This document presents the case of a 32-year-old female patient seeking treatment to align her lower teeth and hide her upper gum during smiling. Her clinical examination revealed gummy smile, crowding on the lower arch, and asymmetry of the gingival margins when smiling. The treatment plan is to relieve crowding, correct midline shifts, achieve normal overjet and overbite, intrude the upper posterior teeth to reduce gummy smile, and perform gingival reshaping. Appliances to be used include low bracket placement, extraction of teeth #18 and #28, TPA, lingual arch, and mini-screw anchorage.
Treatment of a young female patient wit a combination of Invisalign and distalizing appliance. Well treated by one of our students under my supervision.
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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
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HI THIS IS A NICE SEMINAR DESCRIBING ABOUT THE ORTHOGNATHIC SURGERY MAINLY RELATED TO ORTHODONTICS VIEWPOINT AND CEPH TRACING ITS INDICATION AND DIFFERENT TYPES OF SURGERIES. JUST HAVE A LOOK TO IT
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
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
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.
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Chhom Karath
1. A Clinical Conference Case
Presented in Partial Fulfillment of the
Requirements for the Degree of
Master of Science in Dentistry,
m.s. (Orthodontics)
CHHOM KARATH
2. Chief Complaint: Want to align lower teeth and hide upper gum during smiling.
Medical History: Some Remarkable
Dental History:
•Regular check up every 6 month
•Root canal treatment and crown #46
Family History: Unremarkable
Family History: Unremarkable problem
1. Interviews / Questionnaire
Patient Initial: U SP Age: 32y , Sex: f, Birth Date: August 4,1987
Heigh:1.58 m , Weigh: 48 kg, Career: Pharmacist
5. 5
2. Clinical Examination
Soft-tissue assessment
•Increase upper facial heigh
•Competent lip
•Mild facial Asymmetry face
•Short upper lip length
•Imbalance vertical facial height
•Imbalance vertical lip-chin
•Potentially competent lips
•Body type: Athletic
•Shape of head: Mesiocephalic
•Facial form: Mesoprosopic
•Tip of nose deviation to the right
•Chin deviation to the right side
17mm (1/3)
32mm (>2/3)
6. 6
2. Clinical Examination
Smile Aesthetics assessment
•Gummy smile on upper teeth
•Incisal edges of upper teeth 10%
hidden by lower lip.
• Small on right buccal corrido
•No teeth show on lower teeth
•Smile: wide
•Smile arch: straight
•Smile is not acceptable
•Lower midline to upper midline off
to the right side by 0.5mm
•Contact point: not good(50%,40%,30%)
•Embrassure not well
form(20%,30%,40%,50%)
•Hypertonic lower lip
50%
40% 40%
20%40%
7. 7
2. Clinical Examination
Smile Aesthetics assessment
•Gummy smile(Dento-alveolar etiology)
•Narrow on right buccal corridors(dark buccal corridors)
•Hidden upper incisor edges by lower lip 10%-15% (thick lower lip, thin upper lip)
•Gingival display level left central incisor is higher 0.5mm from right central incisor lateral teeth
0.5mm from central
•Gum color: pink, texture: normal, shape: scalloped
•Normal frenal attachment level
•Tooth width ratio non balance(x,x-1mm,x-2mm)
9. 9
2. Clinical Examination
Smile Aesthetics assessment
•Volume of interdental papilla formation is 45%(ideal 40%-50% length max incisor)
10. 1
0
2. Clinical Examination(Orthopantomograph-OPT)
TMJ
•No signs of TMD(No clicking, crepitus, and tenderness to palpation)
•Normal range of opening, lateral movement and no displacement.
•No erosion
•Normal opening and side to side openning
•TMJ space obliterated on the right side. Also associated with mild condylar resorption
on the same side.
•Normal condyles
14. 1. Molar class I, canine class I, lower arch: asymmetric constricted arch
2. Incisor class III(edge to edge)
3. Molar class I, canine class I
4. U-shape arch form, attrition #16,26,staining #17,18,27,28. Rotate #14,15, assymetry arch form
5. Over jet 2mm, over bite 10%
6. Crowding #41,#42,#32,z#32. Rotate #34,#44. U shape arch form
7. Soft tissue: good, Normal tongue size and function
8. Attached gingival scaring
9. Fair oral hygient, good oral mucosa, no teeth missing, no mid line shift, crack #13,#23
10. Normal tongue position, Normal palate
11. IOTN: grade 2
1 2 3
4 5 6
20. AREA OF STUDY YAS MEASUREMENT STANDARD INITIAL INTERPRETATION
Cranial Base BA–S-n 130o 141o
Long face
Maxilla to Cranial Base SNA 82 o 81o
Prognathic maxilla
N-A-FH 90 o 97o
A-Nas Vert. (mm) -2mm 10mm
Mandible to Cranial Base SNB 80 o 76o
Retronathic
mandible
NPog-FH 88 o 91o
Po-N Vert. (mm) -6mm 0o
Maxillo-Mandibular Relationship ANB 2 o 5o
Class IIA-NPog 1mm 2mm
Wits 2mm 5mm
Vertical Height SN-MPA 32 o 32o
Mandibular plan height
angle
Normal facial heigh
FMA 25 o 15o
N-ANS (%) 45% 42%
ANS-Me (%) 55% 58%
Maxillary & Mandibular Incisor Position U1-SN 104 o 106o
proclination of upper
incisor
proclination of lower
incisor
U1-NA (mm) 4mm 2mm
U1-NA 22 o 27o
IMPA 90 o 101o
L1-NB (mm) 4mm 3mm
L1-NB 25 o 31o
L1-APog 2mm 6mm
U1-L1 130 o 119o
Soft Tissue E-line-Lower lip -2mm 0mm Protrusion of the lip
21. ODI=FH pl. to palatal plan angle + AB to mandibular plan angle=8.5O+78O=86.5O
Openbite tendency<(74.5O±6.07O)<Overbite tendency
=> Overbite tendency
Bo
Po
Co
S pt
Go
PNS
ANS
Or
N
A
B
Me
Gn
Pog
Ba
22. •APDI=FH to palatal plane angle(8O)+Facial angle(91O)+AB plane
angle(7O)=8O+91O+7O=106O => Class III tendency
(Class II tendency<(81.4O±3.79O<Class III tendency)
•Facial angle(84.04O±3.42O)=FH to Npog=91O => Prominance of chin
•Y-axis(66.36O±3.85O )=FH-SGo=54O=> Class III facial pattern
•Gonial angle: Ar-Go to Go-Me=119O (122+-6.9 for female, 119.1+-6.5 for male)=>Open bite tendency
Bo
Po
Co
S pt
Go
PNS
ANS
Or
N
A
B
Me
Gn
Pog
Ba
Ar
23.
24. 3. Model Analysis
1. M-D width of teeth
7 6 5 4 3 2 1 1 2 3 4 5 6 7 Sum
Max 8.5 10 7 7 6.5 6 8 8 6 7 7 6 10 9 106
Man 9 11 6.5 7 6 6 5 5 5.5 6 7 7 10.5 9.5 101
2. Arch segments lengths
7-6 5-4 3-2 1-1 2-3 4-5 6-7 sum
Max 19 13.5 12 16 13 13 20 106.5
Man 20 13.5 10 9.5 10.5 13.5 20 97
Total max ant=41.5mm
Total man ant=33.5mm
25. 3. Model Analysis
3. Arch length determination
Max Man
Intercanine width 34mm(N=39) 25mm(N=23-24.7)
Intermolar width 43mm(N=47) 40mm(N=43)
Arch length 36mm 32mm
Arch form U form V form(tapered)
Arch length discrepancy Avialable –Required=
106.5-106=0.5mm(spacing
0.5mm)
Avialable –Required=
97-101.5=-4mm(crowding
4.5mm)
Overbite 1mm
Overjet 1mm
Curve of spee 2 mm
28. 3. Model Analysis
Standard Patient’s index
Overall ratio 87.5-94.8 97/106.5=91.07%
(Man/Max)
Anterior ratio 74.5-80.4 33.5/41.5=80.7%
(Man6/Max6)
4. Bolton Index
Mandible:Maxilla(12
teeth)
Mandible(6 teeth)>Maxilla(6
teeth)
29. 3. Model Analysis
5. M-D width of tooth
Anterior tooth Ratio
= Sum of (M-D) width of mandubular anteriors x 100
Sum of (M-D) width of maxillary Anterior
= 41/33.5 x 100 = 122 %
Result>72.2%= Mandibular excess.
Overall tooth Ratio
Mandibular excess= Actual mandibular 12 – Correct mandibular 12
= 82.5-87 = -4.5mm
30. 3. Model Analysis
6. Pont’s Analysis
ON MAXILLA
•SI=sum of incisor 4= 6+8+8+6=28mm
•MPV(Mesured premolar value)=39mm
•MMV(Mesured molar value)=43mm
•CPV(Calculated premolar value)=SIx100/80=28 x 100/80=35mm
•CPV(35mm)<MPV(39mm) Arch form is normal so no need to expand the arch
on incisor and premolar area
•CMV(Calculated molar value)=SI x 100/64=28 x 100/64=43.75mm
•CMV(43.75mm)>MMV(43mm) Arch form is normal so need to expand the
arch abit or no need on molar area
ON MANDIBLE
•SI=sum of incisor 4= 6+5+5+5.5=21.5mm
•MPV(Mesured premolar value)=35mm
•MMV(Mesured molar value)=45mm
•CPV(Calculated premolar value)=SIx100/80=21.5 x 100/80=21.8mm
•CPV(21.8mm)<MPV(35mm) Arch form is normal so no need to expand the
arch on incisor and premolar area
•CMV(Calculated molar value)=SI x 100/64=21.5 x 100/64=33.59mm
•CMV(33.59mm)<MMV(45mm) Arch form is narrow so need to expand the
arch abit
31. 3. Model Analysis
7. Korkhaus analysisis
Man Value=Max value -2mm
18mm=21-2mm=19mm
=> Procline upper incisor 1mm
32mm
39mm
21mm
18mm
32. Diagnosis summary
• U PS is a 31 year olds female, denied any medical problem , complains of
upper teeth forward, crowding lower anterior teeth and gummy smile.
She has a class I incisor relationship as edge to edge incisor base on class
II skeletal pattern, increased lower facial height. Over jet of 1mm, deep
over bite 5%, lower midline shift to the right 0.5mm, mildly crowed lower
anterior teeth. Canine is class I on both side, actually molar class I on
both sides.
40. Treatment progress
Problem list Treatment & link to photo Date Lecturer
1. Staining#17,18,27,28, plaque
and calculus, crack #13,#23
1. Scaling, polishing ,oral
hygiene
education, observation on
#13,23
30/5/2019 Dr. Anan
2. Release crowding, leveling
and alignment with
MBT(bracket 0.022)
2. Upper and lower bracing 30/6/2019 Dr. Anan
3. Release crowding, leveling
and align ment with
MBT(bracket 0.022)
3. Upper 0.014, lower 0.012 22/8/2019 Dr. Anan