DEFINITION
INDICATION AND OBJECTIVES
PROCEDURES FOR INCREASING WIDTH OF ATTACHED GINGIVA
PROCEDURES FOR ROOT COVERAGE
TECHNIQUES FOR CORRECTION OF ABERRANT FRENUM
PAPILLA RECONSTRUCTION
RIDGE AUGMENTATION
PROCEDURES FOR INCREASING VESTIBULAR DEPTH
CROWN LENGTHENING PROCEDURES
Dental implants require regular professional maintenance as well as proper home care. Taking good care of dental implants is the key for long-term success of Dental Implant.
For more information contact :-
Dr Sachdeva's Dental Aesthetic And Implant Institute,
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
• Phone : +919818894041,01142464041
• Our Websites:
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
• Google+ link: https://goo.gl/vqAmvr
• Facebook link: https://goo.gl/tui98A
• Youtube link: https://goo.gl/mk7jfm
• Linkedin link: https://goo.gl/PrPgpB
• Slideshare link : http://goo.gl/0HY6ep
• Twitter Page : https://goo.gl/tohkcI
• Instagram page : https://goo.gl/OOGVig
DEFINITION
INDICATION AND OBJECTIVES
PROCEDURES FOR INCREASING WIDTH OF ATTACHED GINGIVA
PROCEDURES FOR ROOT COVERAGE
TECHNIQUES FOR CORRECTION OF ABERRANT FRENUM
PAPILLA RECONSTRUCTION
RIDGE AUGMENTATION
PROCEDURES FOR INCREASING VESTIBULAR DEPTH
CROWN LENGTHENING PROCEDURES
Dental implants require regular professional maintenance as well as proper home care. Taking good care of dental implants is the key for long-term success of Dental Implant.
For more information contact :-
Dr Sachdeva's Dental Aesthetic And Implant Institute,
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
• Phone : +919818894041,01142464041
• Our Websites:
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
• Google+ link: https://goo.gl/vqAmvr
• Facebook link: https://goo.gl/tui98A
• Youtube link: https://goo.gl/mk7jfm
• Linkedin link: https://goo.gl/PrPgpB
• Slideshare link : http://goo.gl/0HY6ep
• Twitter Page : https://goo.gl/tohkcI
• Instagram page : https://goo.gl/OOGVig
REFERENCES TAKEN FROM CARRANZA'S TEXTBOOK OF CLINICAL PERIODONTOLOGY AND LINDHE'S TEXTBOOK OF CLINICAL PERIODONTOLOGY AND IMPLANT DENTISTRY. CONTAINS ENOUGH AND MORE DETAILS OF THIS TOPIC FOR BDS STUDENTS.HOPE THIS PRESENTATION WILL HELP U GAIN SOME KNOWLEDGE ABOUT PERIODONTAL PLASTIC AND ESTHETIC DENTISTRY.
“Root Conditioning- to do or not to do”- Guest lecture as a part of Dr NTRUHS Zonal CDE programme at SVS Institute of Dental Sciences, Mahabubnagar, India on 15/7/2014 and at Paneenya Mahavidyalaya Institute of Dental Sciences, Hyderabad, India on 27/09/2014.
Coronal advanced flap in combination with a connective tissue graft. Is the t...MD Abdul Haleem
Coronal advanced flap in combination with a connective tissue graft. Is the thickness of the flap a predictor for root coverage? - A prospective clinical study.
Department of Periodontology and Oral Implantology.
"A Journal Club Presentation"
Bruxism and its effect on periodontiumRamya Ganesh
Bruxism/teeth grinding is a common habit seen among pediatric patients and in older patients with relation to improper occlusion. This habit can cause extreme damage to facial muscles and TMJ. Various treatment options are available including botox injections. Hence as a dentist it is our duty to restore patient's oral health in harmony with other oro facial structures.
REFERENCES TAKEN FROM CARRANZA'S TEXTBOOK OF CLINICAL PERIODONTOLOGY AND LINDHE'S TEXTBOOK OF CLINICAL PERIODONTOLOGY AND IMPLANT DENTISTRY. CONTAINS ENOUGH AND MORE DETAILS OF THIS TOPIC FOR BDS STUDENTS.HOPE THIS PRESENTATION WILL HELP U GAIN SOME KNOWLEDGE ABOUT PERIODONTAL PLASTIC AND ESTHETIC DENTISTRY.
“Root Conditioning- to do or not to do”- Guest lecture as a part of Dr NTRUHS Zonal CDE programme at SVS Institute of Dental Sciences, Mahabubnagar, India on 15/7/2014 and at Paneenya Mahavidyalaya Institute of Dental Sciences, Hyderabad, India on 27/09/2014.
Coronal advanced flap in combination with a connective tissue graft. Is the t...MD Abdul Haleem
Coronal advanced flap in combination with a connective tissue graft. Is the thickness of the flap a predictor for root coverage? - A prospective clinical study.
Department of Periodontology and Oral Implantology.
"A Journal Club Presentation"
Bruxism and its effect on periodontiumRamya Ganesh
Bruxism/teeth grinding is a common habit seen among pediatric patients and in older patients with relation to improper occlusion. This habit can cause extreme damage to facial muscles and TMJ. Various treatment options are available including botox injections. Hence as a dentist it is our duty to restore patient's oral health in harmony with other oro facial structures.
Orthodontic wires /certified fixed orthodontic 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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Computers in orthodontics /certified fixed orthodontic courses by Indian dent...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Recent advances in diagnostic aids 2 /certified fixed orthodontic courses by ...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Diagnostic aids in orthodontics /certified fixed orthodontic courses by India...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.
The rationale for using antibiotics and chemotherapeutics in the periodontal disease treatment is its polymicrobial nature of disease. Antibiotic use should be done cautiously in treating various periodontal infection as improper use of it can lead to its resistance by bacterial strains. Antibiotic in periodontics is a very helpful adjunct in controlling the bacteria in the oral cavity
Common Antibiotics : Used in periodontal therapy, easy approach for therapeut...DrUshaVyasBohra
An antibiotic is an agent that either kills or inhibits the growth of a microorganism.
The term antibiotic was first used in 1942 by Selman Waksman and his collaborators in journal articles to describe any substance produced by a microorganism that is antagonistic to the growth of other microorganisms in high dilution.[3] This definition excluded substances that kill bacteria but that are not produced by microorganisms (such as gastric juices and hydrogen peroxide). It also excluded synthetic antibacterial compounds such as the sulfonamides. Many antibacterial compounds are relatively small molecules with a molecular weight of less than 2000 atomic mass units.
With advances in medicinal chemistry, most modern antibacterials are semisynthetic modifications of various natural compounds.[4] These include, for example, the beta-lactam antibiotics, which include the penicillins (produced by fungi in the genus Penicillium), the cephalosporins, and the carbapenems. Compounds that are still isolated from living organisms are the aminoglycosides, whereas other antibacterials—for example, the sulfonamides, the quinolones, and the oxazolidinones—are produced solely by chemical synthesis. In accordance with this, many antibacterial compounds are classified on the basis of chemical/biosynthetic origin into natural, semisynthetic, and synthetic. Another classification system is based on biological activity; in this classification, antibacterials are divided into two broad groups according to their biological effect on microorganisms: Bactericidal agents kill bacteria, and bacteriostatic agents slow down or stall bacterial growth.Before the early 20th century, treatments for infections were based primarily on medicinal folklore. Mixtures with antimicrobial properties that were used in treatments of infections were described over 2000 years ago.[5] Many ancient cultures, including the ancient Egyptians and ancient Greeks, used specially selected mold and plant materials and extracts to treat infections.[6][7] More recent observations made in the laboratory of antibiosis between micro-organisms led to the discovery of natural antibacterials produced by microorganisms. Louis Pasteur observed, "if we could intervene in the antagonism observed between some bacteria, it would offer perhaps the greatest hopes for therapeutics". The term 'antibiosis', meaning "against life," was introduced by the French bacteriologist Jean Paul Vuillemin as a descriptive name of the phenomenon exhibited by these early antibacterial drugs.[9][10] Antibiosis was first described in 1877 in bacteria when Louis Pasteur and Robert Koch observed that an airborne bacillus could inhibit the growth of Bacillus anthracis. These drugs were later renamed antibiotics by Selman Waksman, an American microbiologist, in 1942. Synthetic antibiotic chemotherapy as a science and development of antibacterials began in Germany with Paul Ehrlich in the late 1880s. Ehrlich noted that certain.
It is a naturally occurring, semi-synthetic, or synthetic type of anti-infective agent that destroys or inhibits the growth of selective microorganisms, generally at low concentrations.
These drugs are used extensively in dentistry for two main reasons: to prevent an infection (chemoprophylaxis) and in the treatment of an infection. Their use in the management of periodontal diseases is often as an adjunct to conventional treatment.
INDICATIONS IN PERIODONTAL DISEASES
1. Patients who do not respond to conventional mechanical periodontal therapy
2. Patients with Aggressive periodontitis and other types of early-onset periodontitis
3. Patients with acute or recurrent periodontal infection
(Periodontal abscess, NUG / NUP, Peri-implantitis, Pericoronitis) associated with/without systemic manifestation)
4. Prophylaxis for medically compromised patients, endocarditis
This topic include all the drugs that are locally applied in periodontal pocket so that their levels in GCF should be more than blood.
Advantages:
Can attain higher concentrations at base of pocket
Can use drugs that are not suitable for systemic administration
Patient compliance is not required
Alternative for patients predisposed to adverse drug reactions from systemic administration.
Reduced risk for drug resistant microbe development
Lower total drug dose
INDICATIONS:
As an adjunct to mechanical therapy in pockets of 5 mm or greater depth
In patients who are systemically compromised & cannot undergo periodontal flap surgery
Localized recurrent pockets with supportive periodontal therapy
In refractory periodontitis (that is resistant to treatment)
Similar to Antiinfective host modulation dr alaa (20)
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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!
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
4. Introduction
• The basic treatment of periodontitis is the
mechanical debridement of periodontal pockets
by scaling and root planing in combination with
effective plaque control.
• Certain periodontal pathogens can invade the
connective tissue e.g. Aa making it unreliably
removed with mechanical debridement alone.
• Systemic and local antimicrobial therapies aim
to help the mechanical and surgical periodontal
treatment by killing susceptible periodontal
pathogens that remain after conventional
mechanical treatment.
5. Systemic Antimicrobial Therapy
General Guidelines for Antimicrobial Use
• Used as “adjunctive therapy”, never a substitute to
mechanical therapy.
• They enhance the effect of debridement.
Indications
• Patients not responding to conventional mechanical therapy.
• Aggressive periodontitis.
• Refractory periodontitis (not respond to conventional ttt).
• Acute periodontal infections e.g. (abscesses and NPD).
• As an adjunct to surgical and non-surgical periodontal
therapy.
7. A- Systemic Antimicrobial Therapy
Disadvantages
• Allergic reactions
• Super infection, e.g. fungal infections, on
prolonged use
• Toxicity
• Drug interactions
• Patient compliance is extremely important
• Bacterial resistance
8. 1- Penicillins
Amoxicillin: Used for all aggressive
periodontitis cases 500mg/3/8.
Amoxicillin-Clavulnate (Augmentin):
Can be used for refractory and localized
aggressive periodontitis cases; 625
mg/3/8.
ttt : Localized aggressive P.
- Refractory periodontitis – P Abscess
9. 2- Tetracycline
Properties
• Broad spectrum antibiotic
• 4-8 µg/ml in the GCF (2-10 times more
than serum concentration)
• Bacteriostatic, Bactericidal (at high doses)
• Tetracycline, Doxycycline, and
Minocycline are the tetracyclines used for
periodontal therapy
• Dose: 250 mg, 4 times daily
10. 2- Tetracycline
Side Effects
• Photosensitivity
• Stains teeth in children
• Absorption is impaired by antacids, milk &
calcium rich foods
• oral contraceptive effect
11. 2- Tetracycline
Indications
• Refractory cases
• Localized aggressive periodontitis
Contraindications
• Pregnancy
• Children
• Renal insufficiency (can use doxycycline)
• Liver dysfunction (can use minocycline)
12. Minocycline
• It suppresses the spirochetes
• Less photosensitivity and renal toxicity than
tetracycline
• May cause reversible vertigo
• Administered in a dose of 200 mg per day for
one week
Doxycycline
• Has the same spectrum as minocycline
• Its absorption is not affected by calcium, metal
ions or antacids.
• Given 100 mg once daily or 50 mg twice daily.
13. 3- Metronidazole
Mechanism of Action
• Bactericidal antimicrobial.
• Disrupts DNA synthesis
• Susceptible bacteria include Bacteroides, P. gingivalis,
Treponema, Campylobacter and Veillonellae.
Indications
• Necrotizing ulcerative gingivitis
• Refractory periodontitis (Combined with Amoxicillin or
Augmentin)
• Localized aggressive cases (combined with amoxicillin or
Augmentin).
• Ineffective against Aa except when combined with other drugs.
• Dose: 250 mg tid for 7-10 days or 500 mg bid for 1-2 weeks.
14. 4- Ciprofloxacin
Action: active against gram-negative rods,
including all facultative and some anaerobic
putative periodontal pathogens.
• Indicated for use in refractory periodontitis
• May facilitate repopulation of pocket with
organisms associated with periodontal health
• Not for use in children as it disrupts the growth
pattern
• Side effect: Nausea, headache, metallic taste
in the mouth, and abdominal discomfort,
enhance anticoagulant.
15. 5- Clindamycin
Action: against anaerobic bacteria and has a
strong affinity for osseous tissue
• Indicated: for refractory periodontitis especially
in cases that are non-responsive to tetracycline.
• Side Effects
- Diarrhea
- Pseudomembranous colitis- caused by clostridium
difficile
- Super infections
- Fungal overgrowth in oral cavity, intestine and
vagina
• Dose: 250-500 mg, tid, for 8 days
16. 6- Azithromycin
Azithromycin is a member of the azalide class of
macrolides.
Action: against anaerobes and gram-negative
bacilli.
For treatment of Aggressive periodontitis.
After an oral dosage of 500 mg qd for 3 days,
significant levels of azithromycin can be detected
in most tissues for 7 to 10 days.
Dose: 250 mg/day for 5 days after an initial
loading dose of 500 mg.
17. Combination Therapies
• Augmentin & Metronidazole
- 250 mg of each 3 times daily
- 8 days
• Ciprofloxacin & Metronidazole
- 500 mg of each twice daily
- 8 days
• Clindamycin & Ciprofloxacin
- 300 mg clindamycin
- 500 mg ciprofloxacin
- twice daily 8 days
18. Important notice
Antibiotic treatment should be reserved for
specific subsets of periodontal patients who do
not respond to conventional therapy.
Selection of specific agents should be guided
by the results of cultures and sensitivity tests
for subgingival plaque microorganisms.
At this time, systemic antibiotics for the
treatment of periodontal diseases have been
indicated primarily for adjunctive use in the
treatment of aggressive periodontal diseases
21. B- Local Delivery Antimicrobials
Advantages
• Facilitates prolonged drug delivery.
• GCF concentration greater than serum
levels.
• Reduces systemic effects.
• Enhances treatment results at specific
locations (i.e. acts on treated sites only).
• Improves clinical signs of periodontitis.
22. 1- Tetracycline (Actisite)
How Supplied
• Fiber of 23 cm in length that has 12.7 mg tetracycline
hydrochloride
Indications:
• Pockets measuring 5 mm that bleed on probing.
• Localized treatment of sites not responding to mechanical
therapy.
Application
• Fiber is inserted into the pocket.
• Some control of saliva is needed.
• Should contact the pocket base.
• Surgical dressing is not necessary.
• Removed 7-10 days after placement.
23. 2- Minocycline (Arestin)
How Supplied
sustained-release form of minocycline
microspheres (Arestin) is available for
subgingival placement as an adjunct to scaling
and root planing. The 2% minocycline is
encapsulated into bioresorbable microspheres
in a gel carrier.
Patient Instructions
• Do not eat hard or sticky foods for 1 week.
• Avoid of brushing for 12 hours.
• Do not use interproximal cleaning aids for 10 days
24. Arestin
It is minocycline microencapsulated in in gel carrier.
Placement of minocycline
microspheres (Arestin).
25. 3- Doxycycline hyclate (Atridox)
It is an 10 % Doxycycline hyclate
• Bioresorbable.
• Released at minimal inhibitory
concentration levels for most
periodontal pathogens over a period of 7-8 days.
How Supplied
• A liquid polymer in one syringe and powdered
doxycycline hyclate in a second syringe, the two
syringes are mixed together just before use.
• The mixture is injected into the pocket using a blunt
needle and solidifies in contact with crevicular fluid
and saliva.
27. 4- Metronidazole (Elyzol)
• Metronidazole. (Elyzol)
Is A topical medication containing an oil-
based metronidazole 25% dental gel
28. 5- Chlorhexidine gluconate (Periochip)
• 34 % chlorhexidine gluconate in a cross-linked
gelatin matrix.
• Each chip contains 2.5mg of chlorhexidine
gluconate.
• Chip is gently pushed into the pocket and it
biodegrades over 7-10 days.
• Chlorhexidine has been detected in gingival fluid
for one week following a single application.
• Absence of any bacterial resistance with
repeated use.
• Good substantively.
30. Conclusions
Mechanical plaque removal remains the
cornerstone of preventive and therapeutic
regimens in the management of gingivitis and
periodontitis.
Specific subgroups of patients can significantly
benefit from an adjunctive antimicrobial agents.
32. Host Modulation: is the process that uses drugs
or chemicals, other than antimicrobials, to reduce
periodontal breakdown and enhance the immune
response of the host.
A- Systemically Administered Agents
B- Locally Administrating Agents
Host Modulations
35. 1- Subantimicrobial dose doxycycline
Periostat
• Periostat is the first therapeutic agent
designed to modulate the host response and
helps to slow the progression of periodontal
disease.
• It is a doxycycline hyclate that is not used as an
antibiotic and has no detectable effect on
bacteria.
• Inhibits collagenase activity in gingival
crevicular fluid of patients with periodontitis.
36. Available as a 20 mg tablet to be taken
orally two times a day (about an hour
before, or two hours after meals). It
should be taken with plenty of fluids.
Typical treatments range from 3
months to 12 months.
Should not be used for children,
pregnant and nursing women or
anyone with tetracycline
hypersensitivity.
38. 2– NSAID
NSAIDs inhibit the formation of
prostaglandins, including PGE2, which is
produced by neutrophils, macrophages,
fibroblasts, and gingival epithelial cells in
response to the presence of LPS, a component
of the cell wall of gram-negative bacteria.
They are used to treat pain, acute
inflammation, and a variety of chronic
inflammatory conditions.
NSAIDs inhibit prostaglandins and therefore
reduce tissue inflammation.
41. COX-1 is constitutively expressed and has
antithrombogenic and cytoprotective functions.
Therefore, inhibition of COX-1 by nonselective NSAIDs
causes side effects such as gastrointestinal ulceration
and impaired hemostasis.
COX-2 is induced after stimulation by various
cytokines, growth factors, and LPS and results in the
production of elevated quantities of prostaglandins.
Inhibition of COX-2 by selective COX-2 inhibitors results
in reduction of inflammation.
42. Research shows that the periodontal benefits of taking
long-term NSAIDs are lost when patients stop taking the
drugs, with a return to or even an acceleration of the rate
of bone loss seen before NSAID therapy, often referred to
as a (rebound effect).
For these reasons, the long-term use of NSAIDs as an
adjunctive treatment for periodontitis has never really
developed beyond research studies.
NSAIDs (including the selective COX-2 specific inhibitors)
are presently not indicated as adjunctive human
modulators (HMTs) in the treatment of periodontal
disease.
43. 3- Bisphosphonates
The bisphosphonates are bone-seeking agents that inhibit
bone resorption by disrupting osteoclast activity.
Bisphosphonates interfere with osteoblast metabolism and
secretion of lysosomal enzymes.
Recent evidence has suggested that bisphosphonates also
possess anticollagenase properties.
In animal models of experimentally induced periodontitis,
bisphosphonates reduced alveolar bone resorption.
In human studies, these agents resulted in enhanced alveolar
bone status and density.
Side effect: ostenecrosis , oral ulcers , altered WBCs count
Dose: very small dose in comparison to anti-malignant dose
about (0.2 to 1 mg/kg/d).
44. B- Locally Administered Agents
1- NASID e.g. topical ketorolac mouthrinse
2- Periodontal bone regenerative agents:
A- Enamel Matrix Proteins
B- Growth Factors e.g.
(Platelet-derived growth factor, insulinlike g. factor).
C- Bone morphogenetic proteins (BMP-2, BMP-7).