The document discusses treatment planning for dental implants. It outlines the steps in the treatment planning process including examination of the patient, study models, medical imaging, and determining candidacy. Treatment options for edentulous jaws are presented including implant-supported and tissue-supported prostheses. Surgical considerations like incision design, drilling templates, and bone quality are covered. The parts of a dental implant and surgical procedure are defined.
Zygomatic Implants
An inadequate bone support requires Zygomatic Implants.
Although Zygomatic Implants are placed when amount of bone is lesser but it also have some complication.
Few complications, during surgery are Zygomatic bone fracture, orbital penetration, Implant head damage.
Post-operative complications are:- severe fracture, failure of Implant, oro-antral fistula, soft tissue inflammation, sinusitis.
Implant placement needs precise hands, and should be perform by impeccable Implantologist.
Dr. Rajat at Dr. Sachdeva's Dental Institute is deft Implantologist.
Thorough experience of dealing with patients and mentoring student establishing next level Implants Dentistry.
Call us to know more:-
+919818894041,01142464041
Follow our link:-
Google link:
https://business.google.com/dashboard/l/04970356233769420071
Facebook link for Dental Courses:
https://www.facebook.com/dentalcoursesdelhi/
Facebook link for Dental Treatments:
https://www.facebook.com/sachdevadental/
You tube Link:
https://www.youtube.com/user/drrajatsachdeva
Linkedin link:
https://www.linkedin.com/in/drrajatsachdeva/
Slideshare:
https://www.slideshare.net/drrajatsachdeva
Twitter Page :
https://twitter.com/drrajatsachdeva
Instagram page :
https://www.instagram.com/surgicalmasterrajat/
Practo Profile :
https://www.practo.com/delhi/doctor/dr-rajat-sachdeva-dentist
Blogger Profile :
http://drrajatsachdeva.blogspot.com/
Facial Aesthetics Facebook Page :
https://www.facebook.com/facialaesthetics.delhi
Facial Aesthetics you tube channel :
http://www.youtube.com/channel/UCheM4wF9nWGXJYOmScvsQNw
Zygomatic Implants
An inadequate bone support requires Zygomatic Implants.
Although Zygomatic Implants are placed when amount of bone is lesser but it also have some complication.
Few complications, during surgery are Zygomatic bone fracture, orbital penetration, Implant head damage.
Post-operative complications are:- severe fracture, failure of Implant, oro-antral fistula, soft tissue inflammation, sinusitis.
Implant placement needs precise hands, and should be perform by impeccable Implantologist.
Dr. Rajat at Dr. Sachdeva's Dental Institute is deft Implantologist.
Thorough experience of dealing with patients and mentoring student establishing next level Implants Dentistry.
Call us to know more:-
+919818894041,01142464041
Follow our link:-
Google link:
https://business.google.com/dashboard/l/04970356233769420071
Facebook link for Dental Courses:
https://www.facebook.com/dentalcoursesdelhi/
Facebook link for Dental Treatments:
https://www.facebook.com/sachdevadental/
You tube Link:
https://www.youtube.com/user/drrajatsachdeva
Linkedin link:
https://www.linkedin.com/in/drrajatsachdeva/
Slideshare:
https://www.slideshare.net/drrajatsachdeva
Twitter Page :
https://twitter.com/drrajatsachdeva
Instagram page :
https://www.instagram.com/surgicalmasterrajat/
Practo Profile :
https://www.practo.com/delhi/doctor/dr-rajat-sachdeva-dentist
Blogger Profile :
http://drrajatsachdeva.blogspot.com/
Facial Aesthetics Facebook Page :
https://www.facebook.com/facialaesthetics.delhi
Facial Aesthetics you tube channel :
http://www.youtube.com/channel/UCheM4wF9nWGXJYOmScvsQNw
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
Description :
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
Anatomical considerations for placing dental implants.
all the basic anatomical landmarks and considerations which are to be taken care off before and while placing a dental implant.
any type of implant it may be...wether endossous or subperiosteal or tranosteal.
lack of knowledge of basic anatomy will never lead to success of implant.
The primary success metric of dental implants is achieving osseointegration, which is influenced by many factors including implant design, surface treatments, as well as treatment method. Implant drilling is also a major influential factor.
PREPROSTHETIC SURGERY: ROLE IN PREPARATION OF AN IDEAL FOUNDATION FOR COMPLET...Dr ARATI HOSKHANDE
The goal of preposthetic surgery is to modify the oral environment to render it free of disease and to make its form and possibly it’s function more compatible with the requirements of prosthesis.
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
Description :
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
Anatomical considerations for placing dental implants.
all the basic anatomical landmarks and considerations which are to be taken care off before and while placing a dental implant.
any type of implant it may be...wether endossous or subperiosteal or tranosteal.
lack of knowledge of basic anatomy will never lead to success of implant.
The primary success metric of dental implants is achieving osseointegration, which is influenced by many factors including implant design, surface treatments, as well as treatment method. Implant drilling is also a major influential factor.
PREPROSTHETIC SURGERY: ROLE IN PREPARATION OF AN IDEAL FOUNDATION FOR COMPLET...Dr ARATI HOSKHANDE
The goal of preposthetic surgery is to modify the oral environment to render it free of disease and to make its form and possibly it’s function more compatible with the requirements of prosthesis.
The treatment of maxillary transverse deficiency in post-pubertal patients has been an area of disagreement among orthodontists. Much of the controversy is over the timing of when it is appropriate for these patients to be referred to an oral and maxillofacial surgeon for an adjunctive surgical procedure or whether traditional orthodontic mechanics should be attempted. The decision, therefore, by an orthodontist of when to refer a patient for surgery
appears to be an individual one. The question then becomes which of the three basic surgical procedures would be most appropriate for the patient. Specifically, consideration must be given to surgically assisted rapid palatal expansion, segmental LeFort I osteotomy, or mandibular midline osteotomy with constriction.
All you need to know about the gummy smile its causes and examination are included in the powerpoint, how to diagnose gummy smile, its treatment options and cases are presented in the powerpoint.
L-PRF for increasing the width of keratinized mucosa around implants: A split...MD Abdul Haleem
Journal Club Presentation: L-PRF for increasing the width of keratinized mucosa around implants: A split-mouth, randomized, controlled pilot clinical trial.
Determination of root canal working length /certified fixed orthodontic cours...Indian dental academy
Welcome to 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 has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
Iimportance of keeping records in dental practice Asmita Sodhi
keeping thorough dental records is very important than you may think , it provide invaluable data to future students and practitioners , save you from litigation , share and spread education , unleash the power within....dental records
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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!
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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.
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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.
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
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.
- 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
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.
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
3. ALGORITHM OF IMPLANT THERAPY
Surgery
Bone healing
period
Second stage
surgery
Early loading period
Recall and Maintainance
Prosthetic treatment
Full functional loading
period
Diagnosis and treatment planning
4. CASE SELECTION & TREATMENT PLANNING
• Entire chronological sequence of clinical steps
necessary to bring about comprehensive and
successful patient care.
5. TREATMENT PLANNING AND CASE
SELECTION
• A planned schedule of procedures and
appointments designed to restore patient's
oral health step by step.
The plan contains the advantages,
disadvantages, costs, alternatives, and
sequelae of treatment.
6. TREATMENT PLANNING AND CASE
SELECTION
• Treatment does not guarantee results
• Not all patients are implant candidates FPD,
RPD &CD still have indications based on
anatomic and other conditions
7. CRITERIA OF SUCCESS
• Thorough study of stomatoganathic system.
• Supervised learning.
• Customized treatment planning.
8. STOMATOGANATHIC SYSTEM
• Stomatoganathic system consists of mouth,
jaw and closely associated
structures(anatomy).
• Structures involved in speech.
• Reception, mastication, and deglutition of
food.
22. FIRST VISIT
• Reason for the patients visit
• Primary selection of the patient
• Information and motivation
• Medical questionnaire
• Patient examination
23. EXAMINATION OF PATIENT
• Extra oral examination
• Intra oral
• Study models
• Complimentary examination
1.Medical imaging eg : IOPA,OPG,Scan
2.Bio-chemical tests
24. EXTRA ORAL EXAMINATION
• Psychologically , functionally & anatomically
• Patients general behaviour
• Palpation for glands and lymph nodes
• Lip line & cheek support
• TMJ disorders
• Facial symmetry
25. INTRA ORAL EXAMINATION
Visual examination
• Patient’s edentulous status
• Width and length of the operative site
• Malocclusion
• Caries
• Periodontal condition
• Amount of attached gingiva
• Mouth opening
• Gagging reflex
• Teeth attrition
• Oral infections and growths
• Muscle attachment
26. INTRA ORAL EXAMINATION
Manual palpation
• Palpate edentulous area
• Thickness of soft tissue
• Convexities and concavities
27. PHYSICAL EXAMINATION
• Evaluation of Mouth opening
• Health of the intraoral soft tissues
• Soft tissue attachment of the floor of the
mouth
• Attachment of mentalis musculature
• Width of the band of keratinized gingival (KG)
on the alveolar crest
• Distance from the crest to the junction of the
attached and unattached mucosa
• Soft tissue examination for vestibuloplasty.
28. PHYSICAL EXAMINATION
• Locations of the submandibular ducts
• Locations of the mental foramina are palpated and
transferred to a diagnostic cast.
• The slopes of the labial and lingual cortices.
• The height of the mandible
• The location of the genial tubercles.
• In a relaxed vertical position of the jaws, the
relationship of the anterior mandible to the maxilla is
observed.
• Confirmed by radiographic evaluation.
• Discuss need for an adjunctive soft tissue procedure
such as a simultaneous vestibuloplasty.
31. BIO-CHEMICAL TESTS
• Serum glucose
Fasting - 80 to 100 mg/dl
Post prandial – 110 to 140 mg/dl
• S. creatinine – 0.8-1.2 mg/dl
• S.urea – 20 to 40 mg/dl
• S. uric acid – 4 to 7 mg/dl
• S. chlolesterol – 150 to 250 mg/dl
• S. bilirubin – 0.2 to 1 mg/dl
• SGOT - Serum Glutamic Oxalacetic .
Transaminase – 5 to 35 IU
32. BIO-CHEMICAL TESTS
• SGPT –Serum Glutamic Pyruvic
Transaminase
• Gamma glutamic transpeptidase - <25 mU
• Alkaline phosphatase – 13 to 39 IU
• Serum calcium – 10mg/dl
• Serum phosphates – 1.5 to 6.8 mg/dl
a. Reciprocal relationship with calcium one>-other<????????
b. Ratio of phosphates to calcium is 4 : 10
• CBC
• Blood tests for hemorrhagic conditions
33.
34. STUDY CASTS
• To study patients occlusion especially
combination syndrome
• Bone mapping
• To plan prosthetic driven surgery
• Cast open to discussion with colleagues and
patient
• To design surgical templates
• To keep patients record
• To educate & motivate patient
55. RADIOLOGIC EVALUATION
• Focused on determining the vertical height and
slopes of the cortices in relation to the opposite arch.
• OPG & lateral Ceph. is typically used.
• Usually magnified.
• Ball bearings of known diameter can be placed in a
stent in the positions that are prescribed to receive
implants, and then magnification error can be
determined and the correct vertical dimension
calculated.
• If the mandible is greater then 15 mm, the
panoramic radiograph is the only film needed.
• If width is doubtful, then Dental scans are preferred.
59. DETERMINING CANINE POSITION
Alla of the nose depicts the mesial position of the canine.
Corner of the mouth depicts the distal aspect of the canine.
86. • If thin band of KG is lingually positioned. Soft tissue grafting
fails.
• Implants placed lingual to the crest of the ridge, lingual to the
attachment of the muscles.
• If labially chronic irritation causes soreness.
• Mucosal recession.
• No vestibuloplasty.(witch like appearance)
ATROPHIC MANDIBLE
87. • Incision crestal or vestibular .
• Incision bisecting the KG allows it to remain on the
labial surface
• Vestibuloplasty if needed.
MANDIBLE >12MM
88. PREMATURE BREAKDOWN OF INCISION
• excessive pressure from the removable prosthesis,
• supracrestal profile of the implant with cover screw in place
• surgical trauma to the tissues,
• poor tissue quality and
• poor healing.
• Poor incision design.
• Poor incision & suturing.
• If the alveolar crest is thin with the band of KG over the thin
portion of the crest, bisecting the KG may create a difficult
dissection of the flaps because the gingiva will be thin over
the thin crest.
• In case of traumatic dissection- Layered suturing.
• Avoid re-suturing.
91. PARTS OF A DENTAL IMPLANT
IMPLANT BODY
OFTEN REFERRED TO AS AN IMPLANT.
92. PARTS OF A DENTAL IMPLANT
COVER SCREW
PREVENTS BONE INGRESS INTO IMPLANT HEAD.
93. PARTS OF A DENTAL IMPLANT
HEALING ABUTMENT
PLACED TEMPORARILY ON THE IMPLANT BODY
TO MAINTAIN POTENCY OF THE MUCOSAL PENETRATION.
94. PARTS OF A DENTAL IMPLANT
TEMPORARY COMPONENTS
PRE-MANUFACTURED COMPONENTS
USED TO MAKE TEMPORARY
CROWNS AND BRIDGES FOR
FITTING ON DENTAL IMPLANTS AND
ABUTMENTS.
95. PARTS OF A DENTAL IMPLANT
IMPRESSION COPING
USED TO TRANSFER THE LOCATION
OF THE IMPLANT BODY
OR ABUTMENT TO A DENTAL CAST.
96. PARTS OF A DENTAL IMPLANT
LABORATORY ANALOGUE
A BASE METAL REPLICA OF
IMPLANT BODY.
97. PARTS OF A DENTAL IMPLANT
INSERTION OF HEALING COLLAR
Length of crown
Missing papilla
Broad crowns
Food impaction
Speech
Hygiene
Adjacent teeth are preserved
Dental implants help to preserve the health of natural teeth as they share the occlusion load.
Preserves occlusion
Hygienic
One additional and very important benefit can be reduction or elimination of bone shrinkage or atrophy commonly related to tooth loss
Maintenance of VDO
Regained proprioception
Increased stability, retention and support of soft tissue
Maintenance of muscles of mastication and facial expression
Improved phonetics and psychological health SMILE WITH CONFIDENCE
Prosthesis over implants lasts longer
Replacement of teeth look, feel and function more like natural teeth .
Improve taste and appetite (less coverage of the palate )
Improve cosmetic appearance.
Ability to chew without pain and gum irritation .
Foods that were unable to eat are back in the diet.
No longer need to use the distasteful adhesives.
Limitations in opening may affect the treatment plan in extreme conditions.
The presence of undiagnosed pathologic and dental infection, as well as mucosal infections, must be treated to completion before implant placement.
The prothrombin time (PT) and its derived measures of prothrombin ratio (PR) and international normalized ratio (INR) are measures of the extrinsic pathway of coagulation. They are used to determine the clotting tendency of blood, in the measure of warfarin dosage, liver damage, and vitamin K status. PT measures factors I, II, V, VII, and X. It is used in conjunction with the activated partial thromboplastin time (aPTT) which measures the intrinsic pathway.
he reference range for prothrombin time is usually around 11–16 seconds; the normal range for the INR is 0.8–1.2. Clinicians desiring therapeutic anticoagulation may aim for a higher INR - in many cases 2.5 - using anticoagulants such as warfarin.[1
The prothrombin time can be prolonged as a result of deficiencies in vitamin K, which can be caused by warfarin, malabsorption, or lack of intestinal colonization by bacteria (such as in newborns). In addition, poor factor VII synthesis (due to liver disease) or increased consumption (in disseminated intravascular coagulation) may prolong the PT.
The surgical placement of implants for a full-arch crown and bridge prosthesis with individual porcelain teeth requires meticulous planning and placement of implants to locate them within the confines of the crown, avoiding the embrasure spaces.
Retentive elements
). The lateral cephalogram demonstrates the slopes of the cortices of the mandible and the skeletal ridge relationships of the mandible to the maxilla, and it provides a simple and inexpensive radiographic assessment of anterior height. If desired, foil can be placed over the anterior teeth in a set of dentures, which if worn during exposure of the lateral cephalogram, can demonstrate clearly the relationship of the teeth to the ridge and the ridge relationships. This provides insight as to angulation of the implants to place then in ideal locations for the implant supported or tissue supported prostheses.
The fixed implant rehabilitation of edentulous maxillas with favorable anatomy and favorable arch position, favorable anatomy, and unfavorable arch position, and unfavorable anatomy and favorable arch position.
If the attachment of the mentalis muscle is 3 mm or more labial to the location of the attached gingiva on the alveolar crest, a crestal incision can be
If the location of the mentalis muscle is adjacent to the alveolar crest, which would result in mobile unattached gingiva directly against the implant abutment when restored, a vestibular incision is used. A type of lipswitch vestibuloplasty is performed to reposition the muscle attachments inferiorly, resulting in nonmobile tissue on the labial -surface of the implant abutment complex.
Difficult dissection.
lipswitch vestibuloplasty contraindicated because displacement of the mentalis musculature in an atrophic mandible will result in a drooping, &quot;witchlike&quot; chin deformity.
10-15mm Mentalis muscle attachment is must
For the atrophic mandible with 12 to 8 mm vertical bone height, the locations of the incisions and implants and the location of the incision for second-stage surgery are critical for successful restoration. The incision for placement should be placed to avoid loss of KG. Thus the incision placed at the anterior border of the mandibular alveolar crest, typically labial to the KG, allows for an adequate dissection.
Attempts to enlarge the band of attached ,KG do not have a high rate of success because the lip muscles tend to displace the graft from the host bed.
CRESTAL INCISION AND DISSECTION. The crestal
incision should bisect the band of KG. Bisecting the
KG is important to avoid a potential soft tissue problem if the incision should open during the healing period. The incision should extend along the alveolar crest posterior to the mental foramen. When the mental forame is on top of the crest, secondary to severe bone resorption, the incision should be stopped anterior to the foramen. After the Periosteum has been flected, the mental foramen is visualized and the crestial incision can then be extended posteriorly along the lingual crest, avoiding trauma to the nerve. Occasionally, vertical release incisions can be used posteriorly. This author avoids a midline vertical release incision because of increased patient discomfort during the first 2 weeks of healing.
After the incision is made through the perios‑teum to the bone, a periosteal elevator is used toreflect subperiosteal flaps both labially and lingually. A clean subperiosteal dissection is important to perform because bleeding is minimal and large lingual blood vessels can be avoided. If muscle attachments are found inserting into the crest, a scalpel is used to sever them cleanly rather than tearing them, which subsequently increases bleeding and trauma to the soft tissue. The reflection of the labial tissues can be tedious because of the firm attachment of the dense fibrous alveolar crestal tissue or if the ridge is narrow. Great care should be taken to raise an intact flap without multiple tears