagnosis, good clinician should have a bird’s eyes to first identify the problem and find its etiology
Definitions:
= Grabber and Rackosi: defined diagnosis as:
Recognition and systemic designation of anomalies, the practical synthesis of the finding, permitting therapy to be planned and identification to be determined
=a continuous evaluation process in orthodontics starting right from the first interaction with the patient continuing through different stages till end of treatment and course follow up visits
Goal of orthodontic diagnosis:
Is to produce a comprehensive description of the patient’s problem and then to synthesis the various elements of description into a rational problem list
Diagnostic aids:
Data required for orthodontic diagnosis are derived from routine essential diagnostic aids and also from supplemental aids when needed, Graber categorized the diagnostic aids into essential and supplemental aids
Essential:
- Case history
- Study models
- Certain radiographs: periapical, bite wing, panoramic radiograph
- Facial photographs
- Intra-oral photographs
Supplemental:
- Specialized radiographs: occlusal of maxilla and mandible, lateral cephalogram
- Hand &wrist radiograph
- Electromyography
- Endocrine test
- Basal metabolic rate
Case history:
Complete case history includes all the relevant information derived from the patient and parents and essential for planning
Personal details:
Name:
The patient’s name should be recorded for the purpose of identification and communications
Calling the patient by his/her name not only establishes a good report but also imparts confidence in the patient mind about treatment providers
In case of children, it might help to know their pet problems
Age:
= certain malocclusion occurring during growth period are transient and self-correcting
= growth modification procedures such as functional appliances can be carried out during growth periods
= surgical respective procedures such as orthognathic surgery are best carried out after cessation of growth
= chronological age is important for the maintaining of shedding and eruption time tables as well
Gender:
= recording gender of the patient is important for treatment planning, females are observed to precede males in growth related events such as onset of growth spurt, eruption of the teeth and onset of puberty
= gender may also have a bearing on patient’s compliance toward certain types of orthodontic treatment
Occupation and address:
Occupation of patient / or parents gives an idea about socioeconomic condition which might affect the selection of orthodontic appliances and can give an idea about awareness
Address of patient determine the sociality of the patient and this effect on the treatment because some countries have normally bi-maxillary protrusion and also determine the awareness of patient about treatment and oral hygiene
Patient behavior:
Behavior of patient depend on: patient
What Are You Willing to Change to Promote Your Patients' Oral Health?Dr Marielle Pariseau
This article, reprinted with the permission of the Ontario Dental Association and Ontario Dentist 2013, offers an introduction to Motivational Interviewing (MI) and its potential for improving the overall process of oral health care for patients and dental staff. Like any new skill, MI takes learning and practise. With training, you can take MI (an evidence-based, patient-centred communication method) and include it in the repertoire of your dental practices and skills so you can more effectively meet your patients’ oral health needs.
Orthodontic Diagnosis
For general practitioners
Prepared by Dr. M Alruby
Orthodontic diagnosis deals with recognition of the various characteristics of the malocclusion. It involves collection of data in a systematic manner to help in identifying the nature and cause of the problem. Comprehensive orthodontic diagnosis is established by use of certain clinical implements called diagnostic aids.
Consideration of general health, appearance and attitude:
The first step in any orthodontic examination is to form a general idea of patient's health status, physical appearance and attitude toward orthodontics.
Case history:
Case history involves eliciting and recording of relevant information from the patient and parents to aid in the overall diagnosis of the case. The information is gathered from the patient and parents.
Personal details:
Name: the patient's name should be recorded for the purpose of communication and identification. Most patients like being called by their name. Addressing the patient by his or her name has a beneficial psychological effect as well. In case of children it is wise to record their pet names.
Age: the patient's chronological age should be recorded. Age consideration helps in diagnosis as well as treatment planning. There are certain modalities that are best carried out during the growing age. Growth modification procedures using functional and orthopedic appliances are carried out during the growth period. Surgical respective procedure is best carried out after the cessation of growth.
** Dental age determination: can be determined by two different methods:
- Stage of eruption of teeth.
- Stage of tooth mineralization on radiograph.
Determination of the dental age from observation has been the only method available for long time. In certain cases however, the accuracy of the method is limited.
When determining the dental age radiographically according to the stage of germination, the degree of development of individual teeth is compared to a fixed scale.
** Skeletal age evaluation: assessment of the skeletal age is often made with the help of a hand radiograph which can be considered the biologic clock. For the analysis of skeletal maturity the stage of mineralization of the carpal bones must be determined thereafter the development of the metacarpal bones and phalanges should be evaluated. For the evaluation of the hand radiograph various indicators regarding the development and maturity are established which occur regularly in a definite sequence during skeletal development.
Sex: the patient sex should be recorded in the case history. This is important in planning treatment, as the timing of growth events such as growth spurts is different in males and females. Females usually precede males in onset of growth spurts, puberty and termination of growth.
Address and occupation: this help in evaluation of socio-economic status of the patients and parents. Some countries
Diagnosis and treatment planning in completely edentulous patientsDr ARYA SUDARSANAN
If you like to view in my youtube channel Dr Aaryas Vlogs please click on these links for parts 1 to 4
https://youtu.be/jBT4UloMqoM
https://youtu.be/cBwQpjW0yD0
https://youtu.be/EO_MSE2wle4
https://youtu.be/1UXMNQ0gPho
Thanks for watching..........
Please do like, share and subscribe my channel for more videos..........
INTRODUCTION
DEFINITIONS
CLASSIFICATIONS
COMMUNICATION WITH GERIATRIC PATIENT
Dr.MM HOUSE CLASSIFICATION
AGE & NUTRITION
FACTORS AFFECTING NUTRITION
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
different classification of complete denture patients, includes house classification
for more
https://youtu.be/aaJ6gpQohcs
https://youtu.be/REMKSUty0cE
https://youtu.be/fv3_tWZPJIU
https://youtu.be/GeZIbCwqKYU
if you want me to make ppt on some topic do let me know on the comment section of my youtube channel
diagnostic aids part 1 diagnosis, examination, BMR, EMG.docxDr.Mohammed Alruby
Introduction:
Proper treatment plane depends on prompt diagnosis, good clinician should have a bird’s eyes to first identify the problem and find its etiology
Definitions:
= Grabber and Rackosi: defined diagnosis as:
Recognition and systemic designation of anomalies, the practical synthesis of the finding, permitting therapy to be planned and identification to be determined
=a continuous evaluation process in orthodontics starting right from the first interaction with the patient continuing through different stages till end of treatment and course follow up visits
Goal of orthodontic diagnosis:
Is to produce a comprehensive description of the patient’s problem and then to synthesis the various elements of description into a rational problem list
Diagnostic aids:
Data required for orthodontic diagnosis are derived from routine essential diagnostic aids and also from supplemental aids when needed, Graber categorized the diagnostic aids into essential and supplemental aids
Essential:
- Case history
- Study models
- Certain radiographs: periapical, bite wing, panoramic radiograph
- Facial photographs
- Intra-oral photographs
Supplemental:
- Specialized radiographs: occlusal of maxilla and mandible, lateral cephalogram
- Hand &wrist radiograph
- Electromyography
- Endocrine test
- Basal metabolic rate
Case history:
Complete case history includes all the relevant information derived from the patient and parents and essential for planning
Personal details:
Name:
The patient’s name should be recorded for the purpose of identification and communications
Calling the patient by his/her name not only establishes a good report but also imparts confidence in the patient mind about treatment providers
In case of children, it might help to know their pet problems
Age:
= certain malocclusion occurring during growth period are transient and self-correcting
= growth modification procedures such as functional appliances can be carried out during growth periods
= surgical respective procedures such as orthognathic surgery are best carried out after cessation of growth
= chronological age is important for the maintaining of shedding and eruption time tables as well
Gender:
= recording gender of the patient is important for treatment planning, females are observed to precede males in growth related events such as onset of growth spurt, eruption of the teeth and onset of puberty
= gender may also have a bearing on patient’s compliance toward certain types of orthodontic treatment
Occupation and address:
Occupation of patient / or parents gives an idea about socioeconomic condition which might affect the selection of orthodontic appliances and can give an idea about awareness
Address of patient determine the sociality of the patient and this effect on the treatment because some countries have normally bi-maxillary protrusion and also determine the awareness of patient about treatment and oral hygiene
Patient behavior:
Behavior of patient depend on: patient
What Are You Willing to Change to Promote Your Patients' Oral Health?Dr Marielle Pariseau
This article, reprinted with the permission of the Ontario Dental Association and Ontario Dentist 2013, offers an introduction to Motivational Interviewing (MI) and its potential for improving the overall process of oral health care for patients and dental staff. Like any new skill, MI takes learning and practise. With training, you can take MI (an evidence-based, patient-centred communication method) and include it in the repertoire of your dental practices and skills so you can more effectively meet your patients’ oral health needs.
Orthodontic Diagnosis
For general practitioners
Prepared by Dr. M Alruby
Orthodontic diagnosis deals with recognition of the various characteristics of the malocclusion. It involves collection of data in a systematic manner to help in identifying the nature and cause of the problem. Comprehensive orthodontic diagnosis is established by use of certain clinical implements called diagnostic aids.
Consideration of general health, appearance and attitude:
The first step in any orthodontic examination is to form a general idea of patient's health status, physical appearance and attitude toward orthodontics.
Case history:
Case history involves eliciting and recording of relevant information from the patient and parents to aid in the overall diagnosis of the case. The information is gathered from the patient and parents.
Personal details:
Name: the patient's name should be recorded for the purpose of communication and identification. Most patients like being called by their name. Addressing the patient by his or her name has a beneficial psychological effect as well. In case of children it is wise to record their pet names.
Age: the patient's chronological age should be recorded. Age consideration helps in diagnosis as well as treatment planning. There are certain modalities that are best carried out during the growing age. Growth modification procedures using functional and orthopedic appliances are carried out during the growth period. Surgical respective procedure is best carried out after the cessation of growth.
** Dental age determination: can be determined by two different methods:
- Stage of eruption of teeth.
- Stage of tooth mineralization on radiograph.
Determination of the dental age from observation has been the only method available for long time. In certain cases however, the accuracy of the method is limited.
When determining the dental age radiographically according to the stage of germination, the degree of development of individual teeth is compared to a fixed scale.
** Skeletal age evaluation: assessment of the skeletal age is often made with the help of a hand radiograph which can be considered the biologic clock. For the analysis of skeletal maturity the stage of mineralization of the carpal bones must be determined thereafter the development of the metacarpal bones and phalanges should be evaluated. For the evaluation of the hand radiograph various indicators regarding the development and maturity are established which occur regularly in a definite sequence during skeletal development.
Sex: the patient sex should be recorded in the case history. This is important in planning treatment, as the timing of growth events such as growth spurts is different in males and females. Females usually precede males in onset of growth spurts, puberty and termination of growth.
Address and occupation: this help in evaluation of socio-economic status of the patients and parents. Some countries
Similar to 5. complete denture diagnosis.pptx (20)
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.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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
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.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.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.
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
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
3. The diagnostic record for complete denture
treatment can best be compiled by using a
systematic diagnostic form. From this
information a treatment plan and prognosis
can be developed.
Each patient must be considered as an
individual. It is possible to categorize patients
and anticipate certain problems, but always
remember that not all patients will fit a
predetermined group.
4. Diagnosis_ diagnosis is the examination of the
physical state, evaluation of the mental or
psychological makeup, and understanding the
needs of each patient to ensure the predictable
results.
Treatment planning_ treatment planning means
developing a course of action that
encompasses the ramification and sequelae of
treatment to serve the patients need. This takes
for granted and exhaustive supply of knowledge
, a realization of what can and cannot be done
for an individual, and an understanding of the
clinical procedures needed
5. AGE- The age of the patient gives an indication of his ability
to wear and use dentures.
An arbitrary change point is considered to be age 40. patient
younger than 40 are usually adaptable to change; their
tissue heal rapidly and offer resistance. Patients over 40
have tissues that do not heal as quickly and a mental
attitude that may not readily adapt to new situations.
Women in this age group are undergoing menopause and its
associated problems. Men are at their height of their
careers and tend to be busy and impatient.
6. Many patient over the age of 60 find it difficult to
adapt to new situations, tissue repair is often slow,
and in many cases there has been extensive
destruction of denture supporting tissues. Problems
can be anticipated with
1. Adaptation to the denture
2. Coordination
3. Bone resorption
4. Tissue sensitivity
5. Healing
6. balanced nutrition
7. In general, women are more difficult to please with
the appearance of their dentures than are men.
They are more aware of their face and lips than are
men. Any change in this part of the body is readily
apparent to them. Women during menopause can
be difficult to treat due to psychological problems,
dry mouth, burning sensation in the mouth, and
general vague pain.
Men tend to be more occupied with their work and
less concerned with their denture. They do expect
comfort and function.
8. A patient in good general health is generally able to
accept and adjust to a complete denture better than
one who is in poor health.
The dentist should know what medication a patient is
taking. Some drugs have a direct effect on the oral
environment.
Endocrine injections and thyroid, estrogen and
androgenic compounds often cause and extremely
sore mouth for edentulous patient.
Tranquilizers can cause a dry mouth
Many systemic diseases have a direct or indirect
effect on the patient. In many instances it will be
necessary to consult the patients physician.
9. Knowing the patients occupation and social
position helps in determining what the
patient expects from his denture. In general,
the higher the social position, the more
demanding the patient is about the esthetics.
10. The ability to accept and adjust to denture is determined largely by the patient’s mental
attitude and feelings about himself, his fellowman and life in general.
House classified patients as philosophical, exacting, indifferent, and hysterical
Philosophical: these patients are rational, sensible, calm and composed in difficult
situations. Philosophical patients overcome conflicts and organize their time and habit in
an orderly manner; they eliminate frustrations and learn to adjust rapidly
Exacting patient: the exacting patient may have all of the good attributes of the
philosophical patients; however, they require extreme care, effort, and patience on the
part of the dentist. These patient are methodical, precise, and accurate and at time make
severe demands. They like each step in the procedure explained in detail.
Indifferent patient: these patients present a questionable prognosis. They are apathetic,
uninterested and lack of motivation. They pay no attention to instructions, will not co-
operate, and are prone to blame the dentist for poor dental health.
hysterical patient: the hysterical type is emotionally unstable, excitable, excessively
apphrensive, and hypertensive. These patients must be made aware that their problem
is primarily systemic and that many of their symptoms are not the result of the denture
11. The history of the patients dental treatment
should include the beginning and severity of
dental disease and his reaction to the dental
treatment. His opinion of the dentists who had
performed a service for him and his family
experiences with complete dentures should be
investigated. If it is noted that the patient has a
poor regard for dental profession, effort must be
made to change his opinion. The success of the
planned dental treatment requires mutual
respect and co-operation.
12.
13. The patients reason for seeking dental
treatment or new dentures at this particular
time should be determined. This is usually
considered to be the patient chief complaint.
The patient chief complaint, his symptom
and the duration of the problem for which he
seeks treatment have important diagnostic
value
14. The length of time that the patient has been
edentulous should be noted. Areas of the jaw
that have not healed properly suggest
1. insufficient healing time
2. incomplete elimination of pathologic tissue
3. a health state not conducive to bone
regeneration
15. The longer the patient has been edentulous,
the more bone resorption or alveolar ridge
loss will usually be noted. more resorption in
one area than in another indicates a serial
type of tooth loss.
Only limited success can be anticipated for
the patient who has been edentulous for a
long time and has not had an artificial
replacement.
16. Previous denture experience should be
noted. The number of dentures that the
patient has had and the length of time each
has been worn may influence the anticipated
prognosis. A patient who has had successful
denture treatment will probably be happy
again
17. The dentures the patient is currently wearing should
be carefully evaluated as to occlusion, border
extension, retention, speech, and aesthetics. The
dentist should attempt to correlate the patient’s
complaints about the dentures with the dentist’s
clinical findings. If the dentist finds a direct
relationship, it is likely that improvements can be
made in the new dentures. On the other hand, a
lack of correlation between the patient’s complaints
and the dentist’s clinical examination should raise
serious doubts concerning the potential successful
outcome and management of the patient.
18.
19. The degree of co ordination shown by the
patient should be observed. This can be seen
by how the patient walks, moves, and handles
himself. Generally, the better coordinated
patient will more readily adapt to new denture.
As the diagnosis interview is being conducted,
the dentist should be aware of the patients
speech habits or patterns, as well as what the
patient is saying. Patients who articulate well
with natural teeth or denture usually learn to
speak distinctly with new denture.
20. If the dress and the amount of cosmetics the
patient wears are above average, the patient
will usually be more exacting about denture
appearance. Beware the patient who is trying to
regain loss youth or is trying to have his face lift
by a new dentures. We can do much to make a
denture look natural, but it is not a cure for the
natural aging process. The person with a
pleasing countenance who has a zest for life is
usually a prosthodontic risk than is the person
who is tense and depressed about life in
general
21. Observe the extra-oral appearance of the face. Both form
and color are important in selecting teeth. Usually there is
a correlation between the form of the face and the form of
the dental arch and the teeth. Likewise, there is a
correlation between the color of the skin, hair, and the
eyes and the color of the teeth.
Skin color, texture, and the lesions indicate the systemic
condition of the patient. Thin, anemic appearance faces
with poor skin texture often indicate a prolonged period of
adjustment for the denture patient, lesions, such as
angular cheilosis, may indicate that the patient's vertical
dimension of occlusion is over closed.
22. Wrinkles due to advancing age cannot and should not be
corrected with new dentures. Some wrinkles caused by a
decreased vertical dimension of occlusion or poor lip
support can be improved with a well made denture.
The form and length of the patient’s lips vary considerably.
Some patients have thick lips, others have lips that are
very thin. Thick lips give the appearance of adequate
support when no teeth are present. Excessively short or
long lips present a problem in the arrangement of anterior
teeth. The amount of vermillion border that is visible
indicates the amount of loss of support.
23.
24. The systemic charting of biologic factors that
are favorable or unfavorable to a successful
service.
Biologic conditions may be classified as i-
favorable / normal, II –less favorable or
medium, III- unfavorable or poor.
29. Posterior border of denture:
› Hamular notches
Over extension - extreme pain
Under extension - non-retentive
Must be captured in impression
30. Posterior border of
denture
› Vibrating line
Identified when patient says "ah"
Junction of movable & non-movable
soft palate
31. Posterior border of denture
› Vibrating line
If termiminate on:
movable portion - displacement
hard palate - no retention
32. Vibrating line
Fovea - close to
vibrating line
Throat form can affect
width
34. The downward slope of the soft palate at its
junction with the hard palate is important to the
formation of the posterior length of the maxillary
denture.
Class I: the soft palate gradually down from the
hard palate.
Class II: the soft palate slope more sharply than the
class I type, thus decreasing the seal area and the
posterior denture length
Class III: the soft palate drop sharply from the hard
palate. The precise location of the posterior extent
is critical.
35. Posterior border of denture:
› Pterygomandibular raphe
Have patient open wide as possible.
36. Glandular tissue
Posterior palatal seal
Posterior palatine salivary glands
• Permits compression of tissues
• Improves adaptation of denture to
compensate for shrinkage of resin
Posterior Palatal Seal
38. Tuberosity
› If enlarged with
fibrous tissue
surgical reduction to
make room for dentures
39. Vertical support and retention for the maxillary denture
is partially determined by the shape of the hard
palate. The palate may be classified as flat, U, V-
shaped
Class I: the broad flat palate offer the best vertical
support and retention.
Class II: the U shaped palate form generally gives
adequate denture support And retention
Class III: the V shaped palate offer little vertical
denture support. The depth of the V also makes a
desirable degrees of retention difficult to attain
40. Ridge form
› U-shape best
› Non-moveable best
› Advise patient if poor
› Affects:
retention
stability
42. The patient with a sensitive palate may react
to the denture construction procedures or the
actual wearing of dentures by gagging
Class I: there is no response to palpation
Class II: a minimal response to palpation
indicates the patient is sensitive
Class III: the patient with a hypersensitive
palate will make a violent response to
palpation.
56. Observe the lateral throat form while the patient
retrudes his tongue.
Class I: approximately 0.5 inch space exists
between the mylohyoid ridge and the floor of the
mouth. This is favorable for the lower denture.
Class II: less than 0.5 inch space exists between
the mylohoid ridge and the floor of the mouth. The
less space here, the favorable is the prognosis for
the mandibular denture
Class III: the mylohoid fold is at the same level as
the mylohoid ridge. Retention of the lower denture
is almost impossible.
57. Mylohyoid Ridge
› Palpate
If prominent, may need relief
Mylohyoid muscle
Raises floor of mouth
Differences between rest and
activity
Affects length of flanges
58. Mucosa in this region is poorly
keratinized and prone to trauma
Mylohyoid ridge
Mylohyoid ridge can cause ulcers if it
is a sharp
Residual Ridge Resorption (RRR)
59. Tori
› Rarely need surgery unless large
› May require relief once dentures are
delivered - advise patient
60. Genial tubercles
› Bony insertion for the
genioglossus muscle
› May be projecting above
the residual ridge if there
has been severe
resorption
61. Examination of the area over the
temporomandibular joint- The fingers should be
placed over each joint and have the patient
slowly open and close his mouth. Any pain or
tenderness in this area may be and indication
of an excessive increase or decrease in the
vertical dimension of occlusion. Crepitus,
clicking or abnormal movement should be
noted.
62. As the patient slowly opens and closes his mouth,
watch for deviation of the mandible to the side.
Then from a vertical dimension of rest position have
the patient move his mandible to the right and left
lateral position, as well as to the straight protrusive.
Some patient can perform all mandibular
movement with ease but others can only open and
close the jaws with ease.
A bilateral balanced occlusion is needed for the
patient with free mandibular movement but is not so
important for those who can move only on hinge
movement .
63. Class 1: tissues are normal in tone and function.
There are sufficient teeth properly distributed to
retain the normal mandibular position and to
furnish normal tension, tone, and placement of the
muscles. No degenerative changes have yet
occurred in the muscles of expression or
mastication or in the tactile tense of the jaws or
mucosa.
Except in instances of an immediate restoration,
edentulous patients do not have a class 1
musculature, as most have experienced
degenerative changes in varying degrees.
64. Class 11: approximately normal function, tone, and tactile
sense have been preserved by wearing of artificial
dentures. Maximum muscular function can never be
utilized once the natural teeth have been lost. Patient who
have been wearing efficient dentures that restore the
correct vertical dimension of occlusion belong to this class.
Class III: subnormal function, tone, and tactile sense result
from ill health, loss of natural teeth, or the wearing of
grossly inefficient dentures. Frequently over closure
produces wrinkles and a droopy mouth, protrusion of the
mandible, loss of muscle power. With the most efficient
replacement, this class of patient requires varying degrees
of time in which to redevelop tone and power in the
mandible.
65. Class I: there is enough muscle control to use denture
efficiently but not to exceed the physiologic tolerance
of the denture supporting tissues by putting excessive
occlusal pressure on the teeth.
Class II: the patient either chews with a great deal of
force or bruxates. Either of these habits may cause
problems. The heavy force may cause sore mouth
Class III: patient with slight development of muscle
often cannot control denture adequately. They are
usually light chewers who complain that their denture
will not cut through food
66. Class I: the mandible and maxillae are well
developed and the size of one to the other is in the
correct relationship.
Class II: the mandible is less develop than the
maxillae. This situation is the most difficult to handle
in denture construction. The small size of the
mandible will increase the amount of masticatory
force per unit area covered by the denture. Smaller
jaw offer less support and retention
Class III: the mandible has had greater
development than the maxillae making it longer ,
wider, or both.
67. The amount of remaining alveolar bone determines
the height of the ridge supporting the denture.
Class I: the alveolar ridge is of adequate height to
give the denture support and resist lateral
movement of the denture base
Class II: the alveolar has undergone some
resorption, however, there is enough remaining
bone to give some resistance to lateral shifts of the
denture
Class III: the alveolar ridge is almost or completely
resorbed. There will be little or no resistance to
lateral shift of the denture.
68. Vertical forces that are placed on the denture are
resisted in part by the residual ridge. The cross
sectional shape of the ridge determines how much of
this force the ridge can actually offset.
Class I: the ridge is U- shaped in its cross section.
The broad, flat ridge crest offer excellent vertical
support
Class II: the ridge is more V- shaped in cross section
than is class I. but the ridge crest is still flat enough to
offer some vertical support
Class III: this is a so called knife edge ridge. The
remaining ridge has a narrow, sharp ridge crest that
can offer little or nothing to vertical support
69. To consider form, one must look at the entire arch.
Generally, arch forms are classified as square, tapering, or
ovoid. Following extractions, the arch may change form to
some extent. It is not uncommon to find the upper arch of
one classification and the lower of another. This irregualrity
may present a problem in tooth arrangement. Arch form is
important in offsetting rotational movement of the denture
base.
Class I: the square arch is the best form to prevent
rotational movement
Class II: the tapering form offers some resistance to
movement but to a lesser degree than a square arch.
Class III: the ovoid form, because of its rounded shape,
gives little or resistance to rotational movement
70. When the teeth are gradually lost, the residual
ridges will diverge from each other. If the ridge are
not parallel to the occlusal plane, denture tend to
slide over the basilar tissues when occlusal forces
are applied to them
Class I: both the ridges are parallel to the occlusal
plane
Class II: either the mandible or the maxillary ridge is
divergent anteriorly. Only one denture tend to slide
anteriorly
Class III: both the ridge diverge anteriorly. Both the
denture will slide anteriorly
71. Class I: the patient has enough interarch
distance to accommodate the denture
Class II: there is excessive space. The
denture are usually less stable because the
distance between the teeth and the
supporting bone is so great
Class III: interarch space is limited .
Placement of the artificial teeth can be a
difficult procedure
72. A residual ridge with a bony undercut is most
unfavorable to a stable denture (because relief may
be required during insertion).
Class I: bony undercuts are absent
Class II: there are small undercut. (denture can be
placed by changing the path of insertion or by
relieving the completed denture after pressure
indicating paste has been applied to reveal
pressure areas.)
Class III: prominent bilateral undercut that must be
corrected by surgery are present. Sometimes
surgery can be limited to undercuts on one side
only.
73. Small maxillary and mandibular tori normally
present no problem in denture construction.
Class I: tori are absent or so small that they will not
interfere with the construction or use of denture
Class II: ridge have tori that offer mild difficulties for
the adaptation of the denture. Surgical intervention
is probably optional
Class III: tori are excessively large , present
undercut, or extent to the posterior palatal seal
area. Surgical intervention is necessary .if the
mandibular tori prevent correct border extension to
the denture , they definitely should be removed.
74. The soft tissues under a complete denture help support of
the denture and acts as a cushion between the denture
and the supporting bone
Class I: the best oral condition is to have the
mucoperiosteum a uniform thickness of approximately
1mm and firm and not tense
Class II: the patient has thin mucoperiosteum that will be
highly susceptible to irritation from denture pressure. If it is
still firm but thicker than 1mm , the denture will have a
tendency to shift excessively
Class III: a poor condition exists when the tissues are not
only thick but also flabby. Surgical removal of the of the
excessive tissues in these situation is usually indicated to
develop and expectable denture base
75. The condition of the mucosa should be
classified according to its oral appearance
Class I: healthy
Class II: irritated
Class III: pathologic
76. Generally, the lower the frenum attachment, the more
favorable the denture prognosis. All lingual tissues of the
mandible are classified as muscular attachment.
Class I: the muscle and frenum attachment are close to
the vestibule and are considered to be low
Class II: the muscle and frenum attachment are higher-
closer to the crest of the residual ridge. To allow for
movement of these attachment, the denture border must
be notched to allow space.
Class III: the muscle and frenum attachment are too high.
The large notches that will be needed to allow space for
them make a denture seal difficult to maintain, and a lack
of retention usually develops. They may require surgical
correction.
77. The tongue plays a major role in the retention of the
mandibular denture. Two components of the tongue
must be considered. Namely, size and position.
Class I: the tongue is of adequate size to fill but not
overfill the floor of the mouth. Since the alveolar ridges
are exposed, there is space for the denture
Class II: the tongue slightly overfills the floor of the
mouth
Class III: the tongue completely fills the floor of the
mouth and cover the alveolar ridges. Impression making
is very difficult with this type of tongue. Denture stability
is also difficult to attain
78. The lingual seal of the lower denture is developed by the
tongue. If the tongue does not maintain correct position a
seal cannot be developed
Class I: the tongue is in corect position. The tip is relaxed
where it rest in the area of the lingual surface of the lower
anterior teeth. The lateral borders of the tongue contact
the lingual surface of the posterior teeth and the denture
base
Class II: the lateral border of the tongue are in correct
position. But the tip of the tongue turns up or down
Class III: the tongue is in a retracted position. The tip does
not touch the lower denture or ridge. Much of the floor of
the mouth is exposed. Because of its retracted position,
the tongue appears to be square off.
79. Class I: the saliva is normal in amount and
consistency
Class II: there is and excessive amount of thin,
watery saliva or of thick, ropy saliva. Excessive
saliva may cause gagging and will usually
complicate impression making
Class III: insufficient saliva reduces the retentive
qualities of the denture and may cause and
excessive amount of soreness.
80. Radiographs are valuable aids for examination the
osseous structure that are to support the restoration. They
also will show the nutrient canal and any bony pathology.
For the radiographic examination to be of any value,
however the films must be of sufficient technical standard
for interpretation and must be interpreted correctly.
Class I: dense bone provides the optimum foundation for
dentures. The trabeculae are compact and the medullary
spaces are few, and the overall picture is one of opacity.
The cortex is solid and well defined. All other factors being
constant, these structures show little or slow resorption
81. Class II: cancellated bone will give adequate support if
occlusal loading is within physioloic limit, but generally it
will not withstand excessive loading without early
deterioration. The overall picture is much lighter, and there
is great contrast. The trabeculae and the medullary space
are evenly balanced. The cortex is defined but lighter in
contrast
Class III: non cortical bone is radiolucent and poor in
organic salts. There is no definite cortex; margins are
feathery, thin, and often apiculated. It offers poor support
for a denture. Unlesss occlusal loading is strictly reduces,
there follows and endless history of discomfort and
resorpyion
82. Preoperative records are desirable for all patients.
These records will serve as guides in the
construction of the proposed new denture and will
also be of importance for any subsequent dentures.
Preoperative records can provide information about
the shape, form, color, and position of the natural
teeth, the vertical dimension of occlusion, the
support of the lips, and the relationship of the teeth
to the lip. These records may consist of
photographs, diagnostic casts, tattooing of intraoral
structures, measurements of extraoral structure,
charts of remaining teeth and radiograph.
83. A series of photographs made prior to
removal of the remaining teeth should show
the patient in a relaxed state and with a
smile, both from the front and profile. Close
up should be made of individual teeth dental
arches and occlusion
84. If the teeth remain diagnostic casts should
always be made serve as guides for the
placement of the artificial teeth and an
indication of the vertical dimension of
occlusion.
Tattooing :
Records of the vertical dimension of occlusion
can be made by tattoing the attached gingivae
prior to extraction. The distance between the
tattoos is measured
85. Permanent landmarks on the face, such as
scars, mole or warts, can be measured. These
measurements can then be used as guides for
establishing the correct vertical dimension of
occlusion. Tattoos also can be placed on the
patient’s face . One above and one below the
mouth. the distance between the tattoos before
the teeth are removed is duplicated when
recording the jaw relations
86. If the patient old dentures are available the
vertical dimension of occlusion can be
approximated by measuring the dentures.
Further evaluation of the vertical dimension
of occlusion can be made by examining the
esthetics of the patient and his ability to
pronounce the sibilant sounds
87. After having the complete case history and diagnosis of the patient,
dentist should create an idea in his mind how to follow or how to
procede for the further steps and the adjunctive cares to undergo
before the commencement of the treatment
ADJUNCTIVE CARE :
Elimination of infection
Elimination of pathology
Pre-prosthetic surgery
Tissue conditions
Nutritional counselling
From the above adjunctive cares nutritional counselling is very important
step in the treatment planning of complete denture. Patient showing
deficiency towards particular minerals and vitamins should be advised
for a balance diet.
88. After all the diagnostic information has been
gathered, the dentist should attempt to arrive at
a prognosis for the patient. One must consider
the overall picture, including the patient’s
expectation, understanding, and mental
attitude. At the conclusion of denture treatment
the wise dentist reviews his initial diagnosis and
prognosis to see where he was correct and
incorrect. This will be an aid in future denture
situation